Fluvoxamine is an antidepressant and a selective serotonin reuptake inhibitor. The National Institutes of Health undertook a research study to see if Fluvoxamine could be given early in the course of a COVID-19 infection to prevent more significant problems including shortness of breath. It inhibited the generation of inflammatory cytokines in a mouse sepsis model and in human endothelial cells in vitro. The expression of inflammatory genes was lowered in human endothelium, yielding similar outcomes. According to the National Health Institute, it was not approved for usage due to a lack of evidence in clinical research.

Referencing

Godman, B., Kurdi, A., McCabe, H., Johnson, C.F., Barbui, C., MacBride-Stewart, S., Hurding, S., Leporowski, A., Bennie, M. and Morton, A., 2019. Ongoing initiatives within the Scottish National Health Service to affect the prescribing of selective serotonin reuptake inhibitors and their influence. Journal of comparative effectiveness research, 8(7), pp.535-547.

1.What does the term "endothelium-dependent" vasodilation mean to you? Explain.
 It is the vasodilation resulting from  drugs that secrete the endothelium and drugs that act on the endothelium
 2.When we talk about  NOS enzymes, what do the "constitutional" and "induced" enzymes mean and what are the pathological and physiological effects? this?
 Constitutive enzymes are enzymes that  the body produces continuously. They will always be present in the body in constant amounts, regardless of  metabolic activity. The pathological and physiological implications of these enzymes are significantly greater than those of the induced enzymes because they are always present. these are the enzymes eNOS and nNOS.
 Induced enzymes are enzymes that are only present in the cell when necessary and, therefore, the synthesis of these enzymes is  induced by drugs or certain sunscreens. Enzymes have a pathological and physiological effect only when they are present and in action, so their effects on the body are less than those of  constitutional enzymes. This is the enzyme iNos
. 3.Explain how NO contributes to the fatal pathology of  shock.
 Septic shock is due to pathogens. The effects that characterize septic shock  are the hypotension that accompanies it. When the body detects an infection, it induces iNOS in the macrophages of the immune system, which in turn release high levels of NO for its antimicrobial effects. Overproduction of NO can cause smooth endothelial  muscles to relax, causing hypotension and septic shock effects, and thus making it worse.
4. What mechanism of action of the autacoids is based on the effects on the  cGMP system of guaniyl cyclase?
 NO (nitrogen monoxide)
 NO can be toxic to the cell. What ways does the body have to counteract this detrimental effect of NO?
 The cell may undergo apoptosis, and the NO may be metabolized prematurely.
5. Name a way in which NO can act proinflammatory. Give examples where it will have advantages or disadvantages.
 May increase cell permeability  by mediating vasodilation.
 This has the advantage of providing access to macrophages, which can prevent infection, activate complement and immune system, and stimulate antibody production.
 Disadvantages  are that it can cause pain and discomfort to the patient  and cause excessive edema.