#Inhibitors

[mcatmemoranda]

Anticoagulation Lecture 6/21/23

Factor Xa inhibitors = rivaroxaban, apixaban (Eliquis)

Direct thrombin inhibitor = dabigatran

Vitamin K inhibitor = warfarin

Apixaban has the lowest bleeding risk compared to the other Direct Oral Anticoagulants (DOACs); avoid in pts with BMI greater than or equal to 40 or weight more than 120 kg. Avoid dual inhibitors or inducers of CYP3A4 and P-gp.

VTE/PE tx = 10mg bid x7 days, then 5 mg bid

AFib = 5 mg bid (reduce to 2.5 mg bid if Cr greater than or equal to 1.5 or weight less than 60 kg or age greater than 80

Rivaroxaban (Xarelto) = once daily dosing compared to Eliquis

VTE/PE: 15 mg bid x21 days; then 20 mg qd

AFib: 20 mg qd with food to increase absorption

PAD/CAD: 2.5 mg bid (+antiplatelets if at increased risk)

Avoid with CYP3A4 inhibitors or inducers and P-gp

Edoxaban (Savaysa) – not used in pts with CrCl greater than 95

VTE/PE = parenteral anticoagulation for 5-10 days, then PO

VTE/PE/AFib = 60 mg qd

Does not have reversal agent like other DOACs do (which are reversed with Kcentra or andexanet)

Dabigatran (Pradaxa)

AFib: 150 mg bid; consider 110 mg bid if bleeding risk

VTE/PE: 5 days IV, then 150 mg bid

VTE ppx after THA/TKA: initial 110 mg once, then 220 mg qd x10-35 days

5-10 day bridge required for PE/VTE

Caution in pts greater than 75 years due to increased bleeding risk

Has own reversal agent (praxbind; idarucizumab)

C/I in pts with prosthetic heart valve

Store in original bottle and discard if unused after 4 months

Eliquis and Xarelto can be crushed and given via feeding tubes.

Warfarin (Coumadin)

Dosing is pt specific. Goal INR is 2-3. (2.5-3.5 if mechanical mitral valve).

Slow onset; slow time to steady state means dose taken today may not be reflected in INR for several days (2-4 days).

So many drug-drug interactions!

Metabolized by CYP pathways

Vitamin K antagonist

Dosing: recommend taking at night because INR is taken during the day, makes it easier to adjust dose.

Warfarin’s therapeutic steady state is based on half-lives of clotting factors. At least 5 days of consecutive warfarin needed for pt to be fully anticoagulated (this is why you use heparin until they get to this point).

Usually start with 5 mg qd. If bleeding risk, start with 2.5 mg qd. For obese pts or otherwise healthy/young can start with 7.5 mg qd. You go to maintenance protocol on 7th day.

Pts on VTE/PE tx are not anticoagulated the first 5 days, so use heparin IV or LMWH outpt. Once anticoagulated x24 hours, d/c heparin.

Start with 5 mg warfarin for first 3 days, then follow up with warfarin clinic on day 4. Typically, pt goes for weekly INRs. Then when at goal INR for 2 weeks, can spread out how often they f/u on their INR levels. Eventually they can go q6-8 weeks to check INR level.

VTE/PE – always bridge

AFib – risk assess to see whether heparin bridging is needed (assess bleeding risk [HASBLED]; CHA2DS2VASc for thrombotic risk).

Every 10 years, the dosing needed will decrease by 10%, so as pts age, the dose of warfarin needed will decrease.

DOACs = no INR monitoring, no dietary interactions, lower rates of bleeding, limited availability of reversal agent; contraindicated in pts with mechanical heart valves

AFib – AC (anticoagulate) indefinitely

1st VTE or PE that is provoked – AC for 3 months

1st episode of VTE/PE in setting of cancer – 3 months of AC (LMWH is better than DOAC or warfarin--new research shows DOAC may actually be more effective, so can use DOAC now; LMWH not preferred)

1st episode of VTE/PE unprovoked (no idea what caused it) – AC more than or equal to 3 months

2nd VTE – AC indefinitely

Heparin reversal – protamine (max dose is 50 mg), to reverse enoxaparin, give 1 mg protamine for each 1 mg of Lovenox

Warfarin reversal – vit K; 4 factor prothrombin compex (KCentra); FFP (if KCentra not available); KCentra is for life-threatening bleeding or if pt needs surgery for life-threatening condition

Apixaban/Rivaroxaban reversal – Kcentra (life threatening bleed or need emergency surgery; has thrombotic risk); FFP (Fresh Frozen Plasma); Andexanet Alfa. KCentra can cause clotting in 5% of pts; don’t give if you don’t need to.

Dabigatran reversal – idarucizumab (Praxbind); dosed as 5 g IV given 2.5 mg no more than 15 minutes apart)

Heparin lasts 2 hours

LMWH is preferred in pts who are pregnant (avoid warfarin). ESRD on dialysis – warfarin or Eliquis (avoid Xarelto). Obese pts – DOACs or warfarin. Cancer – use LMWH; recent study shows Eliquis is equal to or superior to LMWH in cancer pts who need anticoagulation.

Pregnancy = lovenox better, doesn’t cross placenta; UFH (unfractionated heparin) is an alternative in pts with poor renal function.

Stop heparin gtt and give Eliquis now or give 2 hours after stopping heparin gtt. Give loading dose Eliquis even if the pt was on heparin gtt.

[deadfileinthecabinet]

Aiden Caldwell - The Pilgrim

[wmhd]

In silico transcriptome screens identify epidermal growth factor receptor inhibitors as therapeutics for noise-induced hearing loss.

Noise-induced hearing loss (NIHL) is a common sensorineural hearing impairment that lacks U.S. Food and Drug Administration–approved drugs. To fill the gap in effective screening models, we used an in silico transcriptome-based drug screening approach, identifying 22 biological pathways and 64 potential small molecule treatments for NIHL. Two of these, afatinib and zorifertinib [epidermal growth factor receptor (EGFR) inhibitors], showed efficacy in zebrafish and mouse models. Further tests with EGFR knockout mice and EGF-morpholino zebrafish confirmed their protective role against NIHL. Molecular studies in mice highlighted EGFR’s crucial involvement in NIHL and the protective effect of zorifertinib. When given orally, zorifertinib was found in the perilymph with favorable pharmacokinetics. In addition, zorifertinib combined with AZD5438 (a cyclin-dependent kinase 2 inhibitor) synergistically prevented NIHL in zebrafish. Our results underscore the potential for in silico transcriptome-based drug screening in diseases lacking efficient models and suggest EGFR inhibitors as potential treatments for NIHL, meriting clinical trials.

Read the full research paper!

[poojascmi]

Global PD-1 and PD-L1 Inhibitor Market Is Estimated To Witness High Growth Owing To Increasing Adoption of Immunotherapy

The global PD-1 and PD-L1 inhibitor market is estimated to be valued at US$ 30,535.5 Mn in 2022 and is expected to exhibit a CAGR of 14.2% over the forecast period 2022-2030, as highlighted in a new report published by Coherent Market Insights. PD-1 and PD-L1 inhibitors are a type of immunotherapy that helps in boosting the body's natural defenses to fight cancer. These inhibitors block the PD-1 protein on immune cells or the PD-L1 protein on cancer cells, enabling the immune system to recognize and destroy cancer cells more effectively. Market Overview: PD-1 and PD-L1 inhibitors have gained significant attention in recent years due to their effectiveness in treating various types of cancer, such as melanoma, lung cancer, bladder cancer, and kidney cancer. These inhibitors have shown promising results in improving overall survival rates and reducing the risk of disease progression. The advantage of PD-1 and PD-L1 inhibitors over traditional cancer treatments is their ability to target specific pathways involved in suppressing the immune response against cancer cells. This targeted approach minimizes damage to healthy cells and reduces side effects commonly associated with chemotherapy and radiation therapy. Market Key Trends: One key trend driving the growth of the PD-1 and PD-L1 inhibitor market is the increasing adoption of immunotherapy as a standard treatment for cancer. Immunotherapy has revolutionized cancer treatment by harnessing the power of the immune system to selectively target and eliminate cancer cells. PD-1 and PD-L1 inhibitors play a crucial role in this approach by enhancing the immune response against cancer cells. For example, Keytruda (pembrolizumab) - a PD-1 inhibitor developed by Merck & Co., has been approved for the treatment of multiple cancer types, including melanoma, lung cancer, and head and neck cancer. The increasing approval and adoption of PD-1 and PD-L1 inhibitors by regulatory authorities and healthcare providers are driving market growth. PEST Analysis: Political: The political landscape plays a significant role in shaping the PD-1 and PD-L1 inhibitor market. Government policies and regulations regarding drug approvals, intellectual property rights, and reimbursement can affect market growth. For instance, pricing and reimbursement policies can impact the accessibility of PD-1 and PD-L1 inhibitors to patients. Economic: The economic factors influencing the market include healthcare expenditure, insurance coverage, and affordability of PD-1 and PD-L1 inhibitors. The high cost of these drugs can be a barrier to access, particularly in developing countries with limited healthcare budgets. Key Takeaways: The Global PD-1 And PD-L1 Inhibitor Market Size is expected to witness high growth, exhibiting a CAGR of 14.2% over the forecast period, due to increasing adoption of immunotherapy. The key driver for market growth is the superior efficacy of PD-1 and PD-L1 inhibitors in treating various types of cancer. For example, Keytruda has shown remarkable results in improving survival rates in lung cancer patients. In terms of regional analysis, North America is the fastest-growing and dominating region in the global PD-1 and PD-L1 inhibitor market. The presence of a well-established healthcare infrastructure, favorable reimbursement policies, and high adoption of novel cancer treatments contribute to the market's growth in this region.

[pand1on]

learned helplessness

[chattematsu]

THIS EDIT WAS SO CUTE I CAN'T

edit by @ CEOofYingXing on Twitter!

[symbiosisonlinepublishing]

Risk factors of #coronary bypass surgery are: Infection at the incision site, #pneumonia, breathing problems, Pancreatitis, Kidney failure.

Visit: https://symbiosisonlinepublishing.com/thoracic-and-cardiovascular-surgery/

[dixieconley]

How the Clone Wars should have gone, given that Anakin was canonically a slave. (wtf Lucas?)

Rex: Yeah, we all have inhibitor chips. They make us less aggressive-- Anakin: You have slave chips. Rex: No, inhibitor chips. Anakin: Slave chips. They all need to be removed. Kix! Do you have a scanner? Kix: Er, no. You need a level 5-- Anakin: Nevermind. I'll build one. They need to come out immediately.

::slave chip comes out of one trooper who volunteered, because ARCs be crazy:: (Fives. It was Fives. Because Fives.)

Anakin: Huh. Why doesn't this have any explosive? Rex: I *told* you. They're inhibitor chips. Anakin: Nuh uh. Slave chips. They gotta do something else.

::a little later, some slicing, orders discovered::

Anakin: Slave chips! All of them out! Rex: Okay, but this is just one itty bitty bit of the GAR. There's 3 million of us. Anakin: *Lots* more scanners. Rex: ::facepalm::

::Scanners sent to every ship in the fleet and the Guard::

Fives: So who activates the chips? Anakin: Depur. Fives: ::thinking that this is a reasonable name rather than a generic term for a slave master:: Where do we find them? And can we kill them?

Cue Kamino being invaded, the Kaminoans interrogated (and Nala Se summarily executed), and relevant information discovered.

Rex: So it's the Chancellor. Anakin: No, he's my good friend. Rex: … Anakin: I'm depukrata. (The slave word for a freed slave who enslaves others.) Fives: ::no concept of natborn names:: Everyone! The general's Depukrata now! Everyone: Hello, Depukrata! Anakin: ::anakin.exe has stopped working:: Anakin: ::incoherent frothing rage:: Let's fuck some shit up! The 501st: ::cheers, gets out the heavy ordinance::

Palpatine gets wrekt. (Fuck that guy.)

[alleycatchitchat]

I’m kind of obsessed with Shadow’s inhibitor rings. Like he’s connected to so much raw power that his abilities have to be forcibly repressed in order for him to function? Guys that’s BADASS. Starts taking the rings off? Shit’s about to get real. Not to mention the potential risks involved with losing/breaking them. I just think it’s a really underrated aspect of his character that’s not heavily featured in fandom works and that’s a shame.

[emthimofnight]

dark star

[boothillssugarmomma]

Mating Season...

(Dan Heng!Inhibitor Lunae! x Fem!Reader)

cw-: NSFW 18+, breeding!kink, fingering Fem! receiving, cunilingus, oral Fem!receiving, oral Male! receiving, sub!Dan Heng

🎀 authorsnote: Smut is so new to me when writing it...still learning! So tips are appreciated! 🙏

please don't steal my work!

Taglist🎀HSR Master List🎀Other Lists🎀

18+ .MINORS DNI. 18+

After the team had gotten back from the Xianzhou Luofu no one had told you a single thing.

Not. A. Damn. Thing.

So when your boyfriend was unusually quieter than normal after, you didn't pester him. You decided to wait for him to come to you.

Until...he locked himself in his room and refused to come out.

Everyone on the Astral Express crew kept trying to assure you that he's fine, that he's alright, just moody. It's just a little...not like him...

He always opens the door for you and always always always tells you everything...so what changed? Was he mad at you?

You decided to finally put your foot down and knock on his door, confronting your boyfriend. You were scared and worried for him.

"I said go away.." Dan Heng's voice was oddly hoarse and tense. "We'll talk later..."

"Dan. Heng. Open. The. Damn. Door." You demand, a worried tone in your voice.

"I have to decline, Y/N. Please leave." Dan Heng repeated. How frustrating can your boyfriend be...and what's with the tone of his voice? Is he in pain?

"No!" You whine. "Are you mad at me...is that why you're ignoring me?"

There was a faint sound of something dropping on the floor. What was it? But before you could react, the door opened slightly. It was enough for you to see the man was half-naked with a towel wrapped around his waist. His body and hair were drenched in sweat.

He looked at you, a look in his eyes you have never seen before.

"Dan Heng?" You whisper.

Dan Heng took a sharp inhale, as if he saw a mirage. You don't recognize him. He's the same person... yet not. His slender body is now more muscular, he's hiding a tail behind him, his hair and horns are glowing. But there was something more terrifying..

Dan Heng's face was slightly changed. His eyes are full of lust, not the usual look you got used to.

"Y-You..." You gulp and back up slowly.

"Stop right there, sweetheart..."

Dan Heng growled with deep, husky tone. He pinned you against the wall, his breathing was getting ragged as you could feel your body heating upon the man's touch.

"Do you have any.. idea how irresistible you have been all this time..?"

"W-Whats going on?" You whisper.

"You didn't realize why I have to isolate myself, didn't you?" Dan Heng sighed with frustration. He then cupped your cheek, his thumb tracing the skin of your jaw.

"Mating season.." He whispered in your ear. "And you are my prey..."

"Oh no-" You whisper before he hugs you close and drags you into his room.

Dan Heng slammed the door behind him and pinned you down onto the bed. You were unable to resist as he hovered above you, a look of deep desire in his eyes.

"You, teasing me every single time you come to the door... your sweet...sweet scent...I've had enough of it!" His breath was warm against the sensitive skin of your neck, as if he was going to nibble into it at any moment.

"I-Im sorry!" You whimper as his gaze narrows.

His hands started to trail to the buttons of your clothes. "Apology not accepted...." His lips then start to nibble and bite your skin, marking you as his while he slowly undoes the buttons.

"D-Dan Heng honey..." You whimper softly into the air.

The sweet sound of your voice calling his name makes him go crazy. His breathing was becoming ragged. Your scent and the feel of your skin is pushing him to the edge.

His teeth dug deep onto your skin, leaving several marks on the nape of your neck.

"D-Dan Heng what's going on?" You whisper. "W-Why do you have a...tail!?" You cover your mouth as it flicks up in the air.

Dan Heng finally stopped what he was doing and got up slightly to look at you. His tail flicked with annoyance.

"Hasn't anyone told you about Vidyadhara in their...mating season?" He scoffs. "And about my...true form? I find it hard to believe that no one has briefed you about that."

He was clearly irritated.

"No. One. Told. Me." You gaze at his tail dumb founded.

"Well...now you know, and we can continue!"

His voice turned deeper again. He pushed you further back into his bed and his hands resumed their work, unbuttoning your clothes. Finally shaking off your shirt to make it fall on the floor. The heat of his breath on your bare skin was now enough to make you feel flustered.

"The only question is that...are you going to resist?" He purred in your ear.

"N-No, no resisting..." You whisper, feeling something in your core start to tighten.

"Good, good." He grinned and went down to kiss a trail down your body, his hands working to get your clothes off of you. His tail caressed your thighs, leaving faint glowing lines on the sensitive skin it touched.

His markings on your body started to glow, a sign of ownership from the dragon man.

"...so when does this...end?" You breathe out.

Dan Heng didn't answer your question at first and just continued his work. Your clothes were thrown away, leaving you nothing on except for your underwear.

And then, you felt his hand slid into your panties, his long fingers feeling its way there. "Soon.. soon." He whispered against your neck, his tongue and teeth making small marks. He hooks the string against your waist and slides them off, throwing it on the floor.

"Cmon honey I can't be the only one without clothes here..." You smirk.

He chuckled when you said that. "Impatient, aren't we?" Dan Heng got up to discard his own towel, revealing his toned, naked body.

His markings are still glowing on his body, the lines more and more prominent on the muscles of his thighs and arms. "Happy?"

"Oh hell yes..." You grin before leaning up to grab his chin. "Lay down...now."

Dan Heng complied, laying down on his bed with a smirk on his face. "As you wish, my dear." His tail caressed your body in a teasing manner as he waited with anticipation.

You climb over and straddle his lap. "So...how do you know when you're normal again?" You tease as you grind down against his hard cock.

Dan-Heng looked up at you, eyes narrowing with pure lust. His hands moved to rest on your hips as he thought about your question.

"Probably a day or two left by now." He responded with a shrug. "You're going to have to deal with me till then." His tail flicked slightly as if to emphasize that statement.

Dan Heng's eyes flashed with arousal. A smirk made a shiver run down your spine as his tail flicked in anticipation.

"Yes, two days to...breed you." He leaned up to capture your lips into a hungry kiss before pulling back again. "Two days and we're going to spend it all here, together."

"Dan Heng...you sure?" You whisper softly into your lovers ear. "Just because I'm your girlfriend doesn't mean you have to do this..."

Dan Heng's expression softened as he heard your words. He then gently caressed your cheek and looked at you with a gentle warm gaze. "I know, and I know I don't need to. But I want to...because I want you." He replied, his voice filled with sincerity.

"I crave you..." He growls darkly into your ear.

"Oh?" You whisper softly with a gulp.

"There's nothing more that I want than being with you in...every way possible. I just haven't had the chance lately, until now."

His hands slowly traced the smooth skin of your waist and pulled you even closer against him. He was hungry for you and you only.

You smirk softly and grind down against his hips. "Ready?" You whisper softly.

Dan Heng gasped as you grinded against him. His eyes darkened as he looked up at you with desire. "I was born ready, my darling."

He then shifted his position suddenly, grabbing your sides and flipping you underneath him, pinning you down onto the bed with his body. His markings were glowing more intensely as his body grew hotter.

"Oh my Aeons..." You breathe out as he leans down and nibbles on your ear before trailing bites and kisses down your neck and shoulders.

The feel of your body against his was intoxicating. Your scent, your taste, the soft flesh beneath his teeth. Dan Heng couldn't get enough of you.

His hands now trailed down and started to massage your stomach with a teasing, light touch.

"H-Honey..." You whine out. "Cmon...you know you want to..." You smirk.

"Oh, do you want me that badly?" Dan Heng growled in your ear. "Why not have a little more foreplay? We have plenty of time..."

His words were like a challenge, and his hands were still tracing light circles on your stomach and waist. His nails teasing your skin, and sometimes a light bite on your shoulder.

"Can you handle that?" You tease and bite the air at him.

"Careful what you ask for, my dear. You might just end up more flustered than you already are." Dan Heng grinned.

He then moved down and started to plant kisses on your chest, his nails trailing more intensely as his need for you grew stronger.

You gasp out and bite your lip, eyes rolling back as he pops one of your tits in his mouth, stimulating the other one by pinching it gently.

Dan Heng's tongue twirled and licked your sensitive skin, his teeth would nibble from time to time, leaving a feeling of pain but in a pleasant way.

His hands continued to touch you all over, exploring every curve and inch of your body as if it was his new found treasure. His tail gently flicked against the sheets, the scales sliding against your thigh.

"Oh f-fuck..." You whine a bit.

Dan Heng chuckled in response. His head then moved lower on your body, leaving behind a trail of kisses and marks. His tongue slowly traced your stomach, and you can feel how hot it is against your skin.

The more he moved down, the more his hands traced your hips, the more his tail slid against your body. You can feel the scales on his body brushing against your legs, making you shiver.

"L-Laughing huh?" You scoff playfully. "Get down t-there..."

"As you wish, my love~"

Dan Heng grinned and lowered his head even more, his breath tickling your inner thighs. His teeth lightly bite and nibble at your skin, but a flick of his tongue against the bites instantly soothe the pain again.

His hands prop your legs up over his shoulders as he kisses your thigh before gently touching it in a massaging manner, a contrast from the intensity of his teeth and tongue.

He gazes up at you from in between your thighs with a smirk. "God you don't know how much I've been thinking about this..." He growls.

"But we do this...every time?" You whisper softly with a gentle chuckle.

"Yeah we do...but...these last few days..." Dan Heng licks a stripe up your entrance to your clit, swirling his tongue around it before leaving a gentle kiss. "I've been dreaming about this exact moment..."

He takes a deep breath before leaning in to suck lightly, gazing up at you to watch your face make lewd expressions.

"D-Dan Heng!" You whimper loudly before bringing a hand to your mouth to try to be silent. But he stops you, shooting a hand up to stop it. He pulls away from your pussy and sighs.

"Don't. You. Dare. Silence...that pretty fuckin mouth of yours..." He whispers, his tone dripping with lust.

You can hear a small growl from his throat as he continued eating you out, his hands firmly on your thighs and his mouth continuing to move at the same time.

"Your fuckin sweet scent is driving me crazy.." He mumbled pulling away barely. "I can't get enough of it." He then gave another few nibbles at your thighs, leaving small marks here and there.

You take a deep breath as you stop propping yourself up on your elbows, laying back to finally let him have total control.

"Hmm?" He hummed against your cunt as he glanced up at you. Smirking devilishly he sticks his tongue out and swirls it around your slit, making your legs twitch a bit.

"T-Taste so fuckin good..." Your boyfriend whines softly as he slides his tongue into your hole. He drives it in and out of you before he feels you clench on his wet muscle.

He laps up your leaking slit before he freezes and breathes heavily. "N-Need you..."

You let out a low chuckle and smirk. "Need what honey...speak up..."

"Y/N... you know what I need...please..." He whimpers again as he places a kiss against your clit.

You sigh playfully and use your hand to push him back. "Sit down baby~" You smirk. Dan Heng's eyes widen with surprise as you help him sit propped against the pillows.

Now it's your turn for your eyes to widen as his cock is finally out in the open for you to see. A flushed red tip, leaking pre, with a decent size (who are we KIDDING) girth.

"Oh...no..." You gulp softly before leaning in to press a kiss to the head. He lets out a low whimper before he covers his mouth with his hand, his face covered in a red blush.

"Ah, ah!" You smirk. "If I had to be vocal, you do too..." You take a deep breath before sticking your tongue out to lick and suckle on his tip.

Dan Heng's eyes glaze over in pure lust, he tries his absolute best not to start bucking his hips up into your mouth, but all he can think of is you gagging all over his cock. "S-Stop teasing..." He begs.

You don't say a word as you sink down farther, taking more of his girth in your mouth. It burns a bit as his tip hits the back of your throat, but you keep going until your nose touches his abdomen.

He throws his head back with a low guttural moan as he twitches inside your mouth. "H-Honey please!" He whines. "I-I can't take it anymore!"

You start to suck him off at a steady pace, paying special attention to his tip each time you come out for air.

"C-Can I cum? P-Please? Wanna see you swallow..." Your boyfriend is such a sight to behold, glancing up at him your breath nearly stops. Biting his bottom lip, lustful eyes, sweat glistens off his forehead, it's amazing.

You come back up for air and kitten lick his tip. "You want to see me swallow?" You tease him playfully.

Dan Heng nods quickly, nodding until you reach out and brush his forehead gently.

"Then let's do it..." You smirk and cut him off by taking him all in your mouth, the burn returns as it hits the back of your throat again and you can't help but let out a small gagging sound.

His moans, mewls, and gasps filled the room as you kept an unrelenting pace. His hands slide up into your hair as he pulls you back down quicker each time.

"N-Need to c-cum!" The dragon man whimpers. "P-Please!"

You glance up at him with a gaze that tells him all he needs to know. And not even a few seconds later, you were gagging on white seed filling your throat.

"AGH!" He moans out as he bucks his hips up into your face before collapsing on the bed.

When you're sure he's ok, you pull off with a small *plip* noise that makes his face red with embarrassment.

"Hmm you taste so good too~" You tease before crawling up to him and giving him a kiss on the cheek.

Dan Heng gives you a gentle but tired smile. "I'm glad..." He whispers, pulling you into his chest and resting his head on top of yours. "Now rest...we're not done just yet..."

You glance up at him and scoff playfully. "And who says that?"

He takes his head off of yours and grabs your chin, tilting your face up to look at him. "Me" He gives you a quick kiss before nuzzling his face into your shoulder.

...it's going to be a long two days...

🎀End🎀

[nattnattkatt]

dan heng mothering

[eggluverz]

WE REALLY WERE TIMELESS

PAIRING. dan heng x gn!reader (also dan feng x reader ig!)

WORD COUNT. 3,722

SUMMARY. dan heng does not want to remember his previous reincarnation, but there is one part he doesn't want to let go of forever— you.

SOF'S NOTE. i was listening to taylor swift's timeless and thinking about how much i love dan heng...and this was born :3 i love him sm and i def feel like love with dan heng could transcend all lifetimes <3 pls enjoy if ur a fellow dh lover :>

Dan Feng was many things. Cold and ruthless, some said. A merciless killer, said others. Revered and powerful, was the more popular and favorable opinion. But, what most people seemed to wipe from their memories was that he was also a lover.

A lover to you, at least. You, and only you. 

His days as the Imbibitor Lunae were long and laborious. He lead countless battles to destroy threats and rescued Xianzhou fleets from annihilation. 

Dan Feng was used to spending long periods away from home, but when he returned, he knew he would at least be greeted by you. 

Occasionally, you were there fighting alongside him. Capable and strong. But most of the time, you preferred using your strengths to continue studying and advancing medicine. You were compassionate and knowledgeable, and you wanted to help your injured allies rather than cause more destruction.

His favorite moments with you involved the little leisure time he had between battles when he was able to stay in his residence with you, wrapped in your embrace. 

Dan Feng, proud member of the High-Cloud Quintet, was left speechless and in awe at the sight of you. Those nights you spent together were filled with both heat and passion, and attention and love. Every moment he spent with you was intentional; he never took those times for granted. 

Of course, those times couldn’t last. 

Be it his selfishness, his arrogance, his drive to help his friend—he lost you. Not because you shunned him or turned him away, but simply because he was forced to reincarnate and locked away without the ability to say even a simple goodbye. 

His love, lost in the blink of an eye. And he may never see you again. 

Now, as Dan Heng, he was almost in denial when Jing Yuan informed him you forcibly reincarnated as soon as you heard the news of the Sedation of Inhibitor Lunae and slipped away from the Xianzhou Luofu. 

What were you to Dan Heng? Dan Feng was no longer here and Dan Heng did not want to claim his past. 

Imbibitor Lunae was not him. Renowned member of the High-Cloud Quintet was not him. 

But when Jing Yuan spoke your name, memories of his previous life rushed through him. If he didn’t acknowledge his past, would that mean you had no chance of ever being his again?

Dan Heng had no attachment to the name Jing Yuan. Yingxian no longer held special meaning either. He didn’t want it to. But hearing your name stirred something in him. It caused a battle between past and present. And the present was winning until he walked along the streets of Penacony. 

An intense shiver shot through his veins and the hairs on the back of his arm stood up. You were here.

He knew it. He felt it. Dan Heng didn’t know where exactly, but your presence was so powerful, it was something he couldn’t ignore. He wasn’t strong enough to. 

You were his first and only romantic love— A love he thought would be eternal until he got reincarnated. The draw to you was so intense he found himself wandering the wide pathways filled with Gothic buildings until he felt the call was satiated. 

It wasn’t completely gone, but he felt more relaxed. More at peace. 

Dan Heng notice his body stopped in front of a library with a square roof and he immediately entered the building. The interior was filled with rows of bookshelves and large tables, busy with scholars and those here for leisurely reasons alike.

Despite all that, Dan Heng knew where you were right as he laid eyes on you. 

You were half-hidden by piles of books as you took notes on a blank sheet of paper. You sat straight on the chair and briefly put your pen down when you noticed his staring. Your gaze met his as your eyes darted around the room. 

When they landed on Dan Heng, you tilted your head to the side as he watched you, but you showed no signs of recognition. 

His stomach churned. Of course you wouldn’t recognize him. You had reincarnated soon after Dan Feng did. Your past life was gone, your memories were gone, and he didn’t even know if your name was still the one that was so familiar on his lips. 

With an inquisitive look on your face, you beckoned him over. He was surprised that you acknowledged him so overtly, but if you were anything like your past self, he shouldn’t be too shocked. 

Dan Heng wondered if he should turn around and leave. Did he want to pretend he didn’t see you? Pretend that your fates weren’t inextricably linked? 

His heart felt like it was being torn out of his chest as he turned away, ready to go on as if this never occurred so he could continue his life as Dan Heng with no ties to the previous Imbibitor Lunae. He began walking out of the library, shoving his feelings down deep to hide them away for good. 

The cold outside air hit his face as he opened the door. It felt damp out—as if it were raining. 

Dan Heng touched the wet drops on his face before he realized it wasn’t rain. It was his tears. 

It pained him more than he cared to admit. His past love was here and he was going to throw it away before he even had another chance. He grit his teeth and clenched his fists, nails digging into his palms so deep it hurt the flesh. But it had nothing on the pain his heart was feeling. 

He couldn’t do it, he realized. He couldn’t severe the bond from his past completely— Dan Heng couldn’t severe his bond with you. He’d lose a part of himself he wasn’t even aware he still had. 

The muscles in his body screamed as he entered the library once more, this time walking straight to you instead of basking in hesitation. You looked confused as you stared up at him, probably wondering why he ignored you, left, and came back all in the span of one minute.

“Hi there! Can I help you?” 

Dan Heng instantly froze at your words. He yearned for the familiarity; a sense of comfort washed over him at your simple acknowledgement. 

But it didn’t look like you knew who he was. There wasn’t an ounce of recognition on your face even as he stood closer. 

It’s me. Do you remember? he wanted to ask. The desire to reach out and grab your hand, touch your face, was strong enough to make his heart pound. But he refrained. If you didn’t know who he was, it might frighten you if he did that. And discomfort was the last thing Dan Heng wanted to make you feel.  

You laughed nervously, letting out a single cough to fill the silence. 

Dan Heng, realizing he hadn’t said a word, quickly scanned the books you had stacked up. They were books on medicine and the evolution of healthcare. He tried to find something relevant to say.

“I almost gave someone CPR once.”

You blinked slowly, a small and uncertain smile on your face. “That’s great! I think…” For a moment, you considered what he said. “I supposed it’s not great if someone was in a situation where they needed CPR. But it is great you were willing to help.”

Dan Heng nodded, glad his plan went well. 

“Why did they need CPR? If you don’t mind me asking.”

“We found them unconscious. They had a weak heartbeat and pulse so I wanted to make sure they stayed alive.” 

You took in this information, looking slightly impressed. “Typically, we start CPR when there’s no pulse, but if the individual begins gasping for breathe, it’s usually a good sign to start CPR.” 

“I see.”

The two of you fell into a long silence before you gently cleared your throat. 

“Is that all you had to say?” you asked. Dan Heng suspected you didn’t exactly buy that he wanted to talk to you solely about CPR. “Earlier, when you were looking at me, you had a strange look on your face. It looked like you recognized me.” 

Dan Heng stilled. 

You clasped your hands together on top of the table, leaning forward almost conspiratorially. “Do I know you?”

His breathing quickened at the prospect of you remembering your past with him. 

“Maybe from a birthday party as a kid? Or did we go to the same school?” 

Dan Heng’s face dropped. “Oh. No.” 

You hummed in thought.

“You…might know me, though.” 

Curiously, you raised your brows at his vague response. He wondered if he should stop himself, but he wanted to tell you about your past life. Maybe then you would remember him. 

But would that be a good idea? Would it work in the first place? 

Dan Heng didn’t know. 

He felt impulsive but he needed to talk to you more. “I can explain more, but can we go outside first?” 

You craned your neck to the side, considering your options. He knew what he asked of you was something ridiculous in the eyes of a stranger. To stop what you were doing, take time out of your day, and follow this man you had only just spoken to with no explanation. 

It was wishful thinking to expect a yes. 

Yet somehow, you always managed to surprise him. “Of course. Let me just return these books.” 

Dan Heng tried to hide how pleased he was as he patiently waited for you to turn the books back into the librarian. He offered to help you carry them, but you managed to gather the heavy stack into your arms in its entirety. 

“Now I’m ready,” you said with a smile, eyes studying him in wonder. You looked confused, but you didn’t seem concerned. Perhaps something inside of you also sensed familiarity. “Do you want to see the stars with me?” 

He nodded and you led him to a clear, grassy spot away from the town. The grass was tall and green, pastel wildflowers growing amongst the landscape. You smoothed down your clothes and sat on the soft ground. Dan Heng sat next to you, careful to respect your personal space and keep a slight distance. 

He took in the scenery of the night before he saw you gazing at the stars. He quickly followed suit, tilting his head back.

Moments of tranquil silence passed by before he asked, “Do you know what I am?”

You didn’t miss a beat, almost as if you were expecting that question to come. “You appear human, but your presence doesn’t feel as so.”

“Much like you, correct?” he countered. “A Vidyadhara.”

You touched your head instinctively, the place where your horns should be. With wide eyes, you hastily put your arms back against your sides. 

Dan Heng raised his brow. 

“I thought my appearance had changed suddenly,” you said with a nervous laugh. 

He shook his head. “I’m sorry to cause such alarm. You don’t need to worry; you still appear human as well.” 

“It’s not as if I’m trying to pretend I’m not a Vidyadhara,” you explained, “it’s just easier to live here and be unnoticed with this appearance.” You looked away from the starry sky and turned to face Dan Heng. “And you— Why do you choose to appear human?” 

“I refuse to pay for the sins of my past reincarnation. It’s not me,” he said, voice tense. “That’s not who I am.” 

“You remember your past reincarnation?” you asked, your body perking up. Embarrassed by your eagerness, you stilled. “Sorry. That’s insensitive. There must be a reason you don’t want to remember. Sometimes, I just can’t help but wish I did.” 

The corners of Dan Heng’s mouth tilted upward. “Don’t be sorry. I don’t care for my past…except for one particular detail.” 

You shifted your position to sit with your legs folded over the other. You didn’t say anything, instead letting him speak as he felt comfortable.

“Maybe one particular person is more accurate.” 

Your eyes closed as you breathed deeply, the wind blowing around the two of you as if creating a bubble from the rest of the world. In deep concentration, you changed into your normal Vidyadhara form. Your ears were pointed, regal horns emerged from the top of your head, and you looked taller as your tail appeared underneath you. 

Expectantly, you looked at him. 

Dan Heng hesitated, but soon followed suit. He felt his body change to the one of his past as he revealed his true form to you. 

“Am I the person in your past?” you asked slowly, examining everything from his turquoise horns and dark hair, to his long tail landing in a semi-circle around you. 

He smiled to himself. Attentive as always, he thought. Lifetimes had passed, the galaxies never stopped moving, yet you were just as he remembered. Your experiences may have been different, as did the environment you grew up in, but at your core, you were still thoughtful, caring, and intelligent. No matter the reincarnation, you were still you— His beloved. 

A conflicted look formed on his face as that thought. Dan Heng was getting ahead of himself. He wasn’t Dan Feng. You couldn’t be his. 

You didn’t let his lack of response deter you, instead staring up at him with a hopeful gaze. “I’m sorry if that’s too personal of me to ask. It’s only… Something about you just feels safe and warm.”

His tail swayed back and forth. You felt it too?

“But you’re a stranger in this life, as far as I know,” you said with small laugh. “So why do you seem so familiar? Perhaps it means in my previous, you weren’t so strange.”

Dan Heng noticed his tail getting closer to your body before he managed to sway it the other way. You bumped yours against his mischievously. He jolted in surprise, both at the sudden touch of his tail—which he hadn’t felt in years and years—but also the small spark running through him at the point of contact. 

You bristled as well. “What was that?”

“I am not sure either.”

For a moment, you were lost in your thoughts. He wondered what you were thinking as your eyes swirled, looking more captivating than any galaxy he has ever seen. Your elegant horns looked as if they were glowing against the night sky and he wanted to reach out and feel them like he used to. One of your sensitive spots, he remembered. 

“I felt something when our tails brushed,” you said slowly, thinking your words through. “It wasn’t much, but it felt like a glimpse of my previous life. Do you think I can touch you more?”

Dan Heng absolutely did not mind if you touched him. Anywhere—for that matter. But he figured what was visible would be safest for the time being. He bowed his head, offering his horns to start with. “As you wish.”

You smiled brightly and his heart fluttered. He felt deep down he would do anything for you. Even confront his past life. And he vowed that what he didn’t do in his past life—spend enough time with you before it was too late—he would do in this. If only you allowed him. 

Reaching out, your gaze was fixed on his tall horns. You started with a careful touch to the tip and ran your fingers down to where his horns branched out. Heat and cold were both searing through his body at the touch and he was certain from your expression you felt the same. Your hands trailed down his face, feeling the point of his ears and resting on his cheek. 

Whether it was from the pain of the intensity coursing through you or whether it was because you were remembering your past life, Dan Heng saw tears rolling down your cheeks. 

He brought his hand up to you to wipe them away, but stopped right before he could touch your skin. “May I?” 

You nodded, a light sniffle coming from you and Dan Heng yearned to be of comfort. 

He started with a light brush of his thumb to gather the wetness on your face, gently wiping it off. Then, same as you did to him, he felt the elongation of your ears and ran hs fingers from the base of your horns to the very top. They were just as smooth as he remembered and he felt you tremble at the touch. He smiled. They were still also as sensitive as ever. 

“Are any memories resurfacing for you?” he said quietly. 

Your eyes were squeezed shut yet tears still leaked from them. It took a while for your to respond, overwhelmed by all the emotions, but eventually you managed to ask, “Is it… Dan Feng?”

“Dan Heng now,” he gently corrected. “I don‘t go by that name anymore.”

At that confirmation, you cried even more, jumping into his arms and burying your face in his chest. 

“It‘s been so long,” you said in exasperation, your words mixed with sniffles. “The Sedation— We didn’t even get to say goodbye!” You paused, removing yourself from his chest and looking up at him. “Rather, I didn’t get to say goodbye to Dan Feng. But with you here, maybe now I can.”

He nodded in understanding. His ending was so abrupt. Due to his own hubris and for the life of his closest friend, he ended up sacrificing himself. And in the long run, he learned he even sacrificed you. Dan Heng would never treat your relationship with him so casually again. He should’ve showed you it was the top priority in his life. 

Dan Heng watched in silence as you closed your eyes and whispered under your breath. He didn’t fully understand what you were saying, but he allowed you to have your private moment and say your goodbyes. He said goodbye to the past you as well—a right that was also stripped away from him as he was forced into reincarnation without second thought. Anger rose in his cheeks at those who took that away from him. From you. But it died down. Ultimately, what Dan Feng did wasn’t a part of him now. Maybe the person he is today wouldn’t have agreed with those past actions in the first place. 

Moments turned into minutes and minutes turned to hours before you finally opened your eyes and looked at him. Your gaze was clearer, as if it was truly him—Dan Heng—you were seeing. 

You smiled wistfully, hand gently stroking the spine of his tail. “I may have said goodbye to Dan Feng, but, at your core, the Dan Heng in front of me still feels like the man I love.”

He hummed in thought. He understood exactly what you were feeling. “Your core is the same too,” he said, his palm resting on your chest where your heart was beating. “You’re someone I will always love. And I’m sorry it took me so long to find you.”

Your face broke into an expression of sadness and Dan Heng felt his heart tightened. 

“I’m sorry I, as Dan Feng, left you. I’m sorry I couldn’t be with you until the end.”

You shook your head, trying to force a happy look on your face. “No, it’s okay. You didn’t leave me. You were taken and punished and I couldn’t say goodbye. But I forgive you.”

“Why? I valued my power and my friend’s life and, ultimately, was selfish and didn’t consider the impact on yours. There are so many reasons I don’t want to hold onto my past. But if being here with you means facing it, I will.”

You sighed, a small, sad chuckle escaping your lips. “You see someone selfish and arrogant, but I see a kind and selfless soul who wanted his friend to be there with him forever.”

Dan Heng thought back in shame of the Blade he met on Luofu. 

“Our pasts are linked, but so are our presents,” you said, lifting his chin up. “You’re not Dan Feng anymore, are you?”

He nodded firmly. 

You smiled in acceptance. “You’re not exactly my first love, Dan Feng, but I have a feeling I’ll like this Dan Heng person even more, anyway.”

His body immediately warmed and he wanted to melt into your touch. You were always so kind, so thoughtful. Dan Feng may have messed up and got the two of you separated, but he would never. 

“In our last life and this life, and if we have even more to come, we will always find each other,” he vowed. 

You touched your forehead to his before leaning in for a kiss. He met your lips as if he were securing a promise. A promise not to leave you again, a promise he was really here, and a promise he still loved you. There was so much he had to learn about your new life—and you, his. But Dan Heng was certain it’d only make him love you more. 

He had gone through the betrayal of a friend, the betrayal of a nation, and death and exile from the very place he once called home, but no pain compared to that of losing you. And now that he found you again, he didn’t want to make the same mistakes as his past reincarnation. 

You placed your hand on his cheek and deepened the kiss, breaking him out of his thoughts. Your hand was warm against the cool air of the night. Dan Heng ran his hand down to your waist and wrapped around to rest on the small of your back. He pushed you closer to him, wanting to feel your body against his. The heat emanated through the fabric of your clothes and the faint smell of wildflowers and vanilla filled his senses. It was a familiar scent he had always loved. 

He smiled into the kiss and you moved closer, draping a leg around his hip. Dan Heng didn’t ever want to let you go, but he knew he had nothing to fear. Now he knew the strength of your bond—how the draw to each other could withstand lifetimes. 

Not even time itself could separate you from him. 

[newgrean]

The writers were too scared to let Shaak Ti do this

[sapphire240400]

Jealous Dragon 🐉 x clueless raccoon🦝 [end]

If it's not work, I fall sick. I'm still sick but I managed to finish this ;w; please enjoy.

Twitter | Commission info