Heme/Onc meds/class and indications/contraindications

Question 1

Iron

Answer 1

Hematinic
+ Iron deficiency
- Hemochromatosis
-Hemolytic Anemia

Question 2

Deferoxamine (Desferal)

Answer 2

Iron Chelator
+excess serum iron levels (but not hemochromatosis)
-renal insuficiency

Question 3

Cyanacobalamin (Vitamin B12)

Answer 3

B-vitamin
+B12 deficiency (megaloblastic anemia, peripheral neuropathy, depression, CVD)
-minimal

Question 4

Folic Acid (Folactin-800)

Answer 4

Hematopoetic agents-Nutritional

+Folate deficiency (megaloblastic anemia, prevent neural tube defects, CVD)

Question 5

Epoeitin alfa (Epogen)

Answer 5

Erythrocytisis stimulator

+low RBC 2nd ESRD, HIV, antineoplastic therapy, RA

Question 6

Filgrastim (Neupogen)

Answer 6

Myeloid Growth Factors

+neutropenia 2nd chemotherapy

Question 7

Heparin, Unfractionated-UFH

High molecular weight heparin

Answer 7

Indirect Thrombin Inhibitors

+Thrombotic disorders

• prior HIT
• prio severe throbocytopenia
• intracranial bleeding

Question 8

Enoxeprin (Levenox)

Low-molecular weight Heparin-LMWH

Answer 8

Anticoagulant

+Acute cornonary Syndrome

• active major bleeding
• hypersensitivity to pork
• thrombocytopenia

Question 9

Protamine Sulfate

Answer 9

Indirect Thrombin Inhibitors

+excess heparin impact

Question 10

Fondaparinux (Asistra)

Answer 10

Indirect Thrombin Inhibitors

+DVT prophylaxis
+Acute PE tx
+DVT w/o PE tx

-CrCl

Question 11

Dabigatran (Pradaxa)

Answer 11

Direct Thrombin Inhibitor (oral)

+prevent stroke in non-valvular a-fib

-severe renal disease (CrCl

Question 12

Rivaroxaban (Xarelto)

Answer 12

Direct faxtor Xa inhibitor

+reduce risk of clots with knee and hip replacement
+non-valvular atrial fibrillation
+DVT/PE

• Active pathological bleeding
• hypersensitivity
• mod-severe liver disease (child-pugh class B or C)
• coagulopathy

Question 13

Warfarin (Coumadin)

Answer 13

Coumarin Anticoagulant

+px tx of venous thrombosis

• active bleeding
• hx skin necrosis

Question 14

Vitamin K, Phytonadine (mephyton)

Answer 14

Warfarin Anticoagulant Inhibitor

+Vit K deficiency
+antidote for excess Warfarin

Question 15

Streptokinase (Streptase)

Answer 15

Fibriniolytic, Thrombolytic

+severe DVT, PE, AMI, occluded AV cannulas

• active bleeding
• Hx CVA
• Uncontrolled HTN

Question 16

Alteplase (Activase, tPA)

Answer 16

Tissue plasminogen activator, thrombolytic

+Thrombus lysis in AMI, PE

-active bleeding

Question 17

Aminocaproic Acid

Answer 17

Fibrinolysis Inhibitor

+States of excess fibrinolysis

• DIC (what is this?)
• upper GI bleeding

Question 18

Aspirin (ASA, Ascriptin)

Answer 18

Anti-platlet aggregation drug (Cox-1, Cox-2 inhibitor)

+2nd prophylaxis s/p MI, CVA

-Nasal polyposis + brochospasm

Question 19

Clopidogrel (Plavix)

Answer 19

Platelet ADP inhibitor

+2nd prophylaxis MI, CVA, PAD

-active bleeding

Question 20

Abciximab (ReoPro)

Answer 20

Glycoprotein IIB/IIIA inhibitor

+coronary artery stent surgery
+Acute coronary syndrome

-bleeding

Question 21

Dipyridamole (persantine)

Dipyridamole ER 200mg + ASA 25mg (Aggrenox)

Answer 21

Phosphodiesterase inhibitor (& vascular dilator)

+Post-op 1ry prophylaxis s/p prosthetic heart valves
+prophylaxis s/p CVA

-Severe hepatic or renal impairment

Question 22

Cilostazol (Pletal)

Answer 22

Phosphodiesterase Inhibitor

+Peripheral arterial ds (intermittent claudication)

• thrombocytopenia
• heart failure
• severe renal or hepatic impairment