Pharm Projects Flashcards
MOA of aspirin
Irreversibly binds COX1
Only selective NSAID
Celebrex
5 presented NSAIDs
Ibuprofen Naproxen Aspirin Mobic Celebrex
Antiphospholipid syndrome
Autoimmune hypercoagulable disease
Arterial and venous clots
Most common victim of antiphospholipid syndrome
Young women
Can lead to pregnancy morbidity
Primary vs secondary APS
Primary: not linked to any disease
Secondary: along with another autoimmune disease, particularly lupus
APS present in what percent of cases with DVTs
15-20%
Drugs used for APS therapy
Warfarin
Aspirin
Clopidogrel
Perfusion relevance of APS
Risk of thrombosis
Impaired anticoagulation
Anticoagulation management for neonates and Peds
Newborn-1yr: 600U/kg Hep
1-5yr: 500U/kg
5yr: 450U/kg
Pump dose: 100U/kg
Neonate BP management during cooling and rewarming
Cooling: 20-70
Rewarming: 30-70
Affects of pregnancy during 3rd term
Increased CO, BV, HR,SV
Increased clotting factors 1,2,7,8,9,12
Decreased protein C and S
Increased PAI-1 and 2
How high should you keep MAP of a gravid pt?
> 65
FDA gravid. Drug categories
A: safest
B
C
D: fetal risk
Best drugs are alpha or beta agonists (keep BP high)
Contributions to vasoplegic syndrome
Endothelial injury: Vasopressin impairment, thrombin activation Exposure to foreign surface area Exposure to cardiotomy blood XC removal SIRS
Ultimate indicator of VPS
MAP <50
Low SVR
Vasoplegic syndrome treatment
High dose of vasopressors Postop: phenylephrine, NE, dopamine, methylene blue
Drugs to avoid on bypass with renal failure
Lepirudin, Bivalirudin,Warfarin
Antibiotics used on bypass with. Renal failure
Cefazolin
Cefuroxime
Vancomycin
Clindamycin
2 things to consider. With liver failure patients
Impaired production of clotting factors
Impairment of detoxification functions
2 stages of Hyperthermic intraperitoneal chemotherapy
1st: cytoreductive surgery
2: HIPEC
HIPEC drugs
Mitomycin C Cisplatin Oxaliplatin Melphalan Doxorubicin
Causes of lipid dyscrasia
Elevated cholesterol
What must you avoid on bypass with lipid dyscrasia?
Stasis
Cause of normocytic/normothermic anemia
Sudden blood loss
Cause of microcytic/Hypochromic anemia
Iron deficiency
Sickle cell anemia treatment on bypass
Maintain HCT above 24% Prevent hypothermia VO2>80 Use crystalloid cardioplegia Hemoconcentrate
