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Hematology > Drugs for Week 5 and 6 > Flashcards

Drugs for Week 5 and 6 Flashcards

1
Q

Unfractioned Heparin: MOA + lab monitoring

A
  • binds to antithrombin to increase it’s activity in inactivating factors II, IX, X, XI, and XII.
  • Monitor PTT
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2
Q

Unfractioned Heparin + LMWH: Adverse Effect

- MOA of Adverse effect

A

Heparin Induced Thrombocytopenia: Decrease platelet count due to autoantibodies (IgG) to Platelet factor 4

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3
Q

LMWH: Specific name of drug + Difference with Heparin

A

Enoxaparin, inactivates Xa but less effective against thrombin itself.
- Usually no lab monitoring required.

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4
Q

Protamine MOA + Therapeutic Use.

A

Heparin/LMWH Reversal

  • Note: When administered alone = anticoagulant effect
  • Best Adjustment = tincture of time (don’t necessarily need protamine to reverse, just wait)
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5
Q

Direct Thrombin Inhibitor(s) = drug names + Therapeutic Use

A

Bilivarudin + Argatroban

- Used as an alternative anticoagulatnt for HIT patients.

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6
Q

Indirect Xa inhibitor = drug name + therapeutic use

A

Fondaparinux

- Used as an alternative anticoagulant for HIT patients

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7
Q

Treatment approach to DVT or PE

A

Warfarin + Anticoagulant (Enoxaparin or Fondaparinux, etc.) in the beginning, then take off Enoxaprin or Fondaparinux (heparin alternatives) when INR > 2.

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8
Q

Drug used for Immune Thrombocytopenia

A

IV Immune Globulin

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9
Q

IV IgG: Block Box Warning

A
  • Acute Renal Failure due to high sucrose content

- Allergic reaction in individuals with IgA deficiency

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10
Q

Desmopressin

- Therapeutic Use

A

Increases serum levels of vWF and Clotting Factor VIII

- Note: Does not work for Hem B, do not increase Factor VIII high enough is bleeding episodes are severe.

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11
Q

Desmopressin

- Adverse effects

A

Risk of decreasing serum osmolarity (due to hyponatremia) with adverse CNS reactions

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12
Q

First line treatment for Hemophilia A and B

A

Recombinant DNA clotting factor products = doesn’t have risk of transmission of infectious disease compared to plasma derived products

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13
Q

Factor Replacement Therapy: Management + cornerstone of home-based treatment

A
  • Comprehensive Hemophilia center

- self-infusion technique

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14
Q

Advantages of prophylactic treatment for Hemophilia A and B.

A
  • Eliminate bleeding episodes + prevent join deterioration: Especially if started early in life. q
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15
Q

Hemophilia A and B: Factor doses are weight based. What are the recommended treatment goals (target %)

A
  • Minor bleeding = 25-30%
  • Severe bleeding = > 50%
  • Surgical Procedure or Life Threatening = 75% to 100%
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16
Q

Best administrated strategy for Factor VIII and IX

A

Prophylactic treatment

17
Q

Common presenting symptom of Hemophilias + treatment

A 
Mucosal bleeding (nose and mouth)
- antifibrinolytic agents (esp aminocaproic acid and tranexamic acid)
18
Q

Alkylating agent: Specific drug name

A

Cyclophosphamide

19
Q

Cyclophosphamide: MOA

A

Cross-linking of DNA via alkylation of N7 guanine, which leads to eventual DNA strand breakage.

20
Q

Cyclophosamide: Main Adverse effect

A

Hemorrhagic Cystitis

21
Q

Cyclophosamide: pharmacokinetics + Therapeutic Use

A
  • Bioactivation by the liver

- Therapeutic Use: Solid Tumors, leukemia, lymphomas

22
Q

Chemoprotectant of cyclophosphamide: Specific drug name

A

Mesna

23
Q

Mesna: MOA + Therapeutic Use

A
  • Binds to toxic metabolite of cyclophosphamide, protecting bladder
  • Used as Adjuvant w/ alkylating agents
24
Q

G2 phase specific: Drug name

A

Bleomycin

25
Q

Bleomycin: MOA + Therapeutic Use

A
  • Induce Free radicals to break DNA strands

- Used in Hodgkin and Non-Hodgkin Lymphoma

26
Q

Bleomycin: Adverse Effects

A

Pulmonary Fibrosis and Minimal Myelosuppression (does this mean that it’s not really seen?)

27
Q

S Phase specific: Drug Name

A

Methotrexate

28
Q

Methotrexate: MOA + Therapeutic Use

A
  • Competitively inhibits DFHR (Dihydrofolate reductase)

- ALL and Lymphomas

29
Q

Methotrexate: Adverse Effect

A

Myelosuppression

30
Q

Rescue drug for Methotrexate toxicity

A

Leucovorin

31
Q

Leucovorin: Drug interaction

A

Enhance therapeutic and toxic effects of 5-FU (5-fluorouracil)

32
Q

Mitosis (M) Phase Specific: Drug Name

A

Vinicristine

33
Q

Vinicristine: MOA + Therapeutic Use

A
  • Inhibits tubulin polymerization, which disrupts assembly of microtubules = inhibits mitotic spindle formation
  • Versatile: Solid Tumors, Leukemias, Hodgkin’s and Non-Hodgkin’s Lymphoma
34
Q

Vinicristine: Adverse Effects

A

Peripheral Neuropathy (Main), myelosuppression, Nausea and Vomiting

35
Q

Drug(s) used for Hodgkin’s and Non Hodgkin’s Lymphoma

A

Vinicristine (Mitosis (M) phase specific) and Bleomycin (G2 phase specific)

Hematology (7 decks)

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