May 21 wk8-F Flashcards
What drugs are used to maintain a sinus rhythm in patients with paroxysmal atrial fibrillation?
Class III antiarrhythmics
Amiodarone, Sotalol, Dofetilide
What are the glycoproteins on platelets and what do they do?
GP-Ib: binds to vWF that has been exposed by damaged endothelium and activates the platelet to release ADP and TXA-2 and the platelet undergoes a conformational change that exposes GP-IIb/IIIa
GP-IIb/IIIa: binds fibrinogen that links between platelets and allow formation of the platelet plug as part of primary hemostasis
What drug binds to GP IIb/IIIa on platelets to prevent formation of the platelet plug by fibrinogen cross-linking?
Abciximab
Used to treat unstable angina and ACS especially in patients undergoing percutaneous interventions
What are two molecules released by activated platelets and what drugs inhibit this release?
ADP–Clopidogrel inhibits action by blocking P2Y12 on ADP receptors
TXA-2–inhibited by Aspirin
What is Glanzmann Thrombasthenia?
AR disorder caused by defective or deficient GP-IIb/IIIa on platelets
Typically presents in childhood with mucocutaneous bleeding
What are Argatroban and Dabigatran?
Direct thrombin inhibitors
Heparin MOA
Potentiates effects of ATIII activity leading to inactivation of thrombin and factor Xa
Features of serotonin syndrome
Abnormal mental status
Autonomic hyperactivity
Muscle rigidity
Hyperreflexia
Which of the lipid lowering drugs has the greatest effect on Triglycerides?
Fibrates
These up-regulate LPL which breaks down TG’s into FFA’s that can be taken up by cells and stored in adipocytes
Which of the lipid lowering drugs inhibits lipolysis in adipocytes and VLDL synthesis in the liver? What is a common SE?
Niacin (Vit B3)
Red, flushed face that can be decreased by NSAID’s or long-term use
What is Leucovorin?
Folinic Acid
Used to prevent negative effects of Methotrexate
How are allopurinol, xanthine oxidase and 6-mercaptopurine related?
6-mercaptopurine is an immune suppressant used for ALL and Crohn’s and UC. It is broken down by Xanthine Oxidase which is inhibited by Allopurinol as a treatment of gout to reduce the production of uric acid
Therefore, if a patient is on Allopurinol, they should not be given 6-Mercaptopurine.
Cyclophosphamide
Chemotherapy drug
Mustard type drug that alkylates Guanine in DNA to cause intra and interstrand cross-links that prevent DNA replication
Requires activation by P450
When is MESNA administered?
With Cyclophosphamide in treating cancer. It helps to prevent the hemorrhagic cystitis caused by Cyclophosphamide.
What is Filgrastim?
Drug
Granulocyte Colony Stimulating Factor analog used to stimulate granulocytes in patients with neutropenia
What are granulocytes?
Also known as PMN’s
These include Neutrophils, Eosinophils, Basophils, Mast cells
What are Monocytes?
Mononuclear granular cells that differentiate into macrophages and dendritic cells when they migrate into the tissues
Where does Mannitol exert its effects?
Proximal tubule and descending loop of Henle
What are some SE’s of thiazide diuretics?
Hyperuricemia and Hypercalcemia
What are some SE’s of Spironolactone?
Gynecomastia and antiandrogen effects
Acetazolamide MOA
Carbonic Anhydrase inhibitor in the proximal tubule of the kidney used as a diuretic
Amiloride MOA
Diuretic, blocks Na channels in the in the collecting duct
Spares K+
Ethacrynic acid
Loop diuretic
Which of the anti-diuretics increases the reabsorption of urea?
Vasopressin (ADH)
