Blood Drugs

Question 1

MOA and clinical uses for aminocaproic acid

Answer 1

MOA: lysine analogue that binds to and inhibits plasmin (to inhibit fibrinolysis)

Clinical uses: various bleeding disorders

Question 2

MOA and clinical uses for alteplase

Answer 2

MOA: converts plasminogen to plasmin –> fibrinolysis

Clinical uses: MI, PE, ischemic stroke

Question 3

MOA and clinical uses for cyclosporine

Answer 3

MOA: inhibits calcineurin (involved in T cell proliferation)

Clinical uses: after marrow transplant to prevent GVHD, idiopathic aplastic anemia

Question 4

MOA and clinical uses for dabigatran

Answer 4

MOA: direct thrombin (factor II) inhibitior

Clinical uses: stroke prevention in a-fib patients, DVT, PE

Question 5

MOA and clinical uses for desmopressin

Answer 5

MOA: V2 receptor agonist; stimulates vWF release from endothelial cells

Clinical uses: von Willebrand disease, other qualitative platelet disorders

Question 6

MOA and clinical uses for eltrombopag

Answer 6

MOA: TPO receptor agonist –> stimulates megakaryocytes

Clinical uses: chronic idiopathic thrombocytopenic purpura, idiopathic acquired aplastic anemia

Question 7

MOA and clinical uses for enoxaparin

Answer 7

MOA: indirect factor Xa inhibitor

Clinical uses: venous thrombosis prophylaxis or treatment of acute coronary syndromes

Question 8

MOA and clinical uses for epoetin alfa

Answer 8

MOA: EPO receptor agonist

Clinical uses: anemia secondary to cancer, kidney disease, IBD (?)

Question 9

MOA and clinical uses for filgrastim.

Answer 9

MOA: G-CSF analogue –> more neutrophils

Clinical uses: neutropenia secondary to chemo or bone marrow transplantation

Question 10

MOA and clinical uses for fondaparinux

Answer 10

MOA: indirect factor Xa inhibitor

Clinical uses: venous thrombosis prophylaxis or treatment of acute coronary syndromes

Question 11

MOA and clinical uses for hydroxyurea.

Answer 11

MOA: inhibitor of ribonucleotide reductase; somehow stimulates HbF production; also reduces WBC count, which helps sickle cell patients decrease RBC aggregation intravascularly

Clinical uses: sickle cell anemia, myeloproliferative disorders

Question 12

MOA and clinical uses for imatinib

Answer 12

MOA: tyrosine kinase inhibitor (ABL, Kit, PDGF-R)

Clinical uses: CML, Philadelphia chromosome (+) ALL

Question 13

MOA and clinical uses for rituximab

Answer 13

MOA: binds to CD20 on B cells –> dead B cells

Clinical uses: idiopathic thrombocytopenic purpura (ITP), CD20-expressing hematopoietic malignancies

Question 14

MOA and clinical uses for rivaroxaban

Answer 14

MOA: direct factor Xa inhibitor

Clinical uses: stroke prevention in a-fib, DVT, PE

Question 15

MOA and clinical uses for romiplostim

Answer 15

MOA: TPO receptor agonist

Clinical uses: chronic idiopathic thrombocytopenic purpura

Question 16

MOA and clinical uses for warfarin

Answer 16

MOA: inhibits vitamin K epoxide reductase –> no factors II, VII, IX, X, proteins C and S

Clinical uses: stroke prevention in a-fib, DVT, PE, mechanical heart valves

Question 17

Name a way to reverse warfarin-induced bleeding.

Answer 17

Vitamin K infusion

Question 18

MOA and clinical uses for unfractionated heparin

Answer 18

MOA: indirect factor IIa (thrombin) and factor Xa inhibitor

Clinical uses: venous thrombosis prophylaxis or treatment of acute coronary syndromes.

Question 19

Toxicity of warfarin

Answer 19

Bleeding

Question 20

Toxicity of unfractionated heparin

Answer 20

Bleeding, HIT, osteoporosis w/ chronic use

Question 21

Toxicity of rivaroxaban

Answer 21

Bleeding

Question 22

Toxicity of rituximab

Answer 22

Neutropenia

Question 23

Toxicity of imatinib

Answer 23

CHF, GI upset

Question 24

Toxicity of hydroxyurea

Answer 24

Cytopenias

Question 25

Toxicity of fondaparinux

Answer 25

Bleeding

Question 26

Toxicity of filgrastim

Answer 26

Bone pain

Question 27

Toxicity of epoetin alfa

Answer 27

Hypertension, thrombosis

Question 28

Toxicity of enoxaparin

Answer 28

Bleeding, thrombocytopenia

Question 29

Toxicity of dabigatran

Answer 29

Bleeding, GI disturbances

Question 30

Toxicity of cyclosporine

Answer 30

Hypertension, electrolyte wasting, nephrotoxicity

Question 31

Toxicity of alteplase

Answer 31

Bleeding, intracranial hemorrhage

Question 32

Toxicity of aminocaproic acid

Answer 32

Thrombosis

Question 33

What is the MOA of heparin?

Answer 33

Complexes with antithrombin III and upregulates its activity –> inactivation of thrombin and factor Xa