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Finals > Hematology drugs > Flashcards

Hematology drugs Flashcards

1
Q

which class does aspirin belong to?

A

it is an irreversible cyclooxyrgenase (COX) inhibitor

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2
Q

How does aspirin affect blood clotting?

A

platelets: production of TXA2 ( thromboxane) - promotes platelet aggregation
can only be produced by new platelets in 7-10 days.

endothelial cell: Production of PGI2 ( prostacyclin) - inhibits platelet aggregation can be restored by synthesis of the new COX enzyme in 3-4 hours.

prevent aggregation of platelets by inhibiting the synthesis of prostacyclin and thromboxane A2.

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3
Q

clinical use of aspirin?

A

Stroke/ AMI

to reduce mortality for post AMI patients.

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4
Q

Adverse effects of aspirin

A

Upper GI bleed- gastric ulcers.

low dose aspirin is associated with 2-4 fold increase in UGI events.

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5
Q

contraindication of aspirin

A

caution for patients with platelet and bleeding disorders.

HIGH

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6
Q

contraindication of aspirin

A

caution for patients with platelet and bleeding disorders.

HIGH dose of aspirin can inhibit production of prostacyclin ( natural activation inhibitor and vasodilator) production hence becoming less efficacious.

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7
Q

Name some antiplatelets

A

clopidogrel and aspirin

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8
Q

what is clopidogrel’s pharm class?

A

ADP receptor ( P2Y12) inhibitor

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9
Q

MOA of clopidogrel (ADP receptor P2Y12 inhibitor)

A

Clopidogrel active metabolite irreversibly bind to ADP binding site on the P2Y12 receptor
- delayed onset of action for 8 hours and interindividual variability dye to CYP2C19 mediated metabolism

PREVENT aggregation of platelets by blocking the adenosine diphosphate receptors on plasma membrane of platelets causing the membrane not able to receive chemical signals required for aggregation.

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10
Q

clinical use of clopidogrel

A

ACS ( MI and unstable angina)

in combination with aspirin, it is currently the most commonly used P2Y12 receptor inhibitor in ACS and PCI patients.

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11
Q

Adverse effects of clopidogrel

A

Hemorrhage, bleeding,
dyspnea
dizziness
headache

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12
Q

Name some fibrinolytic and their pharm class

A

Alteplase
reteplase
tenecteplase
pharm class: rtPA- recombinant tissue plasminogen activator.

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13
Q

MOA of rtPA

A

preferentially bind to clot associated fibrin
have longer half life- allow for convenient bolus dosing

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14
Q

clinical use of rtPA

A

used after acute ischemic stroke, MI, or PE.

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15
Q

Adverse effects of rtPA

A

Haemorrhage

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16
Q

Contraindications of rtPA

A

haemorrhage, ischemic stroke within the last 3 months and or active bleeding.

17
Q

Antidote for rtPA

A

anti- fribrinolytic agent
:tranexamic acid

18
Q

MOA for the anti fribrinolytic agent

A

they compete for the lysine binding sites on plasminogen and plasma thus blowing their interaction with fibrin. reverse states of excessive fibrinolysis

19
Q

Name some anticoagulants:

A

warfarin dabigatran heparin

20
Q

What is the antidote for warfarin

A

Vitamin K

21
Q

what is the antidote for dabigatran

A

idarucizumab

22
Q

what is the antidote for heparin

A

protamine sulphate

23
Q

pharm class of warfarin?

A

vitamin K antagonist

24
Q

which coagulation factor that warfarin affect?

A

II, VII, IX, X
2, 6 9, 10

25
Q

MOA of warfarin

A

inhibits the synthesis of vitamin K dependent clotting factor, leading to these clotting factors- II VII, IX X

26
Q

clinical indication of warfarin

A

thromboembolic complications and embolic complications from AF or cardiac valve replacement.
MI, stroke.

27
Q

Drug - drug and drug- food interaction

A

barbiturates
rifampicin
disulfiram
fluconazole
metronidazole
no vitamin k rich food or supplements.

28
Q

adverse effects of warfarin

A

bleeding
cutaneous necrosis and infarction o f breast buttons and extremities. - reduced blood supply to adipose tissue. (3-5 days after treatment)

29
Q

contraindication for warfarin

A

pregnancy- teratogen can result in fatal warfarin syndrome

30
Q

Name a non vitamin k antagonist

A

dabigatran, it blocks the active site for thrombin factor IIa.
2a

31
Q

What is the antidote for dabigatran

A

Idarucizumab

32
Q

clinical use of dabigatran

A

AF

33
Q

MOA of heparin

A

the heparin antithrombin III complex inactivates
- thrombin (IIa) and factors IXa, Xa, XIa,
- thrombin is needed for the conversion of fibrinogen to fibrin.
- without fibrin, clot formation Is impeded.

34
Q

clinical use of heparin

A

DVT and PE

oral vit K antagonist such as warfarin is started concurrently for at least 5 days to allow warfarin to achieve its full effect .

LMWH : longer half life and higher bioavailability

OKAY FOR PREGNANT PPL.

Finals (10 decks)

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