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First Aid Heme-Onc Chapter > Hematology Pharm > Flashcards

Hematology Pharm Flashcards

1
Q

MoA of Heparin

A

Lowers the ACTIVITY of thrombin and factor Xa. Short half-life.

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2
Q

Used during pregnancy (does not cross placenta)?

Heparin or Warfarin?

A

Heparin

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3
Q

What do you have to monitor when on Heparin?

A

PTT

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4
Q

ADR of Heparin

A

Bleeding, thrombocytopenia (HIT), osteoporosis, drug-drug interactions

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5
Q

Why does Protamine Sulfate work as a Heparin Antidote?

A

positively charged molecule that binds negatively charged heparin

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6
Q

name the LMW Heparins

A

enoxaparin, dalteparin and fondaparinux

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7
Q

Difference between LMWH and Heparin? (5)

A

Low-molecular-weight heparins act more on factor Xa
have better bioavailability and 2–4 times longer half-life
can be administered subcutaneously
without laboratory monitoring
Not easily reversible.

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8
Q

Pathogenesis of HIT

A

development of IgG antibodies against heparin- bound platelet factor 4 (PF4). Antibody-heparin-PF4 complex activates platelets -> thrombosis and thrombocytopenia.

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9
Q

Name the Direct Thrombin inhibitors

A

Bivalirudin, argatroban, dabigatran

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10
Q

What hematological drug is related to hirudin, the anticoagulant used by leeches?

A

Bivalirudin

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11
Q

MoA of Bivalirudin and the GATRs

A

Directly inhibits activity of free and clot-associated thrombin.

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12
Q

What drugs do you use in place of heparin during HIT?

A

Direct Thrombin Inhibitors

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13
Q

ADR of Direct Thrombin Inhibitors?

A

bleeding with no reversal agent

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14
Q

What can you attempt to use to prevent ADR of Direct Thrombin Inhibitors?

A

Activated Prothrombin Complex Concentrates (PCC)

and Tranexamic Acid (fibrinolytic)

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15
Q

Warfarin inhibits what process?

A

gamma carboxylation of Vitamin K Dependent Clotting factors

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16
Q

What are the Vit K dependent clotting factors?

A

II, VII, IX, X, Protein C and S

17
Q

Warfarin effects what pathway and prolongs what test?

A

Extrinsic Pathway and increases PT

18
Q

What polymorphism affects metabolism of Warfarin?

A

VKORC1

Vit K Epoxide Reductase Complex

19
Q

Pathogenesis of early, transient hypercoaguability of Warfarin?

A

Proteins C and S have shorter half-lives than clotting factors II, VII, IX, and X, resulting in early transient hypercoagulability with warfarin use.

20
Q

Pathogenesis of warfarin-related skin necrosis?

A

Skin/ tissue necrosis within rst few days of large doses believed to be due to small vessel microthromboses.

21
Q

Explain Heparin Bridging

A

heparin frequently used when starting warfarin. Heparin’s activation of antithrombin enables anticoagulation during initial, transient hypercoagulable state caused by warfarin. Initial heparin therapy reduces risk of recurrent venous thromboembolism and skin/tissue necrosis.

22
Q

MoA of Apixaban, rivaroxaban and ADR

A

Bind to and directly inhibit factor Xa.

Bleeding

23
Q

rivaroxaban clinical use

A

Treatment and prophylaxis for DVT

24
Q

MoA of Alteplase (tPA), reteplase (rPA), streptokinase, tenecteplase (TNK-tPA)

A

Directly or indirectly aid conversion of plasminogen to plasmin, which cleaves thrombin and brin
clots.

25
Q

Labs you must monitor when on a Thrombolytic?

A

PT, PTT, no change in platelet count.

26
Q

Name the Thrombolytics?

A

Alteplase (tPA), reteplase (rPA), streptokinase, tenecteplase (TNK-tPA)

27
Q

Name the ADP receptor inhibitors

A

Clopidogrel, prasugrel, ticagrelor, ticlopidine.

28
Q

What ADP receptor inhibitor is reversible?

A

ticagrelor

29
Q

MoA of ADP receptor inhibitors

A

Inhibit platelet aggregation by irreversibly blocking ADP receptors. Prevent expression of glycoproteins IIb/IIIa on platelet surface.

30
Q

Ticlopidine has what ADR?

A

neutropenia

31
Q

ADR of ADP receptor inhibitors

A

TTP may be seen

32
Q

Name the Phosphodiesterase III inhibitor

A

Cilostazol, dipyridamole

33
Q

MoA of Cilostazol, dipyridamole

A

increases cAMP in platelets, resulting in inhibition of platelet aggregation; vasodilators.

34
Q

Cilostazol, dipyridamole prevent stroke or TIAs when combined with what drug?

A

Aspirin

35
Q

Name the Glycoprotein IIb/IIIa inhibitors

A

Abciximab, eptifibatide, tirofiban.

36
Q

MoA of Abciximab, eptifibatide, tirofiban.

A

Bind to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation. Abciximab is made from monoclonal antibody Fab fragments.

37
Q

What drugs are used for percutaneous transluminal coronary angioplasty?

A

Glycoprotein IIb/IIIa inhibitors

38
Q

ADR of Glycoprotein IIb/IIIa inhibitors

A

Bleeding, Thrombocytopenia

First Aid Heme-Onc Chapter (8 decks)

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