Hematology drugs (not including cancer drugs) Flashcards
heparin moa
cofactor for the activation of antithrombin; decreases thrombin and factor Xa;
heparin use
immediately anticoag for PE, acute coronary syndrome, MI, DVT; used during pregnancy (doesn’t cross placenta)
heparin toxicity
bleeding, heparin induced thrombocytopenia, osteoporosis, drug-drug interactions
heparin antidote
protamine sulfate
heparin induced thrombocytopenia
development of IgG against heparin bound to PF4; antibody-heparin-PF4 complex activates platelets –> thrombosis and thrombocytopenia
argatroban, bivalirudin moa
derivatives of hirudin the anticoagulant used by leeches; directly inhibits thrombin; used for anticoagulation in patients with HIT
warfarin moa
interferes with normal synthesis and gamma-carboxylation of Vit. K-dependent clotting factors II, VII, IX, X, C, S by inhibiting eopxide reductase
warfarin toxicity
bleeding, teratogenic, skin/tissue necrosis, drug-drug interactions
warfarin reversal
vit. K; if urgent-FFP
apixaban and rivaroxaban moa
direct factor Xa inhibitors
apixaban and rivaroxaban toxicity
bleeding; no specific reversal agent
thrombolytics
altepase (tPA), reteplase (rPA), tenecteplase (TNK-tPA)
thrombolytics adverse effect
bleeding; contraindicated in patients with active or Hx of intracranial bleeding
thrombolytic toxicity treatment
aminocaproic acid - inhibitor of fibrinolysis
aspirin moa
irreversibly inhibits COX-1 and COX-2 by covalent acetylation;
aspirin toxicity
gastric ulcers, tinnitus, chronic use can lead to ARF, interstitial nephritis, and upper GI bleeding; reye syndrome in children with viral infection
ADP receptor inhibitors
clopidogrel, ticlopidine, prasugrel, ticagrelor
ADP receptor blocker moa
inhibit platelet aggregation by irreversibly blocking ADP receptors; inhibit fibrinogen binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen
ADP receptor inhibitor toxicity
neutropenia; TTP/HUS may be seen
cilostaxol, dipyridamole moa
phophodiesterase III inhibitors; increase cAMP in platelets, thus inhibiting platelet aggregation; vasodilators
phosphodiesterase III inhibitors (cliostaxol and dipyridamole) adverse effects
nausea, HA, flushing, hypotension, abdominal pain
GP IIb/IIIa inhibitors
abciximab, eptifibatide, tirofiban