Hematologic Agents

Question 1

[hematopoietic growth factors]

treatment of iron deficiency anemia

Answer 1

ferrous sulfate

Question 2

[hematopoietic growth factors]

treatment of megaloblastic anemia, vitamin B12 deficiency

Answer 2

cyanocobalamin

Question 3

[hematopoietic growth factors]

treatment of megaloblastic anemia, prevention of neural tube defects (spina bifida)

Answer 3

folate/ folic acid

Question 4

[hematopoietic growth factors]

anemia in chronic kidney disease

Answer 4

erythropoeitin

Question 5

[hematopoietic growth factors]

treatment of neutropenia and agranulocytosis

Answer 5

filgrastim

Question 6

[hematopoietic growth factors]

treatment of chemotherapy induced thrombocytopenia

Answer 6

oprelvekin

Question 7

Iron content of some oral iron proparations (% w/w)

Answer 7

Fe carbonate/carbonyl iron - 100%
Fe fumarate - 33%
Fe sulfate, dried - 30%
Fe sulfate, hydrated - 20%
Ferric ammonium sulfate - 18%
Fe gluconate - 12%

Question 8

[anticoagulants]
acute treatment of DVT, PE and AMI
SE: bleeding, thrombocytopenia, monitor with PTT

Answer 8

heparin

Question 9

antidote to heparin-induced bleeding

Answer 9

protamine sulfate

Question 10

low molecular weight heparin, less risk of thrombocytopenia, does not need monitoring

Answer 10

enoxaparin

Question 11

treatment of heparin-induced thrombocytopenia, percutaneous coronary angioplasty (with aspirin)

Answer 11

lepirudin

dabigatram

Question 12

a heparinoid consisting of 80% heparin and 20% dermatan sulfate

Answer 12

sulodexide

Question 13

chronic anticoagulation

SE: bleeding, skin necrosis, many drug interactions

Answer 13

warfarin

inhibit X, IX, VII, II, protein C, S

Question 14

antidote to warfarin (immediate reversal)

Answer 14

FFP (fast)

Question 15

antidote to warfarin (reversal over time)

Answer 15

vitamin K (slow)

Question 16

what laboratory tests will you request to assess the extrinsic and intrinsic coagulation pathways?

Answer 16

"PweT ni PhiTT"
PiTT
PTT for intrinsic pathway
PeT
PT for extrinsic pathway

Question 17

in patients requiring anticoagulation, why is an overlap between heparin and warfarin usually done?

Answer 17

1. warfarin effect requires elimination of preformed clotting factors (8-60h)
2. to bypass the initial prothrombotic effect of warfarin (skin necrosis)

Question 18

[thrombolytic agents]
thrombolysis in AMI, ischemic CVD and PE
SE: bleeding

Answer 18

alteplase

Question 19

[thrombolytic agents]

bacteria-derived thrombolytic, decreased effect on subsequent uses due to antibody formation

Answer 19

streptokinase

Question 20

[thrombolytic agents]

antidote to thrombolytic overdose

Answer 20

aminocaproic acid

Question 21

[antiplatelet drugs]
irreversible COX inhibitor, instant prevention of arterial thrombosis
SE: tinnitus, hypersensitivity, Reye syndrome

Answer 21

aspirin

Question 22

[antiplatelet drugs]

ADP inhibitor, additive effects with aspirin

Answer 22

clopidogrel, ticlodipine

Question 23

[antiplatelet drugs]

glycoprotein IIb-IIIa inhibitor

Answer 23

“ATE”
abciximab
tirofiban
eptifibatide

Question 24

[antiplatelet drugs]

phosphodiesterase inhibitor, cardiac stress testing

Answer 24

dipyridamole

cilostazol

Question 25

what is the triad of aspirin hypersensitivity?

Answer 25

SAMTER TRIAD
asthma
aspirin hypersensitivity
nasal polyps

Question 26

what are the signs of ASA poisoning?

Answer 26

ASA poisoning "CHAFS"
coma
hyperventilation
acidosis (HAGMA)
fever
seizure

Question 27

what is the expected acid-base abnormality in salicylate poisoning?

Answer 27

respiratory alkalosis with HAGMA

Question 28

what is the difference between in presention of aspirin intoxication in children and adults?

Answer 28

ADULTS
-mixed acid-base disorder respiratory alkalosis with HAGMA

CHILDREN
-pure acid-base disorder HAGMA

Question 29

what is the difference between an inhibitor and an uncoupler of oxidative phosphorylation?

Answer 29

INHIBITORS: completely halt ETC

UNCOUPLERS: dissipate proton gradient without interrupting ETC

Question 30

A fibrinolytic that interacts with plasminogen to produce plasmin which breaks down fibrin

Answer 30

Streptokinase

Question 31

Direct factor XA inhibitor (all with XA except for Enoxaparin)

Answer 31

RivaroXAban

Question 32

Low molecular weight heparin (inhibits factor Xa, lesser inhibition on antithrombin)

Answer 32

Enoxaparin

Question 33

High molecular weight heparin (inhibits both factor XA and antithrombin)

Answer 33

Unfractionated heparin

Question 34

Is commonly used in patients with atrial fibrillation for prevention of thromboembolic events such as stroke

Answer 34

Coumarin