Pharmacology Flashcards
These drugs inhibit plasminogen by preventing it from “sitting” on fibrin.
- EACA (Amicar)
2. Tranexamic Acid
What are indications for the use of a Fibrinolytic Agent? (4)
- Myocardial Infarct
- Peripheral Vascular Thrombosis
- Ischemic Stroke
- Massive PE with hemodynamics
What is Phenytoin? How can it affect B12/Folate absorption?
Phenytoin is an anticonvulsant. It can decrease Vit B12/Folate absorption.
What is the mechanism of action of Clopidrogel (Plavix)?
Blocks ADP in order to decrease platelet aggregation.
What drugs stimulate Thrombopoesis?
Romiplostim
Eltrombopag
What is the mechanism of action of aspirin?
Irreversibly inhibits cyclooxygenase 1 and thromboxane A2. This inhibits platelet activation and aggregation. (platelet dysfunction)
What is the mechanism of action of Warfarin? What is the goal of delivering it?
Warfarin inhibits Vitamin K absorption–> prevents γ-carboxylation of clotting factors VII, IX, X, and II (thrombin)–> factors cannot bind to Ca2+ and to phospholipid surfaces –> clotting is inhibited.
To increase the PT/INR just enough (2-3, normal is <1) so that clots don’t form readily.
What clotting factors are Vit K dependent?
2, 9, 7, & 10.
Proteins C & S
What is the mechanism of action of Unfractionated Heparin (UFH)?
UFH inhibits factor IIa and Xa equally. It also inhibits other factors aswell.
What drugs does protamine sulfate nullify? (2)
Unfractionated Heparin -complete
Low Molecular Weight Heparin (LMWH) - incomplete; the rest is kidney.
What is the mechanism of action of Low Molecular Weight Heparin (LMWH)? Why is it better to use than Unfractionated Heparin?
LMWH inhibits factors Xa & IIa in a 4:1 ratio. Specificity: it does not affect other factors.
What is the mechanism of action of Fondaprinux? How is it neutralized?
Inhibits factor Xa only. By the Kidney only.
What is the mechanism of action of Desmopressin (DDAVP)?
DDAVP stimulates the release of vWF for the vWF deficient vWD patients.
What is the mechanism of action of Rituximab?
Prevents the differentiation of B-cells into plasma cells. This prevents antibody secretion. (used in immune thrombocytopenic purpura, ITP)
What does the “-mab” suffix indicate of a drug?
It’s a monoclonal antibody. It will inhibit immune system from releasing certain antibodies.
Dobutamine. Drug Type? Mechanism of action?
Agonist.
Binds Beta 1 Receptor –> Increases cardiac activity
Metoprolol. Drug Type? Mechanism of action?
Antagonist.
Binds Beta 1 Receptor –> Lowers cardiac activity.
Methacholine: Drug type? Mechanism of action?
M3 agonist –> bronchoconstriction.
M2 agonist –> Low Heart Activity
Describe the mechanism of action for Eculzimab. What Disorder would this treat?
Monoclonal antibodies produced against complement factor C5, which inhibit complement. This is used to treat Paroxysmal Nocturnal Hemoglobinuria (PNH) where RBC’s are susceptible to lysis by complement.
Describe the mechanism of action of Dabigatran (Pradaxa)?
Anticoagulant! Dabigatran inhibits thrombin to prevent clot formation.
Abciximab & Apixaban are both anticoagulants, what differentiates the two?
Abciximab - Antibodies against GP IIb/IIIa on platelets; prevents platelet aggregation.
Apixaban - A Direct Oral Anticoagulant (DOAC) that inhibits Factor Xa only.
A patient presents with evidence of severe ischemia/stroke that is noted to have occurred within the last 3-4 hours, what drug type should you treat with?
Use a FIBRINOLYTIC drug (ie. alteplase, tPA, etc.)
Propranolol: Drug type? Mechanism of action?
Antagonist.
Binds Beta 1 & 2 leading to lower heart activity & bronchoconstriction (bronchospasm)
Salmeterol (LABA) : Drug type? Mechanism of action?
Agonist.
Binds Beta 2 Receptor (Lungs) leading to vasodilation of bronchioles.
Albuterol (SABA): Drug type? Mechanism of action?
Agonist.
Binds Beta 2 Receptor (Lungs) leading to vasodilation of bronchioles.
Atropine: Drug type? Mechanism of action?
Antagonist.
Binds M2 receptor –> Low Heart inhibition
Ipratropium (SAMA) & Tiotropium (LAMA): Drug type? Mechanism of action?
Antagonists.
Bind M3 –> decreased bronchoconstriction
Describe the mechanism of action for ACE inhibitors. What are some examples?
Bind and inhibit angtiotensin converting enzyme –> decreased aldosterone production –> lower blood pressure
Example: Lisinopril (“-pril” suffix)
Describe the mechanism of action for ARBs (angiotensin receptor blockers). What are some examples?
Selectively block angiotensin type 1 receptor –> decreased aldosterone production –> low blood pressure
Example: Losartan (“-artan” suffix)
What is the advantage of using and ARB over an ACE inhibitor?
ACE inhibitors inhibit ACE in the bradykinin system also leading to a persistent cough. ARBs do not do this, they only block the ACE pathway leading to low blood pressure.
In what population of people are ACE inhibitors/ARBS contraindicated?
Pregnant women or women planning on becoming pregnant.
Describe the mechanism of action for Thiazide Diuretics. What are some examples?
Block sodium chloride transporters –> increased Na excretion –> decreased blood volume.
Examples: Hydrochlorothiazide, chlorthalidone
Describe the mechanism of action for Calcium Channel Blockers (CCBs). What are some examples?
Decrease calcium influx to myocardial cells –> lower heart activity –> low blood pressure
Examples: Dilitazen, Verapamil
