Drugs Used to Treat Diseases of the Blood Flashcards
HEMATOPOIETIC GROWTH FACTORS
Required for biosynthesis of heme and heme containing proteins – hemoglobin and myoglobin
USES:
IDA
iron supplementation
ORAL: Ferrous sulfate Ferrous carbonate Ferrous fumarate Ferrous gluconate
PARENTERAL:
Iron dextran
Iron sucrose
Sodium ferric gluconate complex
Acute Iron Intoxication
necrotizing gastroenteritis shock metabolic acidosis coma death
TREATMENT:
removal of unabsorbed tablets form gut
correction of acid base and electrolyte abnormalities
Deferoxamine
Chronic Iron Intoxication
TRIAD:
cirrhosis
DM
skin pigmentation
TREATMENT:
phlebotomy
Deferoxamine or Deferasirox
HEAVY METAL CHELATORS
chelates excess iron
USES:
acute iron poisoning
hemochromatosis
Deferoxamine
Deferasirox
Deferiprone
ERYTROPOIESIS STIMULATING AGENTS
EPO - produced in kidney
main stimulus:
hypoxia inducible factor 1
agonist of EPO receptors expressed by red cell progenitors
USES:
anemia especially associated with chronic renal failure
ERYTROPOIESIS STIMULATING AGENTS
Epoetin Alfa
Darbepoetin Alfa
Methoxy Polyethylene Glycol - Epoetin Beta
MYELOID GROWTH FACTORS
Bind receptors on myeloid progenitors and stimulates cell maturation and proliferation
USES:
neutropenia associated with chemotherapy
myelodysplasia
aplastic anemia
MYELOID GROWTH FACTORS
Filgrastim (G-CSF) Sargramostim (GM-CSF) Pegfilgrastim Plerixafor Lenograstin
MEGAKARYOCYTE GROWTH FACTOR
Recombinant form of an endogenous cytokine
Activates IL-11 cytokine
Oprevelkin (IL-11)
Thrombopoietin
Eltrombopag
Romiplastim
ANTIPLATELETS
Nonselective, irreversible COX 1 and 2 Inhibitor
USES:
prevention of arterial thrombosis (MI, TIA, CVD)
RF, Kawasaki disease, JRA
COX INHIBITOR
Aspirin (Acetylsalicylic acid, ASA)
Salsalate
Sodium salicylate
SE:
GI toxicity
Nephrotoxicity (AKI, and Interstitial nephritis)
associated with REYE syndrome in children
Mechanisms of Hemostasis
Vasoconstriction
Platelet Plug Formation
Formation of Clot via Blood Coagulation
Fibrous Organization
SAMTER TRIAD
Asthma
ASA sensitivity
Nasal polyps
ANTIPLATELETS
Inhibits platelet aggregation by interfering with GPIIb/IIIa binding to fibrinogen and other ligands
USES:
PCI - to prevent thrombosis
Adjunct to thrombolysis
ACS (unstable angina, NSTEMI)
prevents vessel restenosis, reinfarction and death
GPIIIB/IIIA INHIBITOR
Abciximab
Eptifibatide
Tirofiban
ANTIPLATELETS
Irreversibly inhibits binding of ADP to platelet receptors – reduce platelet aggregation
USES:
Prevention and treatment of arterial thrombosis (stroke, TIA, unstable angina)
Prevention of restenosis after PCI
ACS
Part of the ACS regimen – loading dose of 300 mg Clopidogrel can reduce platelet activity by 80% within 5 hrs of administration
ADP INHIBITOR
Clopidogrel
Ticlopidine
Prasugrel
Ticagrelor
SE: bleeding nausea dyspepsia hematologic (neutropenia, leukopenia)
Salicylate Toxicity
nausea
vomiting
tinnitus
ANTIPLATELETS
Inhibits phosphodiesterase III and increases cAMP
Inhibits platelet aggregation – vasodilation
USES:
prevention of thromboembolic complications of cardiac valve replacement
Cilostazol - refractory intermittent claudication in patients with PAD
PDE Inhibitor
Cilostazol
Dipyridamole (Persantine)
SE:
headache
palpitations
Aspirin Toxicity
Toxic dose: 100 mg/kg
Lethal dose: 500 mg/kg
HAGMA Dehydration Hyperthermia Collapse Coma
ANTICOAGULANTS
Binds to THROMBIN (IIa) active site and (-) its enzymatic action
USES:
heparin induced thrombocytopenia (HIT)
percutaneous coronary angioplasty (with aspirin)
DIRECT THROMBIN INHIBITORS
-RUDIN
Lepirudin Bivalirudin Desirudin Argatroban Dabigatran - PO
monitor effect with aPTT
Monoclonal antibody used for reversal of Dabigatran toxicity
Idarucizumab
ANTICOAGULANTS
Inhibit factor Xa in the final common pathway
USES:
Prevention of venous thromboembolism
Prevention of stroke in patients w/ atrial fibrillation
After hip or knee surgery
ORAL DIRECT FACTOR XA INHIBITOR
-Xa
Rivaroxaban
Apixaban
Betrixaban
Edoxaban
ANTICOAGULANTS
Activates antithrombin III
USES: DOC for anticoagulation during pregnancy Deep venous thrombosis PE MI Unstable angina Adjuvant to percutaneous coronary intervention (PCI) and thrombolytics Atrial fibrillation
INDIRECT THROMBIN INHIBITORS
Heparin
SE:
heparin induced thrombocytopenia (HIT)
OSTEOPOROSIS
monitor with aPTT
Antidote for Heparin
Protamine sulfate
A heparinoid consisting of 80% heparin and 20 % dermatan sulfate
Sulodexide
ANTICOAGULANTS
Binds and potentiates effects of antithrombin III on factor Xa (more selective)
Less effect on thrombin
Same use with heparin
INDIRECT THROMBIN INHIBITORS
Enoxaparin Fondaparinux Dalteparin Tinzaparin Danaparoid Nadroparin
ANTICOAGULANTS
Binds and potentiates effects of antithrombin III on factor Xa (more selective)
Less effect on thrombin
Same use with heparin
INDIRECT THROMBIN INHIBITORS
Enoxaparin Fondaparinux - SC Dalteparin Tinzaparin Danaparoid Nadroparin
SE:
less risk of thrombocytopenia
does NOT require aPTT monitoring
ANTICOAGULANTS
Inhibit vitamin K epoxide reductase (responsible for y-carboxylation of the vitamin K dependent clotting factors: II, VII, IX, X, Protein C and S)
USES:
chronic anticoagulation - DVT, atrial fibrillation, valve replacement
EXCEPT in pregnancy
ORAL ANTICOAGULANT
Warfarin
Dicumarol
Anisindione
SE:
warfarin induced skin necrosis
teratogen (bone defects, hemorrhages)
monitor effects with PT
