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Blood and Lymphoid > Drug List > Flashcards

Drug List Flashcards

1
Q

Leucovorin

A

Class: Folinic Acid Supplement Use: Folic acid deficiency anemiaDietary folate = N-methyltetrahydrofolate (require vit B12 cofactor) Folate supplements = Folic acid or Dihydrofolate (do not require vit B12 cofactor)

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2
Q

Erythropoietin

A

Class: Growth Factors Use: Normocytic anemia from chronic renal failure, HIV infection, or cancer pts. receiving chemotherapyMOA: Stimulate RBC productionAdverse Effects: HTN and thrombosis

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3
Q

Filgrastim (G-CSF)

A

Class: Growth Factors Use: Preventing/treating neutropenia from chemotherapy, reducing time to engraftment after autologous stem cell transplant, promotes mobilization of peripheral blood stem cells for transplantation, inherited disorders of myeloid cell productionAdverse Effects: Causes temporary bone pain

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4
Q

Sargramostim (GM-CSF)

A

Class: Growth Factors Use: Preventing/treating neutropenia from chemotherapy, reducing time to engraftment after autologous stem cell transplant, promotes mobilization of peripheral blood stem cells for transplantation, inherited disorders of myeloid cell productionAdverse Effects: COMMON. Fever, malaise, arthralgia, myalgia, capillary leak syndrome (peripheral edema, pleural and pericardial effusions)

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5
Q

Oprelvekin (IL-11)

A

Class: Growth Factors MOA: Promotes megakaryopoiesis. Increases the number of peripheral platelets, decreases need for platelet transfusions Use: Pts. receiving chemotherapy for tx of nonmyloid cancersAdverse Effects: Fatigue, dizziness, anemia, dyspnea

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6
Q

Ferrous sulfate

A

Class: Iron Supplements Use: AnemiaRoute: OralAdverse Effects of Toxicity: GI irritation and necrosis, N&V, cyanosis, bloody diarrhea, shock, lethargy, severe metabolic acidosisTx for Toxicity: Deferoxamine and whole bowel irrigationnormal Hgb usually takes 1-3 monthsTx should last 3-6 months or longer

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7
Q

Ferrous gluconate

A

Class: Iron Supplements Use: AnemiaRoute: OralAdverse Effects of Toxicity: GI irritation and necrosis, N&V, cyanosis, bloody diarrhea, shock, lethargy, severe metabolic acidosisTx for Toxicity: Deferoxamine and whole bowel irrigationnormal Hgb usually takes 1-3 monthsTx should last 3-6 months or longer

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8
Q

Ferrous fumarate

A

Class: Iron Supplements Use: AnemiaRoute: OralAdverse Effects of Toxicity: GI irritation and necrosis, N&V, cyanosis, bloody diarrhea, shock, lethargy, severe metabolic acidosisTx for Toxicity: Deferoxamine and whole bowel irrigationnormal Hgb usually takes 1-3 monthsTx should last 3-6 months or longer

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9
Q

Hydroxycobalamin

A

Class: Vitamin B12 Supplements Use: B12 deficiency anemiahighly protein bound and remains in circulation longersome pts produce Abs against hydroxocobalamin-transcobalamin II complex

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10
Q

Cyanocobalamin

A

Class: Vitamin B12 Supplements Use: B12 deficiency anemiaRoute: nasal, oral, and parenteral (most common)

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11
Q

Bendamustine

A

Class: Alkylating Agents (CCNS)Use: CLL and indolent B-cell NHLMOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolism. Also inhibits mitotic checkpoints along with alkylating DNAAdverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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12
Q

Busulfan

A

Class: Alkylating Agents (CCNS)Use: CML, BMT conditioning regimenMOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolismSignature Adverse Effect: Pulmonary fibrosis, VODOther Adverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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13
Q

Chlorambucil

A

Class: Alkylating Agents (CCNS)Use: CLL (rarely used), HL, NHLMOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolismAdverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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14
Q

Cyclophasphamide

A

Class: Alkylating Agents (CCNS)Use: CLL, ALL, NHL, multiple myelomaMOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolismSignature Adverse Effect: Sterile hemorrhagic cystitisOther Adverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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15
Q

Dacarbazine

A

Class: Alkylating Agents (CCNS)Use: HL, multiple myelomaMOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolismSignature Adverse Effect: Severe acute N&V and delayed myelosuppression Other Adverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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16
Q

Ifosfamide

A

Class: Alkylating Agents (CCNS)Use: HL and NHL or ablation therapy before BM or SC transplant. Component of ICE therapyMOA: Analog of cyclophosphamideAdverse Effects: N&V, urinary tract toxicity, sever BM depression, peripheral neuropathies, CNS effects

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17
Q

Mechlorethamine

A

Class: Alkylating Agents (CCNS)Use: HL (MOPP), NHL, mycosis fungoides MOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolismAdverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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18
Q

Melphalan

A

Class: Alkylating Agents (CCNS)Use: Multiple myeloma, pre-HCT myeloablative therapyMOA: Covalently bind DNA altering structure and f(x), disrupting DNA synthesis and promoting cell death; must be reactive either inherently or generated by metabolismSignature Adverse Effect: Marked myelosuppression Other Adverse Effects: Leukocytopenia and thrombocytopenia is dose-limiting toxic effect; secondary malignancy - concern inversely proportional to age

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19
Q

Methotrexate

A

Class: Antimetabolite - Folate analog (CCS for S phase) Use: ALL, advanced CTCL and NHLMOA: Irreversibly binds DHFR preventing folate production, blocking DNA and RNA synthesis*may be given high dose followed by folinic acid rescue (Leucovorin) Adverse Effects: Hepatotoxicity with chronic use (rare in cancer chemo, more common in immunosuppression)

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20
Q

6-Mercaptopurine

A

Class: Antimetabolite - Purine Analog (CCS for S phase) Use: ALLMOA: Activated by HGPRT (tumor resistance w/ down-regulation of HGPRT or increased alk phos); inhibits AMP and GMP synthesis Adverse Effects: Very toxic in pts. w/ TPMT deficiency (pharmacogenomic testing before use); hepatic metabolism to inactive form by xanthine oxidase (may cause hyperuricemia and gout; allopurinol blocks this, but must decrease 6-MP dose)

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21
Q

6-Thioguanine

A

Class: Purine Antagonists Use: Leukemias and LymphomasMOA: Incorporates into DNA and RNA altering function

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22
Q

Cladribine (2-CDA)

A

Class: Purine Antagonists MOA: activated by deoxycytidine kinase. Incorporated into DNA, causes strand breaks. Inhibits ribonucleotide reductase (ribonucleotide –> deoxyribonucleotide)Use: Hairy Cell Leukemia, CLL, and low grade lymphomas

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23
Q

Fludarabine

A

Class: Antimetabolite - Purine Analog (CCS for S phase) Use: Progressive or refractory B-cell CLLMOA: Inhibits DNA polymerase and ligase, ribonucleotide reductase, incorporated into RNA and DNA

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24
Q

Cytarabine

A

Class: Antimetabolite - Pyrimidine Analog (CCS for S phase) Use: AML, ALLMOA: Incorporated into DNA inhibiting DNA polymerase, reducing synthesis and repair; must be activated by deoxycytidine kinase (polymorphic, so in deficient pt. won’t be effective) Adverse Effects: More toxic than purine analogs - myelosuppression, GI toxicity, stomatitis

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25
Q

Gemcitabine

A

Class: Pyrimidine Antagonists Use: Leukemias and Lymphomas

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26
Q

Hydroxyurea

A

Class: Ribonucleotide Reductase Inhibitor Use: Leukemias and Lymphomas

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27
Q

Bleomycin

A

Class: Antitumor Antibiotics (CCS for G2 phase) Use: LymphomasMOA: Binds to DNA, generates radicals causing strand breaksAdverse Effects: Pulmonary fibrosis; Hypersensitivity, cutaneous reactions

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28
Q

Daunorubicin

A

Class: Antitumor Antibiotics - Anthracycline (CCNS)Use: AML, ALL, blast crisis in CMLMOA: Intercalate into DNA inhibiting topoisomerase II causing strand breaks; generate free radicals Adverse Effects: Cardiotoxicity, effect is cumulative, causes arrhythmias, cardiomyopathy, CHF; minimized with Dexrazoxane administration; Idarubicin is less toxic

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29
Q

Doxorubicin

A

Class: Antitumor Antibiotics - Anthracycline (CCNS)Use: AML, ALL, blast crisis in CMLMOA: Intercalate into DNA inhibiting topoisomerase II causing strand breaks; generate free radicals Adverse Effects: Cardiotoxicity, effect is cumulative, causes arrhythmias, cardiomyopathy, CHF; minimized with Dexrazoxane administration; Idarubicin is less toxic

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30
Q

Idarubicin

A

Class: Antitumor Antibiotics - Anthracycline (CCNS)Use: AML, ALL, blast crisis in CMLMOA: Intercalate into DNA inhibiting topoisomerase II causing strand breaks; generate free radicals Adverse Effects: Cardiotoxicity, effect is cumulative, causes arrhythmias, cardiomyopathy, CHF; minimized with Dexrazoxane administration; Idarubicin is less toxic

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31
Q

Alemtuzumab (Campath)

A

Class: Biologicals Use: CLL refractory to standard treatment, GVH prophylaxis and Tx, other T cell disorders MOA: Anti CD52 Ab (present on both T and B cells)*high rate of viral activation

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32
Q

α-interferon

A

Class: Biologicals Use: Leukemias and LymphomasMOA: Antiviral, proliferative, cytostatic, immunomodulatory, differentiating, and inhibitory of cellular genes including oncogenes. Can act directly on tumor cells and effector cells such as NK cells, T cells, and macrophages.

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33
Q

Asparaginase

A

Class: Biologicals Use: ALLMOA: Catalyzes breakdown of asparagine in blood. Inhibits growth of ALL cells, which lack asparagine synthetaseAdverse Effects: Allergic response; enhances coagulation

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34
Q

Rituximab

A

Class: Biologicals - Monoclonal AbUse: CD20+ B-cell neoplasmsMOA: Monoclonal Ab against CD20; induces ADCC and CDC mediated cancer cell deathAdverse Effects: Hypogammaglobulinemia, viral reactivation (HBV, PML)

35
Q

All-trans-retinoic acid (ATRA)

A

Class: Differing Agents Use: APLMOA: Binds RARα nuclear receptor to promote differentiation of promyelocytes; promotes degradation of PML-RARα fusion protein - a stimulus for abnormal growthAdverse Effects: Teratogenic*metabolized by CYP26A1

36
Q

Arsenic trioxide (As2O3)

A

Class: Differing Agents Use: APL, MDSMOA: Inhibits thioredoxin reuctase enhancing oxidative stress promoting apoptosis; degrades PML-RARα fusion protein

37
Q

Lenalidomide

A

Class: Differing Agents Use: CLL, multiple myelomaMOA: Antiangiogenic. Thalidomide derivative Adverse Effects: May inhibit effects of Rituximab by down-regulating CD20*main treatment for 5q- myelodysplastic syndrome

38
Q

Dexamethasone

A

Class: Hormonal Antineoplastic Therapy - Adrenocorticosteroids Use: Leukemias and LymphomasMOA: Suppress proliferation of leukocytes and lymphocytes; require functional hormone receptor on tumor cellsAdverse Effects: Fluid retention, diabetes

39
Q

Prednisone

A

Class: Hormonal Antineoplastic Therapy - Adrenocorticosteroids Use: Leukemias and LymphomasMOA: Suppress proliferation of leukocytes and lymphocytes; require functional hormone receptor on tumor cells Adverse Effects: Fluid retention, diabetes

40
Q

Etoposide

A

Class: Epipodophyllotoxin (CCS G2 phase)Use: NHLMOA: Podophyllotoxin inhibits Topoisomerase II causing double strand DNA breaks

41
Q

Vincristine

A

Class: Vinca Alkaloids (CCS M phase)Use: Leukemias, HL, NHLMOA: Inhibits tubulin polymerization, disrupting mitotic spindle formation, causing metaphase arrestAdverse Effects: Peripheral neuropathy (limits use to short duration)

42
Q

Vinblastine

A

Class: Vinca Alkaloids (CCS M phase) Use: HL, NHL, mycosis fungoides MOA: Inhibits tubulin polymerization, disrupting mitotic spindle formation, causing metaphase arrestAdverse Effects: Bone marrow suppression

43
Q

Bortezomib

A

Class: Proteasome Inhibitors Use: Multiple MyelomaMOA: Reversible inhibitor of the 26s proteasome. This prevents degradation of intracellular proteins, affecting multiple signaling cascades. Cancer cells depend on proteins regulated by the proteasome for proliferation, metastasis, and survivalAdverse Effects: Thrombocytopenia, fatigue, peripheral neuropathy, transient HTN during infusion

44
Q

Imatinib

A

Class: Signal Transduction Inhibitors Use: CML, Ph+ ALLMOA: Inhibits BCR-ABL tyrosine kinase blocking proliferation and inducing apoptosisAdverse Effects: Edema and fluid retention, hepatotoxicity

45
Q

Dasatinib

A

Class: Signal Transduction Inhibitors Use: Resistance to or poor tolerability of Imatinib in Leukemias and LymphomasMOA: receptor tyrosine kinase inhibitors, with broader spectrum of activity

46
Q

Nilotinib

A

Class: Signal Transduction Inhibitors Use: Broad spectrum Leukemias and Lymphomas. Use when poor tolerability to ImatinibMOA: Newer receptor tyrosine kinase inhibitors.

47
Q

Ibrutinib

A

Class: Signal Transduction Inhibitors Use: Waldenstrom’s Macroglobulinemia MOA: Forms a covalent bond with cysteine-481 in BTK. High BTK specificity. Blocks NF-κB*Metabolized by CYP3A4

48
Q

Idelalisib (Zydelig)

A

Class: Signal Transduction Inhibitors Use: Relapsed CLL, Relapsed follicular B-Cell non-Hodgkins lymphoma, Relapsed SLL (small lymphocytic lymphoma aka CLL but as a mass in lymph nodes)MOA: Potent inhibitor of PI3 kinase deltaAdverse Effects: potentially fatal hepatotoxicity, diarrhea/colitis, pneumonitis, intestinal perforation*Metabolized by aldehyde oxidase and CYP3A4 (strong inhibitor because it sits there a long time)

49
Q

Aminocaproic acid

A

Class: Drugs for Bleeding DisordersUse: Systemic or urinary hyperfibrinolysis (aplastic anemia). Bleeding following cardiac surgeryMOA: Inhibitor of fibrinolysis

50
Q

Protamine sulfate

A

Use: Drugs for Bleeding DisordersHeparin reversalNot useful for Fondaparinux

51
Q

Heparin (acidic) unfractionated (UFH)

A

Class: Anticoagulant Drugs Use: Prevention and Tx of thromboembolic disorders (DVT, PE, and acute MI). UFH okay during pregnancy. DOSE DEPENDENTMOA: UFH complexes w/ antithrombin III (among other proteins) and increases it’s protease inhibitor activity by 1000 fold to inhibit IIa, IXa, Xa, XIa, and XIIa and increase PTT 1.2-2.5x; LMWH has longer t1/2 (watch out in renal Dz) but mainly inhibits FXa (can monitor w/ Xa assay); immediate effectClearance is dose-dependent**Preferred during pregnancy, because it cannot cross the placentaAdverse Effects: Bleeding, allergic rxn, hypoaldosteronism, osteoporosis (long-term therapy)Heparin-induced thrombocytopenia (HIT):(type II bad) due to Ab against PF4; antidote is protamine sulfate (greatly decreased efficacy against LMWH). It binds to heparin (basic peptide)

52
Q

Enoxaparin (LMWH)

A

Class: Anticoagulant Drugs Use: Prevention and Tx of thromboembolic disorders (DVT, PE, and acute MI). UFH okay during pregnancy. MOA: UFH complexes w/ antithrombin III (among other proteins) and increases it’s protease inhibitor activity by 1000 fold to inhibit II, IXa, Xa, XIa, and XIIa and increase PTT 1.2-2.5x; LMWH has longer t1/2 (watch out in renal Dz) but mainly inhibits FXa (can monitor w/ Xa assay); immediate effectAdverse Effects: Bleeding, allergic rxn, hypoaldosteronism, osteoporosis (long-term therapy)Heparin-induced thrombocytopenia (HIT):(type II bad) due to Ab against PF4; antidote is protamine sulfate (greatly decreased efficacy against LMWH). It binds to heparin (basic peptide)

53
Q

Dalteparin (LMWH)

A

Class: Anticoagulant Drugs Use: Prevention and Tx of thromboembolic disorders (DVT, PE, and acute MI). UFH okay during pregnancy. MOA: UFH complexes w/ antithrombin III (among other proteins) and increases it’s protease inhibitor activity by 1000 fold to inhibit II, IXa, Xa, XIa, and XIIa and increase PTT 1.2-2.5x; LMWH has longer t1/2 (watch out in renal Dz) but mainly inhibits FXa (can monitor w/ Xa assay); immediate effectAdverse Effects: Bleeding, allergic rxn, hypoaldosteronism, osteoporosis (long-term therapy)Heparin-induced thrombocytopenia (HIT):(type II bad) due to Ab against PF4; antidote is protamine sulfate (greatly decreased efficacy against LMWH). It binds to heparin (basic peptide)

54
Q

Tinzaparin (LMWH)

A

Class: Anticoagulant Drugs Use: Prevention and Tx of thromboembolic disorders (DVT, PE, and acute MI). UFH okay during pregnancy. MOA: UFH complexes w/ antithrombin III (among other proteins) and increases it’s protease inhibitor activity by 1000 fold to inhibit II, IXa, Xa, XIa, and XIIa and increase PTT 1.2-2.5x; LMWH has longer t1/2 (watch out in renal Dz) but mainly inhibits FXa (can monitor w/ Xa assay); immediate effectAdverse Effects: Bleeding, allergic rxn, hypoaldosteronism, osteoporosis (long-term therapy)Heparin-induced thrombocytopenia (HIT):(type II bad) due to Ab against PF4; antidote is protamine sulfate (greatly decreased efficacy against LMWH). It binds to heparin (basic peptide)

55
Q

Lepirudin

A

Class: Anticoagulant Drugs - Direct thrombin inhibitor Use: Anticoagulation in pts. w/ HITMOA: Reversibly binds to thrombin, inhibiting it’s activity; does not require antithrombin III *Yeast derived *can’t be used in pts. w/ end-stage renal dz

56
Q

Fondaparinux

A

Class: Anticoagulant Drugs Use: Prevention and Tx of thromboembolic disorders (DVT, PE, and acute MI). UFH okay during pregnancy. DOSE DEPENDENTMOA: Synthetic pentasaccharide that works similar to heparin; selective inhibition of FXa; has no activity against thrombinAdverse Effects: Dosed 1x daily

57
Q

Hirudin

A

Class: Anticoagulant Drugs - Direct thrombin inhibitor Use: Specific thrombin inhibitor from leeches MOA: Reversibly binds to thrombin, inhibiting it’s activity; does not require antithrombin III

58
Q

Desirudin

A

Class: Anticoagulant Drugs - Direct thrombin inhibitor MOA: Reversibly binds to thrombin, inhibiting it’s activity; does not require antithrombin III

59
Q

Bivalirudin

A

Class: Anticoagulant Drugs - Direct thrombin inhibitor MOA: Reversibly binds to thrombin, inhibiting it’s activity; does not require antithrombin III

60
Q

Argatroban

A

Class: Anticoagulant Drugs - Direct thrombin inhibitor Use: Anticoagulation in pts. w/ HIT and can be used in pts. w/ end stage renal Dz (as opposed to lepirudin)MOA: Reversibly binds to thrombin, inhibiting it’s activity; does not require antithrombin III

61
Q

Warfarin

A

Class: Anticoagulant Drugs Use: Prevention and Tx of thromboembolic disorders, clot prophylaxis in pt. w/ chronic Afib. Low Vd. MOA: Competitive inhibition of vitamin K epoxide reductase complex 1 (VKORC1) depleting functional vitamin K dependent clotting factors, FII, VII, IX, X, C, S; delayed effect (1-3 days) Puts INR at ~2-3. Long t1/2Adverse Effects: Bleeding/hemorrhage (give FFP); contraindicated in pregnancy due to hemorrhage and bone problems, can see warfarin induced skin necrosis (esp. in pt.s w/ Protein C deficiency) liver Dz, pt. w/ bleeding disorder; numerous drug-drug interactionsAntidote: Vitamin K and fresh frozen plasma

62
Q

Dabigatran (PRADAXA)

A

Class: Anticoagulant Drugs - Direct thrombin inhibitor Use: Afib, DVT, PEMOA: Reversibly binds to thrombin, inhibiting it’s activity; does not require antithrombin III Adverse Effects: Similar efficacy, less adverse effects than Warfarin. First oral thrombin inhibitor. PRAXBIND: reversal agent

63
Q

Apixaban (Eliquis)

A

Class: Anticoagulant Drugs Use: Afib, DVT, PEMOA: Direct inhibitor of Xa*problem with the Xa inhibitors is that theres is no reversal agent

64
Q

Rivaroxaban (Xarelto)

A

Class: Anticoagulant Drugs Use: Afib, DVT, PEMOA: Direct inhibitor of XaAdverse Effects: BleedingMetabolized (inactivated) by CYP3A4/5Improved efficacy over LMWHproblem with the Xa inhibitors is that theres is no reversal agent

65
Q

Aspirin

A

Class: Antiplatelet Drugs - COX InhibitorUse: Prophylaxis of MI and TIAMOA: Irreversibly acetylates COX-1 in platelets inhibiting TXA2 synthesis (vasoconstriction). This reduces the platelet aggregation and degranulation for the life of the plateletAdverse Effects: High dose inhibit COX-2 in endothelial cells, inhibiting PGI2 production, which inhibits platelets and causes vasodilation

66
Q

Ticlopidine

A

Class: Antiplatelet Drugs - ADP antagonistUse: Angina when intolerant/unresponsive to aspirinMOA: Irreversibly inhibits ADP receptors (P2-Y12) on platelets preventing GPIIb-IIIa activation. This reduces platelet aggregation for the life of the plateletAdverse Effects: Severe bone marrow toxicity (rare), increases LFTs. TTP

67
Q

Clopidogrel

A

Class: Antiplatelet Drugs - ADP antagonistUse: Angina when intolerant/unresponsive to aspirinMOA: Irreversibly inhibits ADP receptors (P2-Y12) on platelets preventing GPIIb-IIIa activation. This reduces platelet aggregation for the life of the plateletAdverse Effects: Inhibits CYP2C19, so has many drug-drug interactions (Warfarin); Lower coincidence of adverse effects compared to Ticlopidine

68
Q

Abciximab

A

Class: Antiplatelet Drugs - GPIIb-IIIa inhibitorUse: High risk pts. undergoing coronary angioplasty, atherectomy, or stents MOA: Monoclonal Ab against GPIIb-IIIa blocking fibrinogen binding Adverse Effects: Bleeding. Very expensive.

69
Q

Tirofiban

A

Class: Antiplatelet Drugs - GPIIb-IIIa inhibitorUse: High risk pts. undergoing coronary angioplasty, atherectomy, or stents Route: Very short t1/2. constant infusion.MOA: Bind GPIIb-IIIa receptors blocking fibrinogen binding

70
Q

Eptifibatide

A

Class: Antiplatelet Drugs - GPIIIb-IIIa inhibitorUse: High risk pts. undergoing coronary angioplasty, atherectomy, or stents MOA: Binds GpIIbIIIa receptors on platelets and blocks binding of fibrinogen

71
Q

Dipyridamole

A

Class: Antiplatelet Drugs - Phosphodiesterase inhibitorUse: Reduces risk of embolism due to prosthetic heart valve in combo w/ WarfarinMOA: Prevents degradation of cAMP to AMP by reversible inhibition of PDE increasing intracellular cAMP. This prevent platelet activation and aggregation and causes vasodilation. Also a coronary vasodilator

72
Q

Cilostazol

A

Class: Antiplatelet Drugs - Phosphodiesterase inhibitor Use: Intermittent claudication and peripheral vascular diseaseMOA: Inhibits cAMP phosphodiesterase III (which degrades cAMP) leading to increased cAMP in cells. cAMP needs to be low to activate platelets

73
Q

Anagrelide

A

Class: Antiplatelet Drugs Use: Essential Thrombocytosis, Thrombocytosis secondary to myeloproliderative disorders (PV, CML) to reducxe the risk of stroke and MIMOA: Reduces elevated platelet counts in pts. w/ essential thrombocytosis. Inhibits megakaryocyte development in the late postmitotic stage.

74
Q

Streptokinase

A

Class: Thrombolytic Drugs Use: Acute peripheral arterial thrombosis and emboli including MI, unclogging catheters and shunts; Thombolytic therapy should be followed by anticoagulant therapy w/ Heparin and the Warfarin to counteract whatever is causing the prothrombotic state in the pt. MOA: Forms a 1:1 complex with plasminogen, exposing it’s active site, which causes it to convert additional plasminogen molecules to plasminAdverse Effects: Hypersensitivity/allergic rxns, ASA plus streptokinase may be as effective as t-Pa. RULE OUT INTRACRANIAL BLEEDING (CT SCAN)

75
Q

Urokinase

A

Class: Thrombolytic Drugs Use: Acute peripheral arterial thrombosis and emboli including MI, unclogging catheters and shunts; Thombolytic therapy should be followed by anticoagulant therapy w/ Heparin and the Warfarin to counteract whatever is causing the prothrombotic state in the pt. MOA: Fetal kidney derived serine protease that cleaves plasminogen to plasminAdverse Effects: Systemic lytic state because does not discriminate b/w fibrin-bound and circulating plasminogen. Less hypersensitivity reactions than streptokinase b/c urokinase is human derived vs. bacterial.

76
Q

Alteplase

A

Class: Thrombolytic Drugs Use: Acute peripheral arterial thrombosis and emboli including MI, unclogging catheters and shunts; Thombolytic therapy should be followed by anticoagulant therapy w/ Heparin and the Warfarin to counteract whatever is causing the prothrombotic state in the pt. MOA: Recombinant t-Pa; binds fibrin in a clot and converts entrapped plasminogen to plasmin

77
Q

Tenecteplase

A

Class: Thrombolytic Drugs Use: Acute peripheral arterial thrombosis and emboli including MI, unclogging catheters and shunts; Thombolytic therapy should be followed by anticoagulant therapy w/ Heparin and the Warfarin to counteract whatever is causing the prothrombotic state in the pt. MOA: Modified human t-Pa; binds fibrin in a clot and converts entrapped plasminogen to plasmin. Increased resistance to plasminogen activator inhibitor-1

78
Q

Vismodegib (Erivedge)

A

Use: Disseminated advanced form of Basal Cell CarcinomaMOA: Hedgehog pathway smoothened inhibitors

79
Q

Vemurafenib

A

Use: Metastatic MelanomaMOA: Blocks BRAF (V600E mutation) pathway

80
Q

Iron Dextran

A

Class: Iron Supplements Use: Anemia in pts. who cannot tolerate oral Fe, pts. w/ gastric or small bowel resections, and. pts. w/ IBD involving the proximal small intestineRoute: ParenteralAdverse Effects of Toxicity: Headache, fever, arthralgias, N&V, back pain, flushing, urticaria, bronchospasm, anaphylaxis (rare), death*Small doses should be give first to check for signs if immediate hypersensitivity *Rarely used

81
Q

Procarbazine

A

Class: Alkylating Agents (CCNS)Use: HL and NHLMOA: Inhibits DNA, RNA, and protein synthesis; causes strand breaksAdverse Effect: Higher potential for secondary malignancy than other alkylating agents

82
Q

Cholestyramine

A

Inhibits oral absorption of warfarin. So, can be used to diminish warfarin response, however also affects Vit K absorption.

83
Q

Reteplase

A

Class: Thrombolytic Drugs Use: Acute peripheral arterial thrombosis and emboli including MI, unclogging catheters and shunts; Thombolytic therapy should be followed by anticoagulant therapy w/ Heparin and the Warfarin to counteract whatever is causing the prothrombotic state in the pt. MOA: Recombinant t-Pa; binds fibrin in a clot and converts entrapped plasminogen to plasmin*longer t1/2 than Alteplase

Blood and Lymphoid (47 decks)

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