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Pharmacology Final > Anti-coagulants, Thyroid, GI > Flashcards

Anti-coagulants, Thyroid, GI Flashcards

1
Q

how many units of heparin are in a typical bag mix?

A

25,000 units/ 500ml
-50units/ml

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2
Q

with is the MOA of heparin?

A

-INACTIVATES 2 factors: → Thrombin, Factor Xa
-Inhibits thrombin indirectly

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3
Q

is heparin okay for those who are pregnant?

A

yes

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4
Q

what are some adverse rxn for heparin?

A

-bleeding
-heparin induced thrombocytopenia (HIT)

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5
Q

what needs to be monitored when giving heparin?

A

-aptt
-anti-XA
-ALWAYS check platlets

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6
Q

what is the antidote for heparin?

A

protamine sulfate

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7
Q

what do the low molecular weight heparins end in? some examples?

A

-parin
enoxaparin (Lovenox)
dalteparin (Fragmin)
tinzaparin (Innohep)
fondaparinux (Arixtra)

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8
Q

how do low-molecular weight heparins work?

A

Inhibit thrombus and clot
formation by blocking:
-Factor Xa and 2a

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9
Q

what are low molecular weight heparins used to treat?

A

prophylactic and first line of treatment for DVT’s

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10
Q

do you need to monitor plasma levels of low molecular weight heparins?

A

no

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11
Q

what are some adverse effects of low molecular weight heparins

A

HIT
bleeding

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12
Q

what classifies as HIT?

A

-heparin induced thrombocytopenia
-an allergic response to heparin
-decrease in 50% of platelets or more in 1 day
-can never have heparin again

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13
Q

what do you need to monitor when giving low molecular weight heparins?

A

platelets (150-450)

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14
Q

what is the antidote for low molecular weight heparins

A

protamine sulfate

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15
Q

what medication is a vitamin K antagonist?

A

warfarin

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16
Q

how does warfarin work?

A

interferes with the formation of vitamin k dependent clotting factors in the liver

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17
Q

what dont we like about warfarin?

A

-highly protein bound
-3-5 days to work
-hemorrhage
-many drug interactions
-not useful in emergancy

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18
Q

who shouldn’t take warfarin?

A

pregnant or breastfeeding women

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19
Q

when would you hold warfarin?

A

INR > 3.5

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20
Q

what is the antidote to warfarin?

A

vitamin k

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21
Q

what medication is a direct thrombin inhibitor?

A

dabigatran etexilate

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22
Q

how does dabigatran etexilate work?

A

it directly inhibits thrombin =

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23
Q

what is ab adverse effect of dabigatran etexilate?

A

bleeding

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24
Q

how is dabigatran etexilate taken?

A

orally

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25
Q

what is the antidote of dabigatran etexilate?

A

idarucizumab
-very expensive

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26
Q

what medications are the Hirudin Analogs?

A

bivalirudin (Angiomax)
lepirudin (Refludan)
desirudin (Iprivask)
argatroban

27
Q

how do Hirudin Analogs work?

A

Direct thrombin inhibitor

28
Q

where do Hirudin Analogs occur naturally?

A

in leech saliva as anticoagulant

29
Q

what is an adverse effect of Hirudin Analogs?

A

Angiomax ↓ bleeding
(compared to heparin)

30
Q

what medications are Direct Factor Xa
Inhibitors, what do they end in?

A

-apixaban (eliquis)
-rivaroxaban (xarelto)
end in -ban

31
Q

how do Direct Factor Xa Inhibitors work?

A

Selective inhibition of factor Xa
-Directly inhibits thrombin

32
Q

what is the antidote for Direct Factor Xa Inhibitors?

A

adexanet
-expensive! $25,000-50,0000

33
Q

what medications are P2Y12ADP Receptor Antagonists?

A

clopidogrel (Plavix)
prasugrel (Effient)
ticagrelor (Brilinta)
ticlopidine (Ticlid)

34
Q

how do P2Y12ADP Receptor Antagonists work/

A

they block the receptor site on platelet surfaces

35
Q

what are the adverse effects of P2Y12ADP Receptor Antagonists?

A

-bleeding
-TTS (thrombotic thrombocytopenic purpura)

36
Q

what medications are GP2b/3a Receptor Antagonists?

A

abciximab (ReoPro)
eptifibatide (Integrillin)
tirofiban (Aggrastat)

37
Q

how doe GP2b/3a Receptor Antagonists work?

A

Prevent platelet aggregation
 “Super aspirins”
 Cause reversible blockage of this receptor (inhibits final step of platelet aggregation)

38
Q

which medications are Thrombolytics
(Fibrinolytic)?

A

alteplase (tPA)
tennecteplase (TNKase)
reteplase (Retavase)

39
Q

how does alteplase (tPA) work?

A

Binds w/plasminogen to convert to plasmin
 Plasmin breaks down fibrin (clot)

40
Q

what are the adverse effects of alteplase (tPA)?

A

-bleeding
-intercranial pressure

41
Q

what would you give if someone taking alteplase (tPA) is having severe bleeding that cannot be controlled?

A

-aminocaproic acid

42
Q

how does tennecteplase (TNKase) work?

A

Tissue plasminogen activators
 Plasmin breaks down fibrin (clot)

43
Q

what has a longer half life tPA or TNKase?

A

TNKase

44
Q

how is tennecteplase (TNKase) given

A

-single IV bolis

45
Q

how should reteplase (Retavase) not be given?

A

in a heparin line

46
Q

what is reteplase (Retavase) used only for?

A

acute MI

47
Q

what is TNKase used for?

A

MI and also CVA

48
Q

what is tPA used for?

A

stroke, acute massive pulmonary emboli

49
Q

what are some s/sx of hypothyroidism?

A

sluggish, brittle hair, weight gain, high TSH, low T3, low T4
-hashimoto’s disease

50
Q

what would be given to treat hypothyroidism?

A

levothyroxine

51
Q

what are some s/sx of hyperthyroidism?

A

exothalamus (buldging eyes), thyroid storm (200bpm hr, low bp)
-give a beta blocker ^

52
Q

what drug classification is ondansetron?

A

serotonin 5-HT3 receptor blocker

53
Q

what should be monitored when taking ondansetron?

A

EKG
-lengthen Q-T interval

54
Q

name a H2 blocker and what do they all end in?

A

famotidine
nizatidine
-dine

55
Q

how do h2 blockers work?

A

they decrease the production of gastric acids

56
Q

name a proton-pump inhibitor and what do they all end in?

A

omprazole
pantoprazole
-prazole

57
Q

how do proton-pump inhibitors work?

A

decrease the production of gastric acids

58
Q

how does sulcralfate work?

A

this is a “bandaid” for the stomach, provides a protective layer

59
Q

how do misprostol and asprin work?

A

they coat the stomach, and decrease the prostaglandins

60
Q

what is a side effect of bismuth?

A

-pepto bismol
can turn the tounge black like the color of tar

61
Q

what should we know about antiacids?

A

-liquid is best
-can contain Na (harmful for CHF)

62
Q

what drug classification is metaclopramide?

A

pro-kinetic drug
serotonin 5-HT3 blocker

63
Q

how does metaclopramide work?

A

increases the movement of gastric secretions (diarrhea)

64
Q
A

Pharmacology Final (1 decks)

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