Pharm Block 2 (Heart and Lung) Flashcards

Question

Hydralazine

Answer 1

Vasodilator HTN Relaxes smooth muscle through NO release, use with beta blocker and diuretic to combat compensatory response, combine with organic nitrate for heart failure Adverse: palpitations, angina, headache, drug induced lupus Eliminated via acetylation so watch for slow acetylators

Answer 2

ACE inhibitor Inhibit Angiotensin I to AngII so decreased vasoconstriction and aldosterone, increase bradykinin (vasodilator) Disease state uses: in bilateral renal artery stenosis can get decreased GFR and in chronic renal disease they diminish proteinuria and stabilize renal funct Adverse: hypotension, cough, angioedema, hyperkalemia, decreased renal funct, fetal toxicity, skin rash, alteration in taste

Answer 3

Ang II receptor blocker Oral Adverse: hypotension, hyperkalemia, angioedema, cough, fetal toxicity

Answer 4

CNS antiHTN Alpha 2 ag (metabolite is) Adverse: sedation, decrease concentration, depression, hyperprolactinemia, dry mouth, ortho hypotension, hepatotoxicity, positive Coombs and hemolytic anemia

Answer 5

Vasodilator HTN Opens potassium channels so smooth muscle can't contract Used with beta blocker and loop diuretic to overcome compensatory measures Adverse: palpitations, angina, headache, hypertrichosis, pericardial effusion, ECG changes

Answer 6

ACE inhibitor Inhibit Angiotensin I to AngII so decreased vasoconstriction and aldosterone, increase bradykinin (vasodilator) Disease state uses: in bilateral renal artery stenosis can get decreased GFR and in chronic renal disease they diminish proteinuria and stabilize renal funct Adverse: hypotension, cough, angioedema, hyperkalemia, decreased renal funct, fetal toxicity, skin rash, alteration in taste

Answer 7

Arterial and Venous dilation Continuous IV (light sensitive) HTN emergency and severe heart failure, makes CN before eliminated via urine Stimulates guanylyl cyclase (increase cGMP) Adverse: hypotension, cyanide and thiocyanate toxicity

Answer 8

Blocks L-type Ca channels (relax smooth muscle and slows heartbeat through decreased conduction) Used for angina, HTN, arrythmias Adverse: dizziness, flushing, hypotension, constipation, peripheral edema, bradycardia, AV block, cardiac arrest, heart failure

Answer 9

Blocks L-type Ca channels (relax smooth muscle and slows heartbeat through decreased conduction) More vascular selective Used for angina, HTN, arrythmias Adverse: dizziness, flushing, hypotension, constipation, peripheral edema, bradycardia, AV block, cardiac arrest, heart failure

Answer 10

Relax smooth muscle (veins then arteries) through NO release, has antiplatelet effect Oral but significant 1rst pass effect Adverse: headache, ortho hypo, sildenafil (viagra) increases hypotension is in contraindicated Tolerance: develops if continuously exposed, don't know why but if interrupt therapy for 8-12 hours each day efficacy returns

Answer 11

Relax smooth muscle (veins then arteries) through NO release, has antiplatelet effect Oral Adverse: headache, ortho hypo, sildenafil (viagra) increases hypotension is in contraindicated Tolerance: develops if continuously exposed, don't know why but if interrupt therapy for 8-12 hours each day efficacy returns

Answer 12

Relax smooth muscle (veins then arteries) through NO release, has antiplatelet effect Sublingual-rapid onset (minutes) but short acting (20-30 mins), Oral but 1rst pass effect, transdermal patch Adverse: headache, ortho hypo, sildenafil (viagra) increases hypotension is in contraindicated Tolerance: develops if continuously exposed, don't know why but if interrupt therapy for 8-12 hours each day efficacy returns

Answer 13

Used for angina Mechanism not exactly known, maybe blocks late sodium channels in pacemaker cells Adverse: dizziness, headache, constipation, nausea, increased QT interval

Answer 14

Increases contractility by inhib Na/K ATPase pump (reduced if have hyperkalemia) Used for heart failure and Afib Adverse: arrhythmias at toxic levels, anorexia, nausea and vomiting, abnormal color vision, confusion Drug interactions: thiazide or loop lead to hypokalemia, quinidine/verapamil/amiodarone lead to increased digoxin conc, antacids/kao pectin/cholestyramine decreases digoxin conc

Answer 15

Used for digoxin toxicity to block it

Answer 16

Beta 1 agonist | Adverse: tachycardia, arrhythmias

Answer 17

Inhibs phosphodiesterase (type 3) so increase cAMP and increased contractility and vasodilation In heart failure: decrease pulmonary wedge pressure, decrease vascular resistance, increase CO Only IV and only for acute heart failure or severe exacerbation of chronic heart failure Adverse: arhythmias

Answer 18

Recombinant human B-type natriuretic peptide (increases cGMP which decreases resistance and so decreases afterload and increases CO) Decrease pulmonary wedge pressure and dyspnea Only IV Adverse: hypotension, renal damage

Answer 19

Anti-arrhythmic, used for conversion of paroxysmal supraventricular tachycardia to sinus, acts on adenosine receptor to slow AV conduction and increase refractoriness of AV IV, halflife is seconds Adverse: flushing, headache, hypotenstion, arrhythmias, heart block, asystole, dyspnea, drug interactions

Answer 20

``` Class III, all class actions, used for serious v arrhythmias and some supra ventricular, increase AP duration and QT, vasodilation Oral, IV Adverse: bradycardia, heart block, pulmonary fibrosis (potentially fatal), thyroidism, eye probs, hepatotoxic, peripheral neuropathy, torsades de pointes or worse arrhythmias, decreases elimination of other drugs (warfarin), hypotension (IV) ```

Answer 21

Class 1A, use with ventricular arrhythmias, Na and K blocker, anticholinergic effect and negative ionotropic Oral Adverse: Long QT, torsades de pointes, decreased contractility (cause heart failure)

Answer 22

Class III, K blocker, used for maintaining normal sinus with afib, also used to convert afib to normal rythm, increases AP duration, increases QT Oral Adverse: torsades de pointes

Answer 23

Class III, used for paroxysmal afib only when in sinus rythm Oral? Adverse: death with permanent afib, diarrhea, nausea, vomiting, long QT, hepatotoxic, drug interactions, don't give to preggers or nursing

Answer 24

Class 1C, supraventricular arrythmia, blocks Na and K, shortened AP in Purkinje but prolonged in ventricular cells Oral Adverse: blurred vision, makes fatal arrhythmias worse, DON'T use post MI

Answer 25

Class III, K block, used for rapid conversion of afib or flutter, increases AP duration, long QT IV Adverse: torsades de pointes

Answer 26

Class 1B, use post MI, preferentially effects ischemic tissue, treats acute ventricular arrhythmias IV Adverse: few, tremor, lightheadedness, seizures Mexiletine is Oral version

Answer 27

Class 1A, used for afib and flutter and v arrythmias, blocks Na and K, also has alpha blockade and antivagal effects Oral and IV, IV can causee hypotension Adverse: Long QT, torsades de pointes, diarrhea, headache/tinnitus, decreased platelets, hepatitus

Answer 28

Class 1A, Na and K channel blocker, slows conduction and increases AP duration. Oral, IV or IM, metabolite active also (NAPA) Adverse: Long QT, torsades de pointes, hypotension, slowed conduction, nausea, drug induced lupus, agranulocytosis

Answer 29

Class IC, prolong time to recurrence of symptomatic paroxysmal afib with no heart probs Adverse: exacerbate arrhythmias, DON'T use post MI

Answer 30

Class II, used for afib, decreases Ca and cAMP, increases PR, used also in Vtach and SVT Adverse: impotence, worse asthma, bradycardia, AV block, CHF

Answer 31

Class III, K blocker, used for serious ventricular arrhythmias an to maintain sinus rythm in symptomatic afib/flutter when in sinus rythm, long AP duration, long QT, slow AV conduction Oral torsades de pointes, worsening heart failure

Answer 32

Class IV, Ca block, used for certain supravent arrhythmias, decreases conduction and increases refractoriness of AV, vasodilates and decreases contractility Oral, IV Adverse: hypotension, decreased contractility, bradycard, AV block Diltiazem another example of class IV Blocks L-type Ca channels (relax smooth muscle and slows heartbeat through decreased conduction) Used for angina, HTN, arrythmias Adverse: dizziness, flushing, hypotension, constipation, peripheral edema, bradycardia, AV block, cardiac arrest, heart failure

Answer 33

Inhaled Long Acting Beta Agonist (LABA), used with ICS for long term control of moderate to severe asthma, must be used with an ICS, preferred only until asthma under control Adverse: muscle tremor, anxiety, palpitations, tachycardia, small decreases in potassium and magnesium. Tolerance can be seen.

Answer 34

Beta2 agonist, relaxes smooth muscle and inhibs inflammatory cells, used for relief of acute symptoms and prevention of exercise induced asthma (70% of effect in five minutes, max at 30 and duration of 4-6 hrs), not for daily use, excess use shows poor control with daily regements Adverse: tachycardia, elderly ppl with heart issues shouldn't use, tolerance develops

Answer 35

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 36

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 37

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 38

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 39

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 40

Inhaled Long Acting Beta Agonist (LABA), used with ICS for long term control of moderate to severe asthma, must be used with an ICS, preferred only until asthma under control Adverse: muscle tremor, anxiety, palpitations, tachycardia, small decreases in potassium and magnesium. Tolerance can be seen.

Answer 41

Inhaled Long Acting Beta Agonist (LABA), used with ICS for long term control of moderate to severe asthma, must be used with an ICS, preferred only until asthma under control Adverse: muscle tremor, anxiety, palpitations, tachycardia, small decreases in potassium and magnesium. Tolerance can be seen.

Answer 42

Inhaled anticholinergic, blocks muscarinic receptors, used to relieve bronchospasms in chronic bronchitis and COPD (with or without b2 ag), used in elderly asthma, allergic rhinorrhea, not approved for asthma but used off label when not well controlled Adverse: drying of the mouth, constipation, tachycardia, blurred vision, narrow angle glaucoma

Answer 43

Beta2 agonist, relaxes smooth muscle and inhibs inflammatory cells, used for relief of acute symptoms and prevention of exercise induced asthma (70% of effect in five minutes, max at 30 and duration of 4-6 hrs), not for daily use, excess use shows poor control with daily regements Adverse: tachycardia, elderly ppl with heart issues shouldn't use, tolerance develops

Answer 44

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 45

Oral Leukotriene modifiers, used instead of ICS for mild persistent asthma or with ICS for moderate persistent asthma (not preferred), blocks leukotriene receptor Adverse: Neurophyschotic episodes

Answer 46

Blocks IgE binding to mast and eosinophils and maybe other immune cells also, indicated for severe persistent asthma with positive skin test to allergens and whose symptoms are not controlled with ICS, LABA or LTRAs, used with ICS can help reduce ICS dose and rescue therapies, response can take weeks, dosing determined by IgE conc, expensive Adverse: Malignancies and anaphylaxis (immediately following injection, watch for 2hrs)

Answer 47

Systemic corticosteroids, for long term prevention (> 2 weeks) and suppression and control in severely uncontrolled asthma Adverse: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 48

Systemic corticosteroids, for long term prevention (> 2 weeks) and suppression and control in severely uncontrolled asthma Adverse: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppression

Answer 49

Phosphodiesterase inhibitor, used in exacerbation of COPD (with chronic bronchitis), not a bronchodilator (don't use for acute asthmatic bronchospasm) Adverse: diarrhea, weight decrease, nausea, headache, back pain, flu, insomnia, dizziness, decreased appetite, acetylated so watch slow ones

Answer 50

Inhaled Long Acting Beta Agonist (LABA), used with ICS for long term control of moderate to severe asthma, must be used with an ICS, preferred only until asthma under control Adverse: muscle tremor, anxiety, palpitations, tachycardia, small decreases in potassium and magnesium. Tolerance can be seen.

Answer 51

Oral, don't really know mechanism, may cause smooth muscle relax by inhib phosphodiesterase (so increased cAMP), also enhances histone deacetylase (so decreased inflammation), used for nocturnal asthma symptoms with ICS, not preferred but alternative to inhaled medicines when cost of adherence are an issue, not useful for acute, low dose more common now Adverse: narrow therapeutic range, too much causes anorexia, nausea, vomiting, nervousness, insomnia, tremor, aggravation of ulcer or reflux, hyperactivity in children, difficulty of urination in old men, seizures, arrythmias, acetylated so watch slow ones.

Answer 52

Inhaled anticholinergic, blocks muscarinic receptors, used to relieve bronchospasms in chronic bronchitis and COPD (with or without b2 ag), used in elderly asthma, allergic rhinorrhea, not approved for asthma but used off label when not well controlled, only has to be used once a day compared to Ipratronium Adverse: drying of the mouth, constipation, tachycardia, blurred vision, narrow angle glaucoma

Answer 53

Inhaled corticosteroid, anti-inflammatory (late phase), use terol more than 2 days a week or more than 2 awakenings a month Adverse: Thrush, hoarsness (dysphonia), reflex cough and bronchospasm, Large doses: can impair child growth, osteoporosis (old ladies), varicella, dermal thickening and bruising, hypothalamic-pituitary-adrenal axis suppresion

Answer 54

Oral Leukotriene modifiers, used instead of ICS for mild persistent asthma or with ICS for moderate persistent asthma (not preferred), blocks leukotriene receptor Adverse: Neurophyschotic episodes, gi disturbances, headache, increases half life of warfarin, don't take with food.

Answer 55

Oral Leukotriene modifiers, used instead of ICS for mild persistent asthma or with ICS for moderate persistent asthma (not preferred), inhibs lox (so no leukotrienes) Adverse: Liver toxicity, don't use when preggers, don't use with warfarin or theophyline

Answer 56

HMG-CoA Reductase Inhibs, decrease liver cholesterol synthesis which increases LDL receptors which increases LDL clearance, knocks the crap out of LDL at first, each subsequent dose increase only knocks it down a little, raises HDL 5-15%, lowers TG 7-30%, also antithrombic (platelet ag) and anti-inflammatory and plaque stabalizing, mostly used to lower LDL and when used with bile acid sequestrant really lowers LDL, lowers risk of CHD and regression of coronary atherosclerosis Adverse: myopathy, may increase HbA1C and fasting BG, impaired cognition, don't give to preggers or breastfeeding or liver disease

Answer 57

Bile acid sequestrant, positive charged anion exchange resin, increase bile acid excretion and decrease cholesterol absorption, lowers LDL 15-30%, increases HDL 0-8%, increases TG 0-30%, mostly used to lower LDL and reduce CHD risk Adverse: upper and lower GI (bloating, gas, constipation), can impair absorption of warfarin and digoxin and DAKE vits (can take them 1hr before or 4-6 hr after bile stuff), don't use with patients TG > 400 (but can use in conjunction with a TG lowering med)

Answer 58

Bile acid sequestrant,polymeric hydrophilic gel, increase bile acid excretion and decrease cholesterol absorption, lowers LDL 15-30%, increases HDL 0-8%, increases TG 0-30%, mostly used to lower LDL and reduce CHD risk Adverse: upper and lower GI (bloating, gas, constipation), can impair absorption of warfarin and digoxin and DAKE vits (can take them 1hr before or 4-6 hr after bile stuff), don't use with patients TG > 400 (but can use in conjunction with a TG lowering med)

Answer 59

Cholesterol Absorption blocker, stops Niemann-Pick C1-like 1 prot from absorbing cholesterol in the small intestine, lowers LDL, sort of raises HDL, lowers TG, even more if used with statin, used for Primary hypercholesterolemia, Homozygous Familial Hypercholesterolemia, Homozygous Sitosterolemia (rare disorder, used in adjunct with diet changes, only medicine approved) Adverse: Diarrhea, depression, myalgia, plasma conc higher in older people than expected, don't give to preggers and nursing unless desperate, fibrates can increases bio availability, cholystyremine can decrease absorption, don't use with liver disease

Answer 60

Activate PPAR alpha which binds to PPRE which promotes beta-oxidation of fatty acids in the liver and muscles which reduces TG synthesis, lowers TG and LDL and raises HDL (mostly TG and HDL), can use with statins but get no extra HDL bump, not really efficacious at lowering heart disease Adverse: myalgia, liver issues, gallstones, may prolong warfarin INR ,don't use with renal or hepatic dysfunction or gallbladder issue or for nursing mothers

Answer 61

Activate PPAR alpha which binds to PPRE which promotes beta-oxidation of fatty acids in the liver and muscles which reduces TG synthesis, lowers TG and LDL and raises HDL (mostly TG and HDL), can use with statins but get no extra HDL bump, not really efficacious at lowering heart disease Adverse: myalgia, liver issues, gallstones, may prolong warfarin INR ,don't use with renal or hepatic dysfunction or gallbladder issue or for nursing mothers

Answer 62

HMG-CoA Reductase Inhibs, decrease liver cholesterol synthesis which increases LDL receptors which increases LDL clearance, knocks the crap out of LDL at first, each subsequent dose increase only knocks it down a little, raises HDL 5-15%, lowers TG 7-30%, also antithrombic (platelet ag) and anti-inflammatory and plaque stabalizing, mostly used to lower LDL and when used with bile acid sequestrant really lowers LDL, lowers risk of CHD and regression of coronary atherosclerosis Adverse: myopathy, may increase HbA1C and fasting BG, impaired cognition, don't give to preggers or breastfeeding or liver disease

Answer 63

HMG-CoA Reductase Inhibs, decrease liver cholesterol synthesis which increases LDL receptors which increases LDL clearance, knocks the crap out of LDL at first, each subsequent dose increase only knocks it down a little, raises HDL 5-15%, lowers TG 7-30%, also antithrombic (platelet ag) and anti-inflammatory and plaque stabalizing, mostly used to lower LDL and when used with bile acid sequestrant really lowers LDL, lowers risk of CHD and regression of coronary atherosclerosis Adverse: myopathy, may increase HbA1C and fasting BG, impaired cognition, don't give to preggers or breastfeeding or liver disease, acetylated so watch for slow and interactions

Answer 64

Receptor all over adipocytes, when B3 attaches, it decreases cAMP which decreases lipolysis by deactivating protein kinase A which would normally activate HSL, VLDL and TG and LDL all decrease, HDL increases but we don't know why, also decreases lipoprot, use with statin for more Adverse: Flushing of the face and upper body (eventually toleranced, aspirin helps), may increase insulin resistance and induce hyperuricemia, hepatotoxic, dyspepsia, increased myopathy with statin, don't give to liver disease, active peptic ulcer, gout and watch diabetics

Answer 65

EPA and DHA, don't really know why they work, may reduce hepatic production of TG and VLDL, LDL increases but changes to less plaquey, raises HDL and lowers TG alot, can use with statin, used as adjunct to diet for treatment of high TG (> 500), may reduce CHD Adverse: usually fine, eructation, dyspepsia, taste perversion, diabetic pts may have issues, no increase in myopathy with statins

Answer 66

HMG-CoA Reductase Inhibs, decrease liver cholesterol synthesis which increases LDL receptors which increases LDL clearance, knocks the crap out of LDL at first, each subsequent dose increase only knocks it down a little, raises HDL 5-15%, lowers TG 7-30%, also antithrombic (platelet ag) and anti-inflammatory and plaque stabalizing, mostly used to lower LDL and when used with bile acid sequestrant really lowers LDL, lowers risk of CHD and regression of coronary atherosclerosis Adverse: myopathy, may increase HbA1C and fasting BG, impaired cognition, don't give to preggers or breastfeeding or liver disease

Answer 67

HMG-CoA Reductase Inhibs, decrease liver cholesterol synthesis which increases LDL receptors which increases LDL clearance, knocks the crap out of LDL at first, each subsequent dose increase only knocks it down a little, raises HDL 5-15%, lowers TG 7-30%, also antithrombic (platelet ag) and anti-inflammatory and plaque stabalizing, mostly used to lower LDL and when used with bile acid sequestrant really lowers LDL, lowers risk of CHD and regression of coronary atherosclerosis Adverse: myopathy, may increase HbA1C and fasting BG, impaired cognition, don't give to preggers or breastfeeding or liver disease

Answer 68

HMG-CoA Reductase Inhibs, decrease liver cholesterol synthesis which increases LDL receptors which increases LDL clearance, knocks the crap out of LDL at first, each subsequent dose increase only knocks it down a little, raises HDL 5-15%, lowers TG 7-30%, also antithrombic (platelet ag) and anti-inflammatory and plaque stabalizing, mostly used to lower LDL and when used with bile acid sequestrant really lowers LDL, lowers risk of CHD and regression of coronary atherosclerosis Adverse: myopathy, may increase HbA1C and fasting BG, impaired cognition, don't give to preggers or breastfeeding or liver disease, acetylated so watch for slow and interactions

Answer 69

Ezetimibe and Simvastin

Answer 70

Fab fragment that blocks GpIIb/IIIa (GPI), so blocks platlet agg, used for ischemic heart disease pts about to go PCI, IV Adverse: allergic rxn, thrombocytopenia, bleeding

Answer 71

tPA, should theoretically only break clots and not destroy clotting factors (lytic state), used to treat MI (instead of PCI), IV, used more in stroke

Answer 72

inhibs activation of plasminogen to plasmin (tPA antidote)

Answer 73

Direct thrombin inhibitor, used prohylax for HIT or treat HIT, IV until aPTT ratio of 1.5-2.5, eliminate via CYP3A4/5, can increase INR so make warfarin switch complicated Adverse: bleeding

Answer 74

Irrev blocks COX 1&2, low blocks 1, high blocks both. COX1 is TXA2 (thromboxane, proclot, from platelet), COX2 is PGI2(anticlotting from endoth), platelets blocked for their lifetime, endoth can overcome

Answer 75

Direct thrombin inhibitor, used with aspirin and GPI instead of heparin for unstable angina when undergoing PCI.PCTA, IV bolus then infusion, monitor Activated Clotting Time Adverse: Bleeding

Answer 76

Blocks ADP binding to GIIb/IIIa receptor which inhibits fibrinogen activity, used with aspirin for ACS and STEMI, must stop for CABG Adverse: CYP so watch, bleeding

Answer 77

Oral, reversible thrombin inhib, prodrug, indicated in stroke due to afib, no monitoring, renal clearance, interacts with antifungals Adverse: gastritis like and bleeding

Answer 78

``` Phosphodiesterase inhib (increases cAMP) and blocks uptake of adenosine, don't really know, used for stroke prevention with aspirin Adverse: headache ```

Answer 79

GPI, blocks platlet agg, bleeding

Answer 80

Like LMWH, almost exclusively blocks Xa over everything else, SC, can give to HIT pts Adverse: bleeding

Answer 81

UHF is large, LMWH is smaller, both given IV, act mainly on venous side. Heperain needs antithrombin and inhibs IIa, Xa (and IXa, XIa, XIIa) and enhances Tissue Factor Pathway Inhibitor, monitor with aPTT (or Xa titration). Main difference with LMWH is that it can be given SC and UFH is metabolized a lot faster. Adverse: Bleeding, osteoporosis with prolonged use, Hep Induced Thrombocytopenia (HIT) to embolis. If overdose on UFH can use protamine

Answer 82

use for overdose of warfarin if INR between 4 and 10, over 10 give VitK

Answer 83

same as clopidogrel but more likely to bleed

Answer 84

Give for UFH overdose, sort of works on LMWH but only for IIa, not Xa so only sort of works, doesn't work for Fondaparinux

Answer 85

Oral direct Xa inhib, indicated for a fib stroke risk, prophylaxis of DVT.PE in hip and knee replacement, no lab test, CYP eliminated Adverse: CYP stuff, bleeding

Answer 86

VitK antag, Oral, suppresses II, VII, IX, X (prot C and S), takes a while to take effect (days), CYP eliminated, don't give to preggers Adverse: Use INR (PT)(2-3, valves 2.5-3.5), watch for CYP blockers/inducers, bleeding, recurrent skin necrosis, if INR >4.5 stop and give VitK1 (Phytonadione)