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S.N Pharmacology I > A: 16-19 > Flashcards

A: 16-19 Flashcards

1
Q

3 types of anti-PLT therapy

A

COX inhibitiors: Aspirin
Glycoprotein IIb/IIIa receptor inhibitor: Abciximab
ADP-R antagonists: Clopidogrel, Prasugrel, Ticagrelor

ADP זה כמו שהקלידו סתם במקלדת
כמו גרל
Clap your hand and pres on the tica

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2
Q

What is the result of blocking COX in PLT?

A

Decrease TXA2 –> Decrease stimulatory effect of PLT aggregation

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3
Q

Other name for Aspirin

A

Acetylsalicylic acid

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4
Q

Aspirin dosage amount: Anti-PLT vs. Anti-inflammatory

A

Anti-PLT requires lower dose

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5
Q

Aspirin indications

A

Prevention and treatment of arterial thrombosis
Prevents MI
Prophylaxis in arrhythmias

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6
Q

Aspirin side effects

A 
GI toxicity
Nephrotoxicity Apirinnn=neprho
HSN
Tinnitus
Hyperventilation metabolic acidosis A=A
Hyperthermia
Coma
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7
Q

Glycoprotein IIb/IIIa receptor inhibitor=

A

Abciximab

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8
Q

Abciximab

How to give and what is the molecule?

A

Parenteral

IgG Ab

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9
Q

Abciximab indications

A

Acute coronary syndrome

Post angioplasty to prevent stenosis

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10
Q

Abciximab side effects

A

Bleeding

Thrombocytopenia with prolonged use

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11
Q

ADP-R antagonists

A

Clopidogrel
Prasugrel
Ticagrelor

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12
Q

Clopidogrel
Prasugrel

What are they as molecules?
Do they require activation?

A

Prodrugs
Activated by CYP450
Oral

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13
Q

What can block the activation of Clopidogrel, Prasugrel?

A

Omeprazole

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14
Q

Which ADP-R antagonists does not require activation?

A

Ticagrelor

יש לו שם קצת שונה אז בטח הוא תרופה חדשה

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15
Q

Clopidogrel
Prasugrel
Ticagrelor

Indications

A

Acute coronary syndrome
Post angioplasty to prevent stenosis
Prophylaxis in arrhythmias

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16
Q

Clopidogrel
Prasugrel
Ticagrelor

Side effects

A

Bleeding
Neutropenia
TTP

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17
Q

Heparin inactivates

A 
Thrombin and factor Xa
VII
IX
XI
XII
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18
Q

Heparin drugs

A

Unfractionated Heparin
Low Molecular Weight Heparin: Dalteparin
Fondaparinux (fond of the parinux)

Dalte is like smaller than alpha

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19
Q

Unfractionated Heparin

What is it
How to give it
How to monitor?

A

Acidic polysaccharide polymer
IV, SC
aPTT

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20
Q

Low Molecular Weight Heparin

Name of the drug

A

Dalteparin

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21
Q

Low Molecular Weight Heparin

How is it different than Unfractionated Heparin?

A

Selective for Xa
Higher bioavailability
Longer duration of action
Renal metabolism

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22
Q

Synthestic Heparin=

A

Fondaparinux

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23
Q

Fondaparinux target

A

More selective for Xa

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24
Q

Fondaparinux

How to give?

A

SC

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25
Q

Heparin indicactions

A

Acute and rapid anticoagulation

DIC

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26
Q

Which anticoagulation will we give during pregnancy?

A

LMWH

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27
Q

Heparin side effects

A

Bleeding
HIT
Osteoporosis

heppaa
לחשוב על בהד 10 ועל הבחורה ששברה את הגב שזה מתקשר לאוסטאופורוסיס

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28
Q

Warfarin is a type of ______ anticoagulants

A

Coumarin

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29
Q

Warfarin MOA

A

Inhibit Vitamin K epoxidase reductase (VKOR)

Prevents post-trans. gamma carboxylation of factors II, VII, IX, X

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30
Q

Vit. K is important for which factors?

A 
II
VII
IX
X
Protein C, S
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31
Q

Complete theraputic effect with Warfarin is achieved after

A

2-3 days

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32
Q

Warfarin drug info

A

Lipid soluble
Oral
Highly bound to plasma proteins

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33
Q

Warfarin metabolism

A

CYP450

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34
Q

How should we monitor Warfarin use?

A

PT (INR)

35
Q

INR theraputic range using Warfarin

A

2-3

36
Q

Warfarin indications

A

Chronic anticoagulation

37
Q

Warfarin contraindication

A

Pregnancy

38
Q

Warfarin side effects

A

Warfarin skin necrosis
Bleeding
Teratogenic
Drug interactions

39
Q

Direct acting Thrombin inhibitors

A

Bivalirudin
Dabigatran

ביווה ודבי חברות ממש טובות ושתיהן יחד מעקבות את טרומבין

40
Q

Bivalirudin
Dabigatran

How are they given?

A

Bivalirudin: Parenteral
Dabigatran: Oral

דבי היא זו שמדברת מלא
ביווה שקטה יותר

41
Q

Which Direct acting Thrombin inhibitors does not require monitoring by PT/PTT?

A

Dabigatran

כי היא מדברת כל כך הרבה ואף אחד לא רוצה להתקרב

42
Q

Bivalirudin indications

A

Anticoag. in patients with HIT

In combination with Aspirin during percutaneous coronary intervention

43
Q

Dabigatran indications

A

A. Fib chronic therapy as an alternative therapy for Warfarin

44
Q

Which drug class are considered to be Noval Oral Anticoagulants?

A

Direct acting factor Xa inhibitors

45
Q

Direct acting factor Xa inhibitors:

A

Rivaroxaban
(Dabigatran)

לחשוב על הנהר בציור של סקצי
rivaroxxxxaban factor x

46
Q

Rivaroxanban indications

A

Prevention of venous thromboembolism after knee/hip surgery

Prevention of embolic stroke in A. Fib patients

47
Q

tPA drugs

A

Alteplase
Reteplase

אל תתקרב ראה- תה! פלס

48
Q

What is the difference btw. Alteplase and Reteplase?

A

Alteplase: Rebcombinant tPA
Reteplase: Modified Rebcombinant tPA

49
Q

Which has faster and longer duration of action?

Alteplase
Reteplase

A

Reteplase

rete is more rapid

50
Q

Alteplase
Reteplase

Indications

A

Short term management of thrombotic events (MI, PE…)

51
Q

Alteplase
Reteplase

Side effects

A

Bleeding

Cerebral hemorrhage

52
Q

Alteplase
Reteplase

What is the drug group?

A

tPA

Direct conversion of plasminogen into Plasmin

53
Q

Thrombolytic therapy contraindications

A 
Active internal bleeding
Suspected aortic dissection
Recent head trauma
Previous hemorrhagic stroke
Trauma or surgery in the past 2 weeks
Previous ischemic stroke within the last 1 year
54
Q

Fibrin foam=

A

A spongy substance prepared from fibrinogen and thrombin from human blood plasma and used especially after saturation with thrombin as an absorbable clotting agent in surgical wounds

55
Q

Vit. K indications

A

Vit. K deficiency

Reversal of excessive Warfarin anticlotting activity

56
Q

Who will likely have a Vit. K def.?

A

Patients with fat malabsorption

New borns

57
Q

Vit. K side effects

A

Infusion reaction when given IV or IM

**Can also be given orally

58
Q

Antiplasmin drugs

A

Aminocaproic acid

59
Q

Aminocaproic acid

How to give?

A

Oral

Parenteral

60
Q

Aminocaproic acid indications

A

Management of acute beeding in patients with hemophilia or other bleeding disorders
Reverse the activity od fibrinolytic agents

61
Q

Aminocaproic acid side effects

A

Thrombosis
Hypotension
Myopathy
Diarrhea

62
Q

Aminocaproic acid

Contraindications

A

DIC

Bleeding of the upper urinary tract

63
Q

Iron drugs I should know for the test

A

Iron-hydroxide-polymaltose Complex

64
Q

Iron-hydroxide-polymaltose Complex

How is it given?

A

Oral

65
Q

Iron deficiency manifests as which anemia?

A

Hypochromic microcytic anemia

66
Q

Acute iron overdose

A 
Shock
Necrotizing gastroenteritis
Abdominal pain
Bloody diarrhea
Lethargy
Dysnea
67
Q

Chronic iron overdose

A

Hemochromatosis (Heart, live, pancreas damage)

68
Q

Antitode for acute iron poisoning

A

Deferoxamine

69
Q

Vit. B12 preparations (2)

A

Methyl-cobalamin: Natural

Hydroxo-cobalamin: Synthetic

70
Q

Vit. B12 manifests as which anemia?

A

Megaloblastic anemia

71
Q

Which drug is used as Cyanide antidote?

A

Hydroxocobalamin

72
Q

Folic acid is given how?

A

Oral

73
Q

Folic acid indications

A

Folic acid deficiency

Prevention of congenital neural tube defects

74
Q

Erythropoiesis stimulating agent=

A

Epoetin alfa

75
Q

Epoetin alfa indications

A

Anemia of chronic renal disease, AIDS and cancer

Pre-operative

76
Q

Epoetin alfa side effects

A

HTN
Thrombotic complications
RBC aplasia

77
Q

In which case will we give Epoetin alfa?

A

Very severe anemias

78
Q

How and when to give Epoetin alfa?

A

IV or SC

1-3 times/week

79
Q

Myeloid growth factor=

A

Filgastrin

80
Q

Filgastrin MOA

A

Stimulates G-CSF receptors expressed on mature neutrphils and their progenitors

81
Q

G-CSF=

A

Granulocytes Colony Stimulating Factor

82
Q

How is Filgastrin given?

A

SC

83
Q

Filgastrin indications

A

Neutropenia assosiated with congenital neutropenia
Cyclic neutropenia
Myelodisplasia
Aplastic anemia
Mobilization of peripheral blood cells in preparation for stem cell transplantation

84
Q

Filgastrin side effects

A

Bone pain

Splenic rupture

S.N Pharmacology I (15 decks)

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