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Modules > Drugs Heme Onc > Flashcards

Drugs Heme Onc Flashcards

1
Q

Direct thrombin inhibitors

A

Agatroban, bivalirubin, dagatran

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2
Q

How do you reverse warfarin

A

vit K, fresh frozen plasma

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3
Q

How do you reverse heparin

A

protamine sulfate (if HMW heparin, acute duration so can just discontinue) for LMWH and fondaparinaux

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4
Q

Thrombolytics

A

”-plase” Alteplase (tPa) Reteplase (rPa) Streptokinase tenecteplase (TNK-tPA)

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5
Q

Aspirin

A

irreversible COX1 COX2 inhibitor

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6
Q

ADP receptor inhibitors

A

Clopidogrel, prasugrel, ticagrelor (reversible), ticlopidine

Inhibits ADP receptors and thus blocks appearance of GpIIb/IIIa on cell surface

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7
Q

Cilostazol, dipyridamole

A

phosphodiesterase III inhibitor, increase cAMP and inhibits platelet aggregation; vasodilator

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8
Q

GpIIb/IIIa inhibitors

A

Abciximab, eptifibatide, tirofiban Prevents platelet aggregation

Abciximab made from monoclonal Fab fragments

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9
Q

Clinical use direct Xa inhibitors

A

DVT PE prophylaxis (rivaroxaban)

Stroke prophylaxis in patients with afib

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10
Q

Toxicity of direct Xa inhibitors

A

bleeding (nor reversal agent)

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11
Q

Use of direct thrombin inhibitors

A

Alternative to heparin for patients with HIT

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12
Q

Use of thrombolytics

A

Early MI, early ischemic stroke, direct thrombolysis in massive PE

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13
Q

Toxicity of thrombolytics

A

bleeding

contradidicated in patients with active bleeds, history of intracranial bleeding, recent surgery, known bleeding diathesis, or severe HT

Treat toxicity with aminocaproic acid

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14
Q

Toxicity of aspirin

A

Gastric ulcers, tinnitus,

chronic uses can lead to acute renal failure, interstitial nephritis, and upper GI bleeds

Reyes syndrome in children with flu

Overdose causes hyperventilation and resp alk –> mixed metabolic acidosis resp alk

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15
Q

Uses of ADP receptor blockers

A

Acute coronary syndrome, coronary stenting , decreases incidence or recurrance of thrombolytic stroke

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16
Q

Uses for phosphodiesterase inhibitors

A

intermittent claudication, cornonary vasodilation, prevent of stroke or TIA (combined with aspiring), angina prophylaxis

17
Q

Phosphodiesterase inhibitor toxicity

A

nausea, headache, facial flushing, hypotension, abdominal pain

18
Q

GP IIb/IIIa inhibitors toxicity

A

bleeding, thrombocytopenia

19
Q

Methotrexate (MTX)

A

Folic acid analog that competitively inhibits dihydrofolate reductase (DHF –> THF)

THF needs to be methylated to donate to convert dUMP to dTMP

20
Q

Clinical uses for MTX

A

ALL, lymphomas, choriocarcinoma, sarcoma

Ectopic pregnancy, medical abortion, rheumatoid arthritis, psoriasis, IBD, vasculitis

21
Q

Toxicity for MTX

A

Myelosuppression reversible with leucovorin rescue

Hepatoxicity

Mucositis (mouth ulcers)

Pumonary fibrosis

22
Q

5-flurouracil

A

pyrimadine analog that is bioactivated to 5F-dUMP which complexes with folic acid and as a complex inhibits thymidylate synthase which converts dUMP to dTMP

23
Q

5-FU clinical uses

A

colon cancer, pancreatic cancer, carcinoma (topical)

24
Q

Toxicity of 5-FU

A

myelosuppression not reversible with luecovorin (folinic acid)

25
Q

What is the action of prednisone, prednisolone?

A

glucocorticoid that binds to an intracytosolic receptor and increases transcription of a variety of factors

26
Q

What is prednisone used in?

A

Most common glucocorticoid used in cancer treatment

CLL, non hodgkins lymphoma

Autoimmune diseases

27
Q

What is prednisone’s toxicity?

A

Cushing like symptoms, weight gain, cattaracts, acne, osteoporosis, HT, muscle breakdown, peptic ulcers, hyperglycemia, psychosis

Story; “Man complains of 15 lb weight gain and facial acne, has a BP of 142/90 and his glucose is 220”

28
Q

What are the first line drugs for treatment of lead poisoning?

A

Dimercaprol and EDTA

Succimer for children

29
Q

Which ADP receptor blocker is reversible?

A

Ticagrelor

All the rest are irreversible

30
Q

ADP receptor inhibitor tox

A

Neutropenia (ticlopidine), TTP

Modules (19 decks)

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