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mata drugs Flashcards

1
Q

vitamin K1

A

essential cofactor for g-carboxylation to produce II, VII, IX, X

reverse bleeding episode

SE: dyspnea, chest pain, death

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2
Q

Tranexamic Acid

A

fibrinolytic inhibitor

control heavy menses

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3
Q

Aminocaproic Acid

A

fibrinolytic inhibitor

reduce bleeding in hemophiliacs

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4
Q

fibrinolytic inhibitor MOA

A

competes for Lys binding site on fibrinogen and plasmin to block interaction

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5
Q

Dipyridamole

A

phosphodiesterase inhibitor

+warfarin to prevent thrombus on prosthetic heart valves

+aspirin to decrease risk of thrombotic diathesis

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6
Q

cilostazol

A

phosphodiesterase inhibitor

treat intermittent claudication

don’t give if CHF

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7
Q

phosphodiesterase inhibitor MOA

A

increase intracellular cAMP to decrease platelet aggregation

1) block adenosine uptake
2) inhibit platelet phosphodiesterase

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8
Q

Ticagelor

A

ADP inhibitor

equipotent

interacts w/P2Y12 ADP receptor

metabolized by CYP3A4

BBW: bleeding risk

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9
Q

Prasugrel

A

ADP inhibitor

greater P2Y ADP antagonism

metabolized by CYP3A4

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10
Q

Clopidogrel

A

ADP inhibitor

metabolized vy CYP2C19

poor metabolizers risk CV SE (screen for genotype)

BBW: diminished effectiveness in poor metabolizers

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11
Q

Ticlopidine

A

ADP inhibitor

delay in action

1) prescribe w/aspirin
2) give loading dose

BBW: life-threatening bleeding reactions (monitor WBC and platelets)

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12
Q

ADP Inhibitors MOA

A

covalently modify/inactivate P2Y ADP receptors

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13
Q

Tirofiban

A

platelet GPR blocker

small molecule inhibitor

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14
Q

Eptifibatide

A

platelet GPR blocker

small molecule inhibitor

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15
Q

Abciximab

A

platelet GPR blocker

monoclonal Ab

irreversibly binds

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16
Q

platelet GPR blocker MOA + SE

A

MOA: binds GP IIb/IIIa receptor and prevents interaction w/fibrinogen

SE: bleeding

17
Q

Aspirin

A

irreversibly binds COX

efficacy is not dose related

SE: GI bleeding, ulceration

rec: daily baby aspirin

18
Q

Streptokinase

A

combines w/plasminogen to create plasmin

SE: Ab production (allergies)

19
Q

Tenecteplase

A

tPA

mutated form

longer t1/2

20
Q

Reteplase

A

tPA

mutated form

faster onset of action
longer duration of action

21
Q

Alteplase

A

tPA

normal human

non-Ag

22
Q

tPA MOA + SE

A

MOA: binds fibrin, converts plasminogen to plasmin

SE: bleeding w/cerebral hemorrhage

can have Rx interactions

23
Q

Warfarin

A

inhibits epoxide reductase needed to regenerate vitamin K for cofactor synthesis (II, VII, IX, X)

delayed onset (18-24hrs)

CYP2C19 metabolism

narrow therapeutic range (individual dosing)

SE: bleeding, Rx interactions

can be reversed w/vitamin K or transfusion

resistance: VKORC1 gene

24
Q

Dicumarol

A

natural anticoagulant in spoiled clover

25
Q

Dabigatran

A

direct thrombin inhibitor

no monitoring
no dose adjustment
no Rx interactions
greater predictive PK and PD

26
Q

Argatroban

A

direct thrombin inhibitor

biliary excretion (safe for renal insufficiency)

27
Q

direct thrombin inhibitor MOA

A

binds active site of thrombin

28
Q

Desirudin

A

hirudin

modified form

29
Q

Bivalirudin

A

hirudin

modified form

inhibits platelet activation

30
Q

Lepirudin

A

hirudin

recombinant form

prolonged t1/2 if renal compromise (dose adjustment)

SE: bleeding, Ab (anaphylaxis)

no reversal agents

31
Q

hirudin MOA

A

irreversibly binds thrombin

monitor w/PTT

32
Q

Rivaroxaban

A

directly inhibits Xa

prevents DVT
reduces stroke risk

premature discontinuation: thrombotic event

33
Q

low MW heparin MOA + SE

A

MOA: binds ATIII to inhibit Xa

less bleeding
longer t1/2
no lab monitoring
less risk ITP

SE: renal failure

34
Q

Arixtra (Foundparinux)

A

binds Xa

35
Q

unfractionated heparin

A

MOA: binds ATIII to inhibit Xa and thrombin

works on preformed blood components (immediate effect)

+thrombolytics for revascularization

not IM: risk hematoma
not oral: susceptible to acid
doesn’t cross placental barrier

36
Q

heparin SE

A

HAT - heparin associated thrombocytopenia (type 1): direction interaction btwn heparin and platelets causes aggregation

HIT - heparin induced thrombocytopenia (type 2): IgG Ab against heparin/platelet complexes cause aggregation

SE: bleeding, hemorrhagic stroke

BL (2 decks)

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