Ch. 25 Pharm

Question 1

Inhalation Agents- 4

Answer 1

1) NO- analgesia, changes HR/contractility= for induction
2) Fluothane- lowers BP, HR, dilates= liver damage, arrhythmiae
3) Etharne- lowers BP, sweet odor
4) Flurane- lowers BP, increase CO/HR

Question 2

Anticoagulants- 5

Answer 2

1) Heparin- potentiates ATIII and lowers F IX, XI
- stored blood with heparin- 48 horus
2) Coumadin/Warfarin- lowers vit K dep in liver= F II, VII, IX, X
3) ATIII- inactivates thrombin and F IX, X, XI, XII
- equation= [(desired ATIII % - actual) x kg]/(1.4)
4) Citrate Phosphate Dextrose= binds to Ca
- stored blood with CPD 35 days (with ATP)
5) Bivalirudin= direct thrombin inhibitor, short half life, no reversal

Question 3

Anticoagulant Antagonist - 2

Answer 3

1) Protamine + heparin= salt= neutralizes heparin
* *Protamine reaction w/ prior exposure, vasectomy, insulin, fish allergy= treat with inontropes, vasoactive, pulm a dilators, nitroglycerin
- no faster than 5 mg/min
2) Aquamephtyon= treats vit K deficiency

Question 4

Platelet Inhibiting- 7

Answer 4

1) aspirin= block enzyme function- platelet inhibitor
2) Perantine= increase with aspirin, lowers ATP
3) Abciximab, Plavix, Integrilin= binds to platelet glycoprotein
4) Ticlid- aspirin alternative
5) Aggrenox= aspirin + perantine

Question 5

Platelets Inhibitors and what they are used for

Answer 5

1) Aspirin= CAD
2) Persantine= valve, lower emboli
3) Abciximab= PTCA, abrupt closure
4) Plavix= MI, stroke, acute coronary disease, perph artery disease
5) Integrilin= balloon angioplasty, chest pain, heart attach
6) Aggrenox= prevent strokes due to ischemia

Question 6

Fibrinolytics

Answer 6

all end in “ase”

• -increase plasminogen into plasmin - which breaks down fibrin
• destroys thrombus in coronary and pulmonary

Question 7

Fibrinolytic Inhibitor- 3

Answer 7

1) DDAVP= antiduretic that increase factor VIII
2) Aprotinin= works on kallikein, glycoprein
- artificially increases ACT
- Hammersmith dosing
3) Amicar= inhibits plasminogen, half life 2 hr