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M3 Pharm B3 > Blood Drugs > Flashcards

Blood Drugs Flashcards

1
Q

Hematinics (4)

A
  1. Iron
  2. Vitamin B12
  3. Folic Acid
  4. Hematopoietic growth factors
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2
Q

Oral Iron Therapy: Types (3)

A
  1. Ferrous sulphate
  2. Ferrous succinate
  3. Ferrous fumerate
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3
Q

Oral Iron Therapy: Adverse Effects (4)

A

Nausea

Epigastric discomfort

Abdominal cramps

Constipation

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4
Q

Parenteral Iron Therapy: Types (2)

A
  1. Iron - dextran

2. Iron - sucrose complex

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5
Q

Parenteral Iron Therapy: Indications (4)

A
  1. Unable to tolerate oral iron
  2. Unable to absorb oral iron
  3. Non-compliance
  4. Along with recombinant erythropoietin therapy
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6
Q

Hematopoietic Growth Factors: Erythropoietin Synthesis

A

Peritubular cells on the cortex of the kidney

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7
Q

Hematopoietic Growth Factors: Erythropoietin Physiological Role

A

Proliferation of erythroid precursor cells

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8
Q

Hematopoietic Growth Factors: Erythropoietin Types (2)

A
  1. Epoetin alfa

2. Darbopoietin alfa

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9
Q

Hematopoietic Growth Factors: Erythropoietin Therapeutic Uses (3)

A
  1. Anemia of CRF
  2. Anemia of AIDS (zidovudine treatment)
  3. Anemia associated with cancer chemotherapy
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10
Q

Myeloid Growth Factors: Produced naturally by 4)

A

Fibroblasts

Endothelial cells

Macrophages

T cells

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11
Q

Myeloid Growth Factors: G-CSF (2)

A

Increases neutrophil production

Recombinant G-CSF (filgrastim)

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12
Q

Myeloid Growth Factors Use: Cancer chemotherapy Induced neutropenia (2)

A

Accelerates the rate of neutrophil recovery after dose-intensive myelosuppressive chemotherapy

Reduces the duration of neutropenia and raises the lowest count

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13
Q

Myeloid Growth Factors: Other Uses (2-4)

A
  1. Autologous stem cell transplantation
  2. Mobilization of peripheral blood stem cells (PBSCs)
  3. Severe congenital neutropenia
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14
Q

Myeloid Growth Factors: GM-CSF (2)

A

Increase neutrophil, monocyte production

Recombinant human GM-CSF (sargromostim)

  • Autologous bone marrow transplantation
  • Intenseive cancer chemotherapy
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15
Q

Thrombopoeitic Growth Factors: IL-11 (2)

A

Increases platelet production

Recombinant IL-11 (oprelvekin): patients undergoing chemotherapy for nonmyeloid malignancy

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16
Q

Anticoagulants: Hemostasis Defined (3)

A
  1. Platelets adhere to damaged subendothelium
  2. Aggregate to form hemostatic plug
  3. Stimulate local activation of clotting factors
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17
Q

Natural anticoagulant mechanisms: (4)

A
  1. Prostacylin
  2. Antithrombrin III
  3. Protein C
  4. Protein S
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18
Q

Anticoagulants: General Info (3)

A
  1. Glycosaminoglycan (GAG)
  2. Mol. Weight: 10000-20000
  3. Secretory granules of mast cells
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19
Q

Anticoagulants: Heparin MOA (2)

A

Catalyzes the inhibition of several coagulation factors by antithrombin

Increases the rate of thrombin-antithrombin reaction

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20
Q

Anticoagulants: Heparin Uses (3)

A

Initiate treatment of DVT and pulmonary embolism

Initial management of unstable angina or acute MI

During or after coronary angioplasty or stent placement

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21
Q

Anticoagulants: Heparin Lab Test Monitored by?

A

aPTT

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22
Q

Anticoagulants: Heparin Adverse Effects (5)

A
  1. Bleeding
  2. Thrombocytopenia
  3. Alopecia
  4. Osteoporosis
  5. Allergic reactions: urticaria, rigors
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23
Q

Anticoagulants: Low Molecular Weight (LMW) Heparins Defined

A

Heparin is fractioned into LMW forms (3000-7000)

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24
Q

Anticoagulants: Low Molecular Weight (LMW) Heparins Types (5)

A
  1. Enoxaparin
  2. Nalteparin
  3. Reviparin
  4. Nadoparin
  5. Ardeparin
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25
Q

Anticoagulants: Low Molecular Weight (LMW) Heparins MOA

A

Selectively inhibits factor Xa with little effect on IIa

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26
Q

Anticoagulants: Low Molecular Weight (LMW) Heparins Advantages (4)

A
  1. Better subcutaneous bioavailability
  2. Longer biological half-lives
  3. Routine monitoring not necessary
  4. Lower incidence of bleeding and thrombocytopenia
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27
Q

Protoamine Sulphate: Defined (3)

A

Heparin antagonist

Strongly basic

Binds to heparin and NEUTRALIZES its anticoagulant effect

28
Q

Protoamine Sulphate: Indication

A

To reversethe anticoagulant effect of haparin following cardiac surgery and other vascular procedures

29
Q

Other Anticoagulants: Bivaluridiin (3)

A
  1. Direct thrombin inhibitor
  2. Also inhibits platelet activation
  3. Percutaneous coronary angioplasty
30
Q

Other Anticoagulants: Argatroban (2)

A
  1. Direct thrombin inhibitor

2. Thrombosis in patients with heparin induced thrombocytopenia

31
Q

Other Anticoagulants: Rivaroxaban (Xarelto) and Apixaban (Eliquis) (3)

A
  1. Oral Xa (10a) Inhibitors
  2. Prevention and treatment of patients with venous thromboembolism
  3. Stroke prevention in patients with atrial fibrillation
32
Q

Oral Anticoagulants: Coumadin derivatives (2)

A
  1. Dicumarol

2. Warfarin

33
Q

Oral Anticoagulants: Warfarin MOA (2)

A
  1. Vit K. Anatagonist

2. Interferes with the activation of Vit. K dependent clotting factors

34
Q

Oral Anticoagulants: Warfarin Onset of Action

A

> 3-5 days

35
Q

Oral Anticoagulants: Warfarin Half Life of Factor VII

A

6

36
Q

Oral Anticoagulants: Warfarin Half Life of Factor IX

A

24

37
Q

Oral Anticoagulants: Warfarin Half Life of Factor X

A

40

38
Q

Oral Anticoagulants: Warfarin Half Life of Factor II

A

60

39
Q

Oral Anticoagulants: Warfarin Adverse Effect - Bleeding (3)

A
  1. Ecchymosis, epistaxis
  2. Hematuria, intracranial
  3. Pericardial, spinal cord hemorrhage
40
Q

Oral Anticoagulants: Warfarin Adverse Effect - Birth Defect (1)

A

Fetal warfarin syndrome

41
Q

Oral Anticoagulants: Warfarin Other Adverse effects (2)

A
  1. Purple toe syndrome

2. Skin necrosis

42
Q

Oral Anticoagulants: Warfarin Drug Interaction - Increase PT with? (3)

A
  1. Sulphonamides
  2. Cimetidine
  3. Aspirin (high doses)
43
Q

Oral Anticoagulants: Warfarin Drug Interaction - Decrease PT with? (1)

A

Barbiturates

44
Q

Oral Anticoagulants: Warfarin Uses (3)

A

Prevent progression or recurrence of acute DVT or pulmonary embolism

Prevent venous thromboembolism in patients undergoing orthopedic or gynecological surgery

Prevent systemic embolization in patients with acute MI, prosthetic heart valves or chronic atrial fibrillation

45
Q

Oral Anticoagulants: Warfarin Monitoring (2)

A
  1. PT

2. INR

46
Q

Oral Anticoagulants: Warfarin Contraindications (6)

A
  1. Bleeding disorders
  2. Severe hypertension
  3. Endocarditis
  4. Ocular/neurosurgery
  5. Lumbar puncture
  6. Chronic alcoholics
47
Q

Fibrinolytics (Thrombolytics): Streptokinase MOA

A

Streptokinase to Plasminogen to Plasmin to Fibrin to Fibrin breakdown

48
Q

Fibrinolytics (Thrombolytics): Adverse Effects (3)

A
  1. Antigenic-hypersensitivity reactions
  2. Hypotension, arrhythmia
  3. Bleeding
49
Q

Fibrinolytics (Thrombolytics): Urokinase activates and is what?

A

Activates plasminogen directly

Is non-antigenic

50
Q

Fibrinolytics (Thrombolytics): Alteplase and Reteplase is what type of tPA?

A

Recombinant tPA

51
Q

Fibrinolytics (Thrombolytics): Use - Acute MI

A

To recanalize thrombosed coronary artery

52
Q

Fibrinolytics (Thrombolytics): Use - Acute ischemic stroke

A

tPAs - alteplase

53
Q

Fibrinolytics (Thrombolytics): Use - DVT

A

SVC syndrome, ascending thrombophlebitis

54
Q

Fibrinolytics (Thrombolytics): Other Uses (2)

A

Unstable angina

Pulmonary embolism

55
Q

Fibrinolytics (Thrombolytics): Toxicity leads to? (1)

A

Hemorrhage

56
Q

Fibrinolytics (Thrombolytics): Contraindications (3)

A
  1. In surgery within 10 days
  2. GI bleeding within 3 months
  3. Hemorrhagic disorder
57
Q

ANTI-fibrinolytics: Epsilin amino-caproic acid (EACA) MOA

A

Combines with plasminogen and plasmin and prevents it from binding to fibrin

58
Q

ANTI-fibrinolytics: Epsilin amino-caproic acid (EACA) Uses (3)

A
  1. Overdose of thrombolytics
  2. Prevent recurrence of subarachnoid and GI hemorrhage
  3. Prostatic surgery, tooth extraction in hemophiliacs
59
Q

Antiplatelet Drugs: Aspirin MOA

A

Inhibits TXA2

60
Q

Antiplatelet Drugs: ADP Receptor Antagonists (2)

A
  1. Ticlopidine

2. Clopidogrel (fewer adverse effects)

61
Q

Antiplatelet Drugs: Glycoprotein (GP) IIb/IIIa Receptor Antagonists (3)

A
  1. Abciximab
  2. Tirofiban
  3. Eptifibatide
62
Q

Antiplatelet Drugs: Dypyridamol MOA

A

Inhibits phosphodiesterase (PDE) and blocks uptake of adenosine (increases cAMP)

63
Q

Antiplatelet Drugs: Cilostazol Use

A

Used priamry to treat intermittent claudication

64
Q

Antiplatelet Drugs: Use - Coronary Artery Disease (5)

A
  1. Low dose aspirin (50-320 mg/day) immediately after MI
  2. To cover percutaneous transluminal coronary angioplasty (PTCA)
  3. Unstable angina
  4. Primary and secondary prevention of MI
  5. All individuals with evidence of CAD
65
Q

Antiplatelet Drugs: Use - Cerebrovascular Disease (1)

A

Reduces the incidence of TIAs and stroke

66
Q

Antiplatelet Drugs: Use - Coronary Bypass Implants (1)

A

Improves the patency of the implanted bypass vessel

67
Q

Antiplatelet Drugs: Use - Prosthetic Heart Valves (1)

A

Used with warfarin to reduce formation of microthrombi

M3 Pharm B3 (10 decks)

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