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 gland saliva (salivation) is mediated by parasympathetic stimulation; acetylcholine is the active neurotransmitter and binds to muscarinic receptors in the glands, leading to increased salivation. The salivary glands are detailed below: The two parotid glands are major salivary glands wrapped around the mandibular ramus in humans. These are largest of the salivary glands, secreting saliva to facilitate mastication and swallowing, and amylase to begin the digestion of starches. It is the serous type of gland which secretes alpha-amylase (also known as "ptyalin"). It enters the oral cavity via the parotid duct. The glands are located posterior to the mandibular ramus and