Heme Drugs II Flashcards
aspirin class
cyclooxygenase inhibitor
abciximab, eptifibatide, tirofiban class
glycoprotein Iib/IIIa inhibitors
clopidogrel, prasurgel ticlopine class
ADP receptor inhibitor
agratroban, bivalirudin, dabigatran class
direct thrombin inhibitors
fondaparinux, rivaroxaban, apixaban class
Factor 10 inhibitors
streptokinase class
fibrinolytic
TPA class
serine protease
romiplostin, eltrombopag, erythropoetin, filgrastim class
factors (stimulate differation of committed progenitor cells by receptor dimerization, kinase activity; some stimulate stem cells to commit upon a particular line)
folic acid mechanism
Functions to transfer one-carbon fragments between molecules
B12 (cobalamin) mechanism
Required for demethlyation of methyl-THF, converstion of methylmalonyl CoA to succinyl CoA, and methylation of myelin in folate metabolism
aspirin mechanism
Irreversibly acetylates and blocks action of cyclooxygenase (COX1), which is an enzyme in arachidonic acid TXA2 pathway, on platelets
abciximab, eptifibatide, tirofiban mechanism
Reversibly inhibits binding of activated platelet GP IIb/IIIa receptors to fibrinogen and VWF, inhibiting platelet from sticking together
clopidogrel, prasurgel ticlopine mechanism
After conversion to active metabolites in the liver, inhibits ADP-mediated activation of platelets by irreversibly binding to P2Y12
dipyramole mechanism
May act by increasing cAMP levels, either by inhibiting phosphodiesterase or blocking cellular uptake and destruction of endogenous adenosine
agratroban, bivalirudin, dabigatran mechanism
Inhibit circulating and clot-bound thrombin activity independently of antithrombin
fondaparinux mechanism
Complexes with antithrombin to inactivate factor Xa
streptokinase mechanism
Produces extra plasmin to break down fibrin in clots
TPA mechanism
Catalyzes conversion of plasminogen to plasmin
thrombopoietin, romiplostin, eltrombopag mechansim
platelet production!
Stimulates differentiation and maturation of megakaryocytes to platelets; Stimulates pluripotent stem cells to divide and commit to megakaryocytic development
erythropoietin mechanism
Cytokine produced in kidney and necessary for erythroid proliferation and differentiation; bind to erythropoietin receptor leading to dimerization of that receptor leading to activation of tyrosine kinase activity
absence of erythropoietin
apoptosis of committed erythroid cells and anemia of renal failure
filgrastim mechanism
Stimulates differentiation/maturation of neutrophils; Puts pluripotent stem cells into cycle and commits to neutrophil development
Supplementation required in poor diet (alcoholism and extreme poverty); increased folate requirement (pregnancy, severe hemolytic anemia, severe psoriasis); drug therapy (certain abx, chemotherapy); malabsorption (tropical sprue, celiac disease)
folic acid
required in gastric failure (pernicious anemia, total gastrectomy); ilial failure (Chrohn’s disease, ileal resection, tropical sprue, Celiac disease); competing organisms (bacterial overgrowth/ blind loop, diphyllobothrium latum)
B12
