Quiz 7

Question 1

warfarin 1

Answer 1

Brand: Coumadin
Class: Vitamin K Antagonist
Indication: Ppx & tx of thromboembolic disorders and embolic complications (after Afib, prosthetic valves), adjunct to reduce risk of systemic embolism after MI

Question 2

warfarin 2

Answer 2

MOA: Inhibits synthesis of factors II, VII, IX, and X, inhibits vitamin K epoxide reductase, which leads to vitamin K depletion.
BBW: Bleeding risk
SE: Bleeding, hemorrhage, alopecia

Question 3

enoxaparin 1

Answer 3

Brand: Lovenox
Class: LMWH
Indication: acute coronary syndromes (UA, NSTEMI, STEMI), DVT prophylaxis for abd surgery, immobile patients, & following hip/knee replacement, acute DVT treatment

Question 4

enoxaparin 2

Answer 4

MOA: inhibits thrombin (IIa) and to a larger extent factor Xa
BBW: Spinal/epidural hematomas
SE: anemia, hemorrhage

Question 5

dalteparin 1

Answer 5

Brand: Fragmin
Class: LMWH
Indication: ABD surgery postop DVT ppx; ACS; VTE in cancer; DVT ppx in hip replacements

Question 6

dalteparin 2

Answer 6

MOA: inhibits Factor IIa (thrombin) and to a greater extent factor Xa by means of antithrombin
BBW: Spinal/epidural hematomas
SE: hematomas, injection site pain, thrombocytopenia

Question 7

dabigatran 1

Answer 7

Brand: Pradaxa
Class: Direct Thrombin Inhibitor
Indication: DVT/PE treatment and ppx in pts who have been treated on a parenteral anticoag for 5-10 days, afib, ppx after hip replacement

Question 8

dabigatran 2

Answer 8

MOA: prodrug; inhibits both free and fibrin bound thrombin. Inhibits coagulation by preventing thrombin mediated effects
BBW: premature discontinuation increases risk for thrombotic events; spinal/epidural hematoma
SE: GI symptoms, hemorrhage

Question 9

epoetin alfa 1

Answer 9

Brand: Epogen, Procrit
Class: Erythropoiesis-Stimulating Agent
Indication: Treatment of anemia in cancer, CKD, zidovudine usage

Question 10

epoetin alfa 2

Answer 10

MOA: Induces erythropoiesis by stimulating the division and differentiation of committed erythroid progenitor cells; induces the release of reticulocytes from the bone marrow into the bloodstream, where they mature to erythrocytes.
BBW: CKD- increased risk of death, serious adverse CV reactions, stroke
Cancer- shortens overall survival and/or increased risk of tumor progression or recurrence
Perisurgery- increased risk of DVT
SE: HTN, fever, HA, pruritus, rash, N/V, injection site reaction, arthralgia, cough

Question 11

darbepoetin alfa 1

Answer 11

Brand name: Aranesp
Class: Erythropoiesis-Stimulating Agent (ESA);
Indication: anemia in cancer (nonmyeloid malignancies), CKD

Question 12

darbepoetin alfa 2

Answer 12

MOA: Induces erythropoiesis by stimulating the division and differentiation of committed erythroid progenitor cells; induces the release of reticulocytes from the bone marrow into the bloodstream, where they mature to erythrocytes. There is a dose response relationship with this effect. This results in an increase in reticulocyte counts followed by a rise in hematocrit and hemoglobin levels.
BBW: CKD- increased risk of death, serious adverse CV reactions, stroke
Cancer- shortens overall survival and/or increased risk of tumor progression or recurrence
SE: HTN, peripheral edema, edema, abdominal pain, dyspnea, cough

Question 13

fondaparinux sodium 1

Answer 13

Brand: Arixtra
Class: Factor Xa Inhibitor
Indication: DVT prophylaxis in hip/knee replacement, treatment of acute pulmonary embolism, treatment of acute DVT

Question 14

fondaparinux sodium 2

Answer 14

MOA: Fondaparinux is a synthetic pentasaccharide that causes an antithrombin III-mediated selective inhibition of factor Xa. Neutralization of factor Xa interrupts the blood coagulation cascade and inhibits thrombin formation and thrombus development.
BBW: Spinal/epidural hematomas
SE: Anemia

Question 15

filgrastim 1

Answer 15

Brand: Neupogen
Class: Hematopoietic Agent
Indication: febrile neutropenia ppx in myelosuppressive chemo recipients with nonmyeloid malignancies; AML following induction or consolidation chemo; neutropenia with BMT; Hematopoietic radiation injury syndrome; Peripheral blood progenitor cell collection and therapy; Severe chronic neutropenia

Question 16

filgrastim 2

Answer 16

MOA: stimulate the production, maturation, and activation of neutrophils to increase both their migration and cytotoxicity.
BBW: N/A
SE: chest pain, fatigue, dizziness, pain, increased lactate dehydrogenase, increased uric acid, skin rash, splenomegaly, thrombocytopenia, petechiae, increased ALP, fever, ostealgia in lower back, epistaxis, cough, dyspnea, fever

Question 17

tbo-filgrastim 1

Answer 17

Brand: Granix
Class: Hematopoieic Agent
Indications: neutropenia

Question 18

tbo-filgrastim 2

Answer 18

MOA: increases neutrophil counts and activity by binding to G-CSF receptors and stimulating differentiation commitment and some end-cell functional activation
BBW: n/a
SE: leukocytosis and bone pain

Question 19

pegfilgrastim 1

Answer 19

Brand: Neulasta
Class: Hematopoietic Agent
Indication: hematopoeic radiation injury; To decrease the incidence of infection, by stimulation of granulocyte production, in patients with nonmyeloid malignancies receiving myelosuppressive chemo associated with a significant risk of febrile neutropenia

Question 20

pegfilgrastim 2

Answer 20

MOA: Stimulates the production, maturation, and activation of neutrophils, pegfilgrastim activates neutrophils to increase both their migration and cytotoxicity. Pegfilgrastim has a prolonged duration of effect relative to filgrastim and a reduced renal clearance
BBW: N/A
SE: ostealgia, limb pain

Question 21

sodium ferric gluconate 1

Answer 21

Brand: Ferrlecit
Class: Iron Salt
Indication: iron deficiency anemia

Question 22

sodium ferric gluconate 2

Answer 22

MOA: Supplies a source to elemental iron necessary to the function of hemoglobin, myoglobin and specific enzyme systems; allows transport of oxygen via hemoglobin
BBW: N/A
SE: Hypotension, HTN, tachycardia, HA, dizziness, N/V/D, abnormal erythrocytes, injection site reaction, cramps, dyspnea

Question 23

ferumoxytol 1

Answer 23

Brand: Feraheme
Class: Iron Salt
Indication: iron-deficiency anemia in adults with CKD

Question 24

ferumoxytol 2

Answer 24

MOA: releases iron within vesicles in the macrophages of the liver, spleen, and bone marrow where it then enters into either the intracellular storage iron pool, or is transferred to plasma transferrin and is incorporated into hemoglobin by erythroid precursor cells
BBW: Fatal and serious hypersensitivity reactions
SE: diarrhea, nausea, dizziness, constipation, peripheral edema