Hematology Pharmacodynamic

Question 1

Direct Thrombin (2a) inhibitors Effect on Pt/PTT and Names

Answer 1

Rudins and Argatroban/Gatran Hirudin, Bivalurdin, Lepirudin, Desirudin Argatroban, inogatran, melagatran, dabigatran. PT+PTT cannot be restored with FFP

Question 2

Warfarin MOA

Answer 2

Vit K sythesis antagonism; affects; 10, 9, 7, 2

Question 3

Garlic Effect on Blood Coag

Answer 3

Inhbiit plt aggregation and inc fibrinolysis

Question 4

Ginseng effect on Coag

Answer 4

Prolong Pt; PTT

Question 5

Gingko effect on Coag

Answer 5

Inhibit platlet activating factor

Question 6

Parental Iron Dangerous AE/Benefit

Answer 6

Anaphylaxsis/safer than blood transfusion.

Question 7

EPO AE

Answer 7

Thrombosis.

Question 8

Platelet Infusion Compositions; storage and transfusion note

Answer 8

Plasma 200 ml with minimal rbc and wbc and abod, transfuse and store at room temp, to avoid lost of activity, higher due to manufactor)

Question 9

PLT infusion complications

Answer 9

HLA, RH senstization, Hemolysis (esp in Infants), Higher Chance than rbc of Trali, Sepsis, Febrile Rxn, Allergic Rxn

Question 10

Vincristine AE

Answer 10

Immunosupression, Peripheral Neuropathy (esp with charcot marie tooth), Urinary retention, paralytic ileus, SIADH

Question 11

Cyclophosamide MOA, AE

Answer 11

Liver Metabolizes leading to alkylating agent prevening DNA replication; may cause hemorrhagic cystitis if not prevented with Mesna (antioxi)

Question 12

Doxorubicin MOA, AE

Answer 12

Prevent DNA replication, Cardiotoxic -> cardiomyopathy, peak dose dependent esp with Trastuznumab (HER-2)

Question 13

6MC (mercaptopurine) MOA and AE

Answer 13

Prevent Guanine for DNA syn, Myelosuppressive, May be affected by xanthine oxidase (affected by allopurinol)

Question 14

Stored Blood Decreased in what Substance related to Oxygen

Answer 14

2,3 DPG to 0 within 2-3 wk. blood return back to 1/2 in 7hr and then full in 48hr

Question 15

Thrombophlebitits Med offenders and tx

Answer 15

Etomidate due to (propylene glycol esp in high dose/slow injection); Increased in small vein, without lidocaine; Tx: NSAID + compression stockings

Question 16

Dextran and hetastarch AE

Answer 16

Coagulopathy due to affecting PLT and F8.

Question 17

reduction of graft va host

Answer 17

leukocyte irradiation

Question 18

reducing IGA deficiency rxn

Answer 18

leukocyte washing

Question 19

,reducing inc in potassium for hd pt

Answer 19

leukocyte washing

Question 20

TRIM effect and how to limit it

Answer 20

from donor cells like nk and t cells, due to release of histamine, eosinophilic actinic protein, protein x that leads ta proinflammatory state, leukocyte reduction leading to Inc recurrence of cancer, infection and inc mortality. To reduce this. may be beneficial in survival of renal allograft (pre cyclosporine era); Con: may be responsible for early mortality after cardiac surgery (leukoreducted blood reduces this)

Question 21

MOA of and compare of LMWH vs Heparin

Answer 21

MOA: binds to antithrombin3, increases antithrombin affinity to .Lvd selectively inhibits activated factor x but less thrombin inhibition. Less associated with HIT vs Hep

Question 22

Warfarin Reversal Indication Preoperative

Answer 22

Urgent Surgery; INR 1.9-5 FFP/PCC + 1-3 mg of IV K; 5-9: PCC/FFP + 2-5 mg/IV Vit K

Question 23

EPO Indication and Onset:

Answer 23

Anemia 2/2 Chemo; ESRD. 15 days (10 days before surgery; surgery day and 4 days post surgery or per week x 3 prior to surgery)

Question 24

Jehovah Acceptance
Red Cells, Whites, Plasma, PLT

Answer 24