Pharm Flashcards
Heparin
MOA: activates Antithrombin III inhibiting the formation of Thrombin
Use: immediate anticoagulation for PE, stroke, coronary syndrome, MI, DVT, used in pregnancy
Toxicity: HIT, osteoporosis
Antidote for Heparin overdose
Protamine Sulfate
Enoxaparin (and other LMWH)
MOA: activates Antithrombin III (however this complex preferentially inhibits Xa rather than thrombin)
Use: immediate anticoagulation for PE, stroke, coronary syndrome, MI, DVT, used in pregnancy
Describe HIT
Heparin binds platelet factor IV causing an Ab production that overactivates platelets and depletes them
Lepirudin, Bilavirudin
MOA: direct thrombin inhibitors
Use: anything that you use heparin for when there is a risk of HIT
Warfarin
MOA: inhibits Vit. K epoxide reductaase
Use: post STEMI, DVT, prophylaxis for clotting (slow acting so heparin usually given first)
Tox: bleeding, Teratogenic, tissue necrosis
Streptokinase, Urokinase, tPA, APSAC
MOA: activates plasminogen to plasmin
Use: early MI, ischemic stroke
Tox: bleeding
Antidote for thrombolytics
Aminocaproic Acid
Aspirin
MOA: COX1 and 2 inhibitor, prevents formation of TxA2
Use: anti-pyretic, analgesic, anti-inflammatory
Tox: GI ulcer, bleeding, hyperventilation, Reye Syndrome, tinnitus
Clopidogrel, Ticlopidine
MOA: ADP blockers preventing platelet aggregation
Use: acute coronary syndrome, stenting, stroke
Tox: neutropenia
Cilostazol, Dipyridamole
MOA: Phosphodiesterase III inhibitor, increases cAMP and inhibits platelet aggregation
Use: claudication, coronary vasodilation, TIAs
Tox: nausea, HA, flushing, hypotension
Abciximab
MOA: mab that binds GpIIb/IIIa receptor on platelets preventing aggregation
Use: vasospasm, coronary angioplasty
Tox: bleeding thrombocytopenia
Methotrexate
MOA: folic acid analog inhibiting dihydrofolate reductase, so no protein synthesis
Use: cancers, ectopic pregnancy, RA, psoriasis
Tox: myelosuppression, fatty liver, teratogenic
5-Fluorouracil
MOA: pyrimidine analog that inhibits thymidylate synthase, so no protein synthesis
Use: colon cancer, solid tumors
Tox: myelosuppression, photosensitivity
6-Mercaptopurine
MOA: purine analog, decreases purine synthesis, activated by HGPRT
Use: leukemias, lymphomas
Tox: myelosuppression, not to be used with allopurinol
Doxorubicin
MOA: generates free radicals, intercalates DNA
Use: HL and myelomas
Tox: cardiotoxicity, myelosuppression, alopecia
Bleomycin
MOA: free radical formation which breaks DNA strands
Use: testicular cancer, HL
Tox: pulmonary fibrosis
Etoposide
MOA: inhibits topoisomerase II
Use: small cell lung cancer, prostate, and testicular cancer
Tox: myelosuppression, GI upset
Cyclophosphamide
MOA: alkylate DNA, needs liver to activate
Use: NHL, breast and ovarian carcinoma
Tox: hemorrhagic cystitis
Antidote for hemorrhagic cystitis caused by cyclophosphamide
Mesna
Bisulfan
MOA: alkylates DNA
Use: CML, ablate bone marrow before transplant
Tox: pulmonary fibrosis
Vincristine
MOA: alkaloid that inhibits microtubule polymerization
Use: HL, Wilms tumor, ALL
Tox: neurotoxicity, ileus
Vinblastine
MOA: alkaloid that inhibits microtubule polymerization
Use: HL, Wilms tumor, ALL
Tox: bone marrow suppression
Paclitaxel
MOA: keep microtubules stabilized in the M phase (stuck)
Use: ovarian and breast cancer
Tox: myelosuppression
