Blood Drugs Flashcards
a decrease in the amount of hemoglobin per RBC
microcytic, hypochromic anemia
decrease in the number of mature, circulating RBCs
megaloblastic (macrocytic), hyperchromic anemia
loss of RBCs (hemorrhage) or decrease in hematopoietic growth factors, esp erythropoietin
normocytic anemia
ferrous sulfate, gluconate, fumarate, iron dextran treat?
microcytic anemia
iron antidote?
deferoxamine
folic acid, leucovorin, cyanocobalamin, hydroxycobalamin treat?
macrocytic anemia
epoetin alfa (EPO) treats?
normocytic anemia
iron deficiency –> loss of hemosiderin granules in bone marrow –> serum _____ decreases –>serum iron decreases
ferritin
best indicator of iron deficiency is elevation of _________
total iron binding capacity of transferrin
- essential for normal synthesis of DNA and normal mitosis of proliferating cells
- conversion to cofactors required for purine and pyrimidine synthesis
folic acid
conversion of homocysteine to methionine requires folate as methyl donor with _____ as cofactor
B12
- given during pregnancy to prevent neural tube defects (spina bifida)
- -hyperhomocystinuria possible risk factor for coronary heart disease
- low methionine levels in deficiency
folate deficiency
- essential for normal synthesis of DNA and for maintenance of myelin throughout nervous system
- required to convert dietary form of folate
- required to convert methylmalonyl coA to succinyl coA
- required to convert homocysteine to methionine
vitamin B12
absorption of vitamin B12 requires ______, a glycoprotein synthesized by parietal cells of stomach
intrinsic factor
IF binds B12, and complex absorbed in the ______
ileum
- usually given parenterally
- does not cause antibody response to complex
- preferred for long term use
cyanocobalamin
- highly protein bound and remains in circulation longer
- some patients produce antibodies
- treatment for cyanide poisoning
hydroxycobalamin
-megaloblastic anemia due to B12 deficiency resulting from lack of production of intrinsic factor by the parietal cells of the gastric mucosa, accompanied by achlorhydria
pernicious anemia
- glycoprotein that stimulates red cell production
- treatment of anemia patients with chronic renal failure and in cancer patients
epoeitn alpha (erythropoietin)
- recombinant granulocytic macrophage colony stimulating factor
- promotes myeloid recovery in patients with non hodgkins, ALL, Hodgkin’s undergoing bone marrow transplant
- promotes myeloid recovery after standard dose chemo
- treats drug induced bone marrow toxicity or neutropenia assoc’d with AIDS
- AE incidence and severity
sargramostim (GM-CSF)
- recombinant colony stimulating factor
- for chemo related neutropenia, promotion of myeloid recovery in patients undergoing bone marrow transplantation
filgrastim (G-CSF)
promotes megakaryopoiesis, increasing peripheral platelets
oprelvekin
clopidegrel, ticlodipine, prasugrel, ticagrelor, cangrelor mehanism of action?
ADP antagonists
abciximab, tirofiban is a platelet receptor ________ inhibitor
GP2b3a
inhibit blood coagulation in vitro
calcium chelators
accelerates action of antithrombin III to neutralize thrombin and other coagulation factors
heparins
-rudins and -gat drugs
direct thrombin (IIa) inhibitors
-xaban drugs
direct Xa inhibitors
coumarin derivatives interfere with the hepatic synthesis of functional _______ clotting factors
vitamin K dependent
enoxaparin, dalteparin, tinzaparin, nadroparin are ______ heparins
low molecular weight
________ for use in patients who are taking the anticoagulant dabigatran during emergency situations when there is a need to reverse the blood thinning effects
praxbind (idarucizumab)
rivaroxaban, apixaban, edoxaban class?
direct Xa inhibitors
vitamin K epoxide reductase inhibitor?
warfarin
- PTT monitoring not required
- does not increase vascular permeability
- minimal endothelial cell/protein binding
- dose independent clearance
- 3-6 hours elimination half life
LMWH
warfarin has _____ volume of distribution (albumin space), long half life 36 hrs, and metabolized by CYP450
low
amiodarone, cimetidine, disulfiram, fluconazole, metronidazole, phenylbutazone, sulfinpyrazone, TMP-SMX and erythromycin ________ warfarin metabolism, requiring a ______ dose
inhibits
decreased
barbiturates, carbamazepine, primidone, rifampin, St johns wort, cholestyramine _______ warfarin metabolism, requiring ______ dose
induces
increased
monitor heparin with _______, monitor warfarin with ______
PTT
PT (INR)
treatment of heparin overdose?
protamine sulfate
treatment of warfarin overdose?
vit K, FFP
urokinase, alteplase, reteplase, tenecteplase?
fibrinolytic drugs
fibrinolytics work by lysing thrombi by catalyzing formation of ______ from its precursor zymogen
plasmin
fibrinolytic inhibitor?
aminocaproic acid
