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
Salivary microbiome parotid submandibular, and sublingual. These glands secrete electrolytes, proteins, genetic material, polysaccharides, and other molecules. Most of these substances enter the salivary gland acinus and duct system from surrounding capillaries via the intervening tissue fluid, although some substances are produced within the glands themselves. The level of each salivary component varies considerably depending on the health status of the individual and the presence of pathogenic and commensal organisms. Salivary microbiome The Salivary microbiome is the nonpathogenic, commensal bacteria present in the healthy human salivary glands. It is distinct from bacteria that may cause infection in the glands. It differs from