Pharm: Hema and Dyslipidsmia Flashcards
What is the triad for aspirin hypersensitivity?
Samter Triad or Aspirin triad
Asthma / aspirin exacerbated resp dse
Aspirin sensitivity
Nasal polyps / non allergic rhinitis with eosinophilia
Expected acid-base abnormality in aspirin intoxication
Respiratory alkalosis with HAGMA
Antidote to streptokinase
Aminocaproic acid
Two MOAs of dipyramidole?
Inhibits phophodiesterase
Inhibit endothelial uptake of adenosine
Both lead to increased cAMP and decreased platelet aggregation
This drug acts as an agonist of erythropoietin receptors expressed by red cell progenitors.
Epoietin alfa
When using erythropoietin stimulating agents, Hg levels should be maintained < ___.
12 g/dL
Iron chelator which is used in acquired hemochromatosis. Toxicities include neurotoxicity and increased susceptibility to infections.
Deferoxamine
Myeloid growth factor that acts through a distinct GM-CSF receptor to stimulate proliferation and differentiation of early and late granulocytic progenitor cells, and erythroid and megakaryocyte progenitors.
Sargramostim (GM-CSF)
This drug stimulates the growth of primitive megakaryocytic progenitors and increases the number of platelets.
Oprevelkin
IL-11
Necrotizing gastroenteritis, shock and metabolic acidosis are manifestations of toxicity with ___.
Iron
What is the MOA of the following drugs used in coagulation disorders?
- Rivaroxaban
- Abciximab
- Tenecteplase
- Ticlopidine
- Direct factor Xa inhibitor
Rivaro-Xa-BAN! - Monoclonal antibody against glycoprotein IIb/IIIa
- Tissue plasminogen activator
- ADP receptor inhibitor
Which form of Vitamin K is given to reverse warfarin toxicity?
Vitamin K1
Phytonadione
The heparin-antithrombin complex inhibits which factors.
Thrombin
Factor V, VIII, XI
Coumarins inhibit which enzyme.
Epoxide reductase
T/F. aPTT is used to monitor response to heparin and LMWH
False. The aPTT test does NOT reliably measure the anticoagulant effect of LMWH and fondaparinux.
Antidote for heparin toxicity
Protamine sulfate
This drug class is used in anticoagulation of patients with heparin-induced thrombocytopenia
Direct thrombin inhibitors
Lepirudin, Dabigatran
What is the MOA of prasugrel?
ADP receptor antagonist
This antiplatelet is contraindicated in CHF and may cause headache and palpitations. What is its MOA?
Dipyridamole
MOA: Inhibit adenosine uptake and inhibit phosphodiesterase
What is the MOA of tranexamic acid?
They inhibit fibrinolysis by inhibiting plasminogen activation.
This drug used to lower lipid levels can paradoxically raise LDL levels in patients with familial combined hyperlipidemia.
Fibrates
This drug used to lower lipid levels can paradoxically raise VLDL and triglycerides levels in patients with familial combined hyperlipidemia.
Resins
MAJOR MOA of fibrates
Inhibit hormone-sensitive lipase
decreases triglyceride levels
Statins inhibit which reaction in fatty acid metabolism
HMG-CoA (HMG-CoA reductase) > mevalonate
Most common adverse effect with all members of the fibric acid derivatives subgroup?
Nausea
This drug used to lower lipid levels increase risk of cholesterol gallstones.
Niacin
Which drug class is most effective in modifying the levels of:
- Triglycerides
- HDL
- LDL
- Fibrates
- Niacin
- Statins
MOA of fibrates?
PPAR-a agonist
MOA of ezetimibe?
Reduces intestinal uptake of cholesterol by inhibiting sterol transporter
Which drug used to lower lipid levels is also used to relieve pruritus in patients with cholestatic jaundice?
Bile-acid binding resins
Colestipol
What is the MOA of probenecid?
Inhibits renal reuptake of uric acid (uricosuric agent).
Probenecid decreases the serum concentration of uric acid while increasing the concentration of another weak acid, penicillin. Explain!
Probenecid competes with uric acid for the transporter that causes its reuptake, facilitating its excretion. On the other hand, it competes with penicillin for the transporter that will secrete the drug into urine.
How is aspirin different from the other NSAIDs?
It binds to COX irreversibly.
This is a recombinant protein that binds to TNF and prevents its inflammatory effects.
Etanercept
COX-2 inhibitors reduce gastric side effects but increase risk of thrombosis. Explain!
- COX-2 does not inhibit COX-1 which secretes gastroprotective prostaglandins.
- It increases risk of thrombosis because it inhibits prostacyclin more than thromboxane synthesis.
Gold compounds are used in rheumatoid arthritis. It is effective because it interferes with the function of which inflammatory cell.
Macrophages
This drug causes inhibition of microtubule assembly decreasing migration and phagocytosis.
Colchicine
Reversible inhibitor of xanthine oxidase
Febuxostat
Allopurinol is an IRREVERSIBLE inhibitor.
Half-life of acetaminophen?
2 hrs. Hence, its q4 dosing
Effects of alcohol on lipid profile
Increase HDL
Increase triglyceride
Increase VLDL
Least potent of the statins
Fluvastatin
Absorption of Vitamin K, dietary folates, and some drugs including thiazides, and warfarin is impaired by intake of this lipid-lowering drug.
Resins
Cholestyramine, colestipol, colesevelam
Heparin or warfarin?
- Site of action: liver
- Activity measured by PT
- Rapid onset of action
- Antidote: Vitamin K1
- Warfarin
- Warfarin
- Heparin
- Warfarin
This antiplatelet drug is no longer commonly used because of high risk of bleeding, neutropenia and thrombotic thrombocytopenic purpura.
Ticlopidine
Lipid lowering drug used in the treatment of phytosterolemia.
Ezetimibe
