Bivalirudin Bivalirudin Bivalirudin (Angiomax or Angiox, manufactured by The Medicines Company) is a direct thrombin inhibitor (DTI). Chemically, it is a synthetic congener of the naturally occurring drug hirudin (found in the saliva of the medicinal leech "Hirudo medicinalis"). Bivalirudin is a DTI that overcomes many limitations seen with indirect thrombin inhibitors, such as heparin. Bivalirudin is a short, synthetic peptide. It is a potent and highly specific inhibitor of thrombin. It inhibits both circulating and clot-bound thrombin, while also inhibiting thrombin-mediated platelet activation and aggregation. Bivalirudin has a quick onset of action and a short half-life. It does not bind
Anatoxin-a(S) Anatoxin-a(S) Anatoxin-a(S) "Salivary" is a naturally occurring cyanotoxin commonly isolated from cyanobacteria (specifically of the genus "Anabaena") and causes excess salivation in mammals via inhibition of acetylcholinesterase. Anatoxin-a(S) is structurally a cyclic "N"-hydroxyguanine organophosphate with a phosphate ester moiety. The main mechanism of action for anatoxin-a(S) is by irreversibly inhibiting the active site of acetylcholinesterase leading to excess acetylcholine in the parasympathetic and peripheral nervous systems; inducing poisoning via nicotinic and muscarinic cholinergic receptor stimulation. Treatment of afflicted case by atropine has attested to suppress the muscarinic mediated toxicity; which prevents the namesake salivation that similarly reacts to prevent the