Hemorrhagic drugs

Question 1

Fligastrim

Answer 1

• stimulates proliferation in myeloid progenitor cells
• activates PMNs
• mobilizes hematopoetic stem cells to circulation

Question 2

Oprelvekin

Answer 2

• Stimulates myeloid, lymphoid and megarkaryocyte progenitor cells w/ growth factors
• used for thrombocytopenia

Question 3

Heparin

Answer 3

• mixture sulfated mucopolysaccharides
• enhances AT-III
  
  • inhibits activated clotting factors: thrombin IIa and Xa
• uses:
  
  • acute anticoagulant, initial treatment of thrombosis and thromboemoblic disease
  • ONLY PREVENTS FORMATION OF THROMBUS
  • does not lyse
• Toxicities
  
  • bleeding & thombocytopenia
    
    • can neautralize with *protamine sulfate *

Question 4

Enoxaprin

Answer 4

• from generic heparin
• less toxicities
  
  • bleeding and thrombocytopenia
• better heparin

Question 5

Warfarin

Answer 5

• oral anticoagulant vit K antagonst
  
  • reduce clotthing factors II, VII, IX, X
• use as chronic prevention
  
  • administer with heparin
• **Toxicity **
  
  • bleeding
  • vit k antagonist
  • can cross placenta

Question 6

Aspirin

Answer 6

• anti platelet drug
• ONLY IRREVERSIBLE NSAID binding to COX1
• prevents thrombus and re-thrombosis
• Toxicity
  
  • GI ulcer
  • renal damage
  • bleeding tendencies

Question 7

Clopridogrel

Ticlopidine

Answer 7

• inhibits ADP synthesis
  
  • P2Y12 receptor antagonist
• “prodrug” must be activated by liver

Question 8

Abciximab

Answer 8

• Fab frag antibody against IIb/IIIa receptor
  
  • glycoprotein IIb/IIIa once activated will anchor platelets and exposed matrix
• **Toxicity **
  
  • bleeding tendencies

Question 9

Tissue Plasminogen Activator (t-PA)

Answer 9

• serine protease binding to fibrin
• systemic plasmin activation
• Toxicity
  
  • bleeding tendicies

Question 10

vitamin K

Answer 10

• confers growth factor II, VII, IX, X
• requires bile salt for absorption
• use
  
  • anticoagulant toxicity
  • vit k deficiency
  • hemorrhagic disease
• types
  
  • K1 phytonadione (foods)
    
    • oral and parental use
    • IV for anaphylaxis
  • K2 menaquinon (GI bacteria)

Question 11

Aminocaproic Acid

Answer 11

• fibrinolytic inhibitor
• blocks lysine binding site on fibrin (similar to lysine)
• use
  
  • bleeding from fibrinolytic therapy
  • hemophiliacs

Question 12

Desmopressin acetate

Answer 12

• increase factor VIII in hemophilia A / Van Willbrand disease

Question 13

Protamine Sulfate

Answer 13

• for heparin OD
  
  • binds to heparin = neautralize

Question 14

Erythropoetin

Answer 14

• made in kidney response to hypoxia
  
  • prepared by recomb. technology
• for chronic anemia from reduced EPO production in CRF
• Toxicities:
  
  • hypertension and thrombosis