Hematology drugs (not including cancer drugs)

Question 1

heparin moa

Answer 1

cofactor for the activation of antithrombin; decreases thrombin and factor Xa;

Question 2

heparin use

Answer 2

immediately anticoag for PE, acute coronary syndrome, MI, DVT; used during pregnancy (doesn’t cross placenta)

Question 3

heparin toxicity

Answer 3

bleeding, heparin induced thrombocytopenia, osteoporosis, drug-drug interactions

Question 4

heparin antidote

Answer 4

protamine sulfate

Question 5

heparin induced thrombocytopenia

Answer 5

development of IgG against heparin bound to PF4; antibody-heparin-PF4 complex activates platelets –> thrombosis and thrombocytopenia

Question 6

argatroban, bivalirudin moa

Answer 6

derivatives of hirudin the anticoagulant used by leeches; directly inhibits thrombin; used for anticoagulation in patients with HIT

Question 7

warfarin moa

Answer 7

interferes with normal synthesis and gamma-carboxylation of Vit. K-dependent clotting factors II, VII, IX, X, C, S by inhibiting eopxide reductase

Question 8

warfarin toxicity

Answer 8

bleeding, teratogenic, skin/tissue necrosis, drug-drug interactions

Question 9

warfarin reversal

Answer 9

vit. K; if urgent-FFP

Question 10

apixaban and rivaroxaban moa

Answer 10

direct factor Xa inhibitors

Question 11

apixaban and rivaroxaban toxicity

Answer 11

bleeding; no specific reversal agent

Question 12

thrombolytics

Answer 12

altepase (tPA), reteplase (rPA), tenecteplase (TNK-tPA)

Question 13

thrombolytics adverse effect

Answer 13

bleeding; contraindicated in patients with active or Hx of intracranial bleeding

Question 14

thrombolytic toxicity treatment

Answer 14

aminocaproic acid - inhibitor of fibrinolysis

Question 15

aspirin moa

Answer 15

irreversibly inhibits COX-1 and COX-2 by covalent acetylation;

Question 16

aspirin toxicity

Answer 16

gastric ulcers, tinnitus, chronic use can lead to ARF, interstitial nephritis, and upper GI bleeding; reye syndrome in children with viral infection

Question 17

ADP receptor inhibitors

Answer 17

clopidogrel, ticlopidine, prasugrel, ticagrelor

Question 18

ADP receptor blocker moa

Answer 18

inhibit platelet aggregation by irreversibly blocking ADP receptors; inhibit fibrinogen binding by preventing glycoprotein IIb/IIIa from binding to fibrinogen

Question 19

ADP receptor inhibitor toxicity

Answer 19

neutropenia; TTP/HUS may be seen

Question 20

cilostaxol, dipyridamole moa

Answer 20

phophodiesterase III inhibitors; increase cAMP in platelets, thus inhibiting platelet aggregation; vasodilators

Question 21

phosphodiesterase III inhibitors (cliostaxol and dipyridamole) adverse effects

Answer 21

nausea, HA, flushing, hypotension, abdominal pain

Question 22

GP IIb/IIIa inhibitors

Answer 22

abciximab, eptifibatide, tirofiban