50 Drugs Flashcards
State the class of drugs to which Aspirin belongs
Anti-Platelet
Describe the MOA of Aspirin
Irreversible inactivation of Cyclooxygenase enzyme This reduces production of Platelet Thromboxane (TXA2) and Endothelial Prostaglandin (PGI2) Reduced TXA2 production reduces platelet aggregation and thrombus formation Reduced prostaglandin synthesis decreases nociceptive sensation and inflammation
State indications for Aspirin
Secondary prevention of thrombotic events Pain relief
State side effects of Aspirin
Bleeding Peptic Ulcer Disease Angiooedema Bronchospasm Reye’s Syndrome
Describe important pharmacokinetic features of Aspirin
Half life increases with very large doses (therefore pharmacokinetics may be non-linear in overdose)
State some important pieces of patient information that should be given alongside Aspirin
May be advisable to take PPI with long term aspirin Avoid OTC preparations containing aspirin Not to be take by children under 16
State the class of drugs to which Clopidogrel belongs
Anti-Platelet
Describe the MOA of Clopidogrel
Irreversibly blocks the ADP receptor on platelet cell membranes Therefore prevents formation of the GPIIb/IIIa complex, required for platelet aggregation Decreased thrombus formation
State indications for Clopidogrel
Secondary prevention of thrombotic events
State side effects of Clopidogrel
Abdominal Pain Diarrhoea Bleeding
Describe important pharmacokinetic/pharmacodynamic features of Clopidogrel
Should be avoided in patients with liver failure
State some important pieces of patient information that should be given alongside Clopidogrel
Patients may be advised to stop clopidogrel before surgical procedures Patients should not stop clopidogrel without consulting their doctor if they have an arterial stent in-situ
Give examples of Recombinant Tissue Plasminogen Activators
Tenecteplase Alteplase
Describe the MOA of Recombinant Tissue Plasminogen Activators
Catalyses conversion of plasminogen to plasmin to promote fibrin clot lysis
State indications for the use of Recombinant Tissue Plasminogen Activators
Acute Ischaemic Stroke (within 4.5 hours) Myocardial Infarction (within 12 hours) Massive Pulmonary Embolism
State side effects of Recombinant Tissue Plasminogen Activators
Bleeding Allergy Angiooedema
Describe important pharmacokinetic/pharmacodynamic features of Recombinant Tissue Plasminogen Activators
Alteplase is given as a bolus-infusion regimen Tenecteplase is given as a single bolus Interacts with other blood thinners (anticoagulants/antiplatelets)
State some important pieces of patient information that should be given alongside Recombinant Tissue Plasminogen Activators
Patient should be made aware of the risk benefit ratio which should include reference to bleeding complications
Describe the MOA of Unfractioned Heparin
Unfractioned Heparin enhances the action of Antithrombin III, which inhibits thrombin
It also inhibits multiple other components of the coagulation cascade to have an anticoagulant effect
State the indications for Unfractioned Heparin
Treatment and Prophylaxis of Thromboembolic Disease
Renal Dialysis (Haemodialysis)
Treatment of Acute Coronary Syndrome
State the side effects of Unfractioned Heparin
Bleeding
Heparin-Induced Thrombocytopaenia
Osteoporosis
State important pharmacokinetic/pharmacodynamic features of Unfractioned Heparin
Administered by continuous IV infusion or subcutaneous injection
Complex kinetics - non-linear relationship between dose/half life and effect
Requires Therapeutic Dose Monitoring (TDM)
Anticoagulant effect can be reversed by Protamine
Shorter duration of action than LMW Heparin
Used in preference to LMW Heparin in selected patients due to shorter duration of action and reversibility (e.g. peri-operatively)
State some important pieces of patient information that should be given with Unfractioned Heparin
Risk of bleeding
Requires regular blood monitoring
Describe the MOA of LMW Heparin
LMW Heparin enhances the action of Antithrombin III, which inhibits thrombin
It also inhibits multiple other components of the coagulation cascade to have an anticoagulant effect