Drugs

Question 1

Aspirin

Answer 1

Irreversible inhibition of COX-1, in response to stimulation by thromboxane.

Question 2

Rivaroxaban/ Xarelto

Answer 2

Anticoagulant- Direct Factor 10a inhibitor.

Question 3

Clopidogrel

Answer 3

Antiplatelet- Irreversibly inhibit binding of ADP to PY12

Question 4

Unfractionated heparin

Answer 4

Anticoagulant- enhance inhibitory action of anti-thrombin (inhibits thrombin induced platelet aggregation).
Also inhibits Factor 10 a.

Question 5

Doxaparin

Answer 5

Bind antithrombin to inhibit Factor 10a, inhibition of thrombin is less than with UFH

Question 6

Warfarin

Answer 6

activate Vit K in hepatic microsomes, interferes with formation of Vit K dep clotting factors.

Question 7

Furosemide mech of action

Answer 7

Inhibit Na/K/2Cl cotransporters in the ascending loop of Henle.
Elites remain luminal and are lost in urine
Also causes venodilation (not understood)

Question 8

Furosemide mech of tolerance

Answer 8

After 1st dose, RAAS activated and response decreased

Long term tolerance caused by increased Na secondary to hypertrophied nephrons (secondary to increased aldosterone)

Question 9

Hydrochlorothiazide

Answer 9

Inhibits reabsorption of Na and Cl in early distal tubule (loop diuretics don’t work here).
Increase active secretion of K.

Question 10

Triamterene

Answer 10

Inhibits Na- proton exchanger

Late distal tubule

Question 11

Amiloride

Answer 11

Inhibits renal epithelial exchanger, lessen Na resorption in late distal and collecting tubules, helps retain Mg

Question 12

Spironolactone

Answer 12

Block mineralocorticoid receptor that binds aldosterone, cortisol, deoxycortisone
Late distal tubule to collecting ducts
Decrease extracellular markers of fibrosis
Decrease release of cardiac norepinephrine- may prevent arrhythmias
Vasodilator properties

Question 13

Vaptans

Answer 13

Collecting ducts-an aquaretic
Antagonize AVP-2 receptors to promote solute free H20 clearance to correct hyponatremia.
Inhibit Aquaporin 2

Question 14

Carbonic anhydrase inhibitors

Answer 14

Decrease secretion of H in proximal tubule

Increase loss of bicarb and sodium

Question 15

Dopamine

Answer 15

Indirect diuretic only during fluid retention- may involve dopamine agonists in renal tubular cells (antagonizes ADH)

Question 16

A1-adenosine blockers

Answer 16

As a diuretic: afferent arterial dilation , increases glomerular filtration rate, and enhance response to loop diuretics.

Question 17

Antidote for UFH overdose

Answer 17

Protamine sulfate

Question 18

Simvastatin

Answer 18

A statin- for cholesterol.

But, may also enhance endothelial function via action of BMP pathway

Question 19

Imitibifi

Answer 19

Platelet derived growth factor receptor antagonist