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TBL Flashcards

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1
Q

What’s the MOA of oprelvekin?

A 
Interleukin 11 (IL-11) 
Inc. platelets
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2
Q

What are the uses and CI of oprelvekin?

A

Thrombocytopenia
(Drug-induced)

CI: myeloid malignancies

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3
Q

What is the MOA of anagrelide?

A

Dec. platelets

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4
Q

What are the Uses and CI of anagrelide?

A

Thrombocytosis

CI: thrombocytopenia

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5
Q

What is the MOA of EPO?

A

Inc. RBCs

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6
Q

What are the use and CI of EPO?

A

Anemia
(Drug-induced or chronic kidney failure)

CI: myeloid malignancies, high Hct, uncontrolled HTN

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7
Q

What is the MOA of filgrastim?

A

Granulocyte colony stimulating factor (G-CSF):

Inc. neutrophils and their activity
Helps trigger stem cell mobilization

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8
Q

What are uses for filgrastim?

A

Neutropenia
(Drug-induced or post stem cell transplant)

Stem cell harvesting

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9
Q

What CIs are associated with filgrastim?

A

Myeloid malignancies

Leukocytosis

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10
Q

What is the MOA of Sargramostim?

A

Granulocyte macrophage colony stimulating factor (Gm-CSF):

Inc. production of platelets, RBCs, granulocytes, monocytes

Inc. neutrophil activity

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11
Q

What are uses for Sargramostim?

A

Neutropenia

Inc. stem cell transplant success

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12
Q

What are CI of Sargramostim?

A

Myeloid malignancies
Leukocytosis

**dont use with chemo/radiation - damage dividing cells

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13
Q

What are causes of microcytic anemia?

A

Iron deficiency
Thalassemia
Chronic inflammation

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14
Q

What are causes of normocytic anemia?

A

Chronic inflammation

Kidney disease

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15
Q

What are causes of macrocytic anemia?

A

Non-megaloblastic:
EtOH, liver disease

Megaloblastic (dec. DNA synthesis):
Folate/B12 deficiency
Chemo

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16
Q

Differentiate RDW in iron deficiency vs. thalassemia

A

Inc. RDW = iron deficiency

dec. RDW = thalassemia

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17
Q

What are effects of iron deficiency on

Serum iron
TIBC
Serum ferritin
Transferrin saturation

A

Serum iron ⬇️
TIBC ⬆️
Serum ferritin ⬇️
Transferrin saturation ⬇️

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18
Q

What are effects of chronic inflammation on

Serum iron
TIBC
Serum ferritin
Transferrin saturation

A

Serum iron ⬇️
TIBC ⬇️ or normal
Serum ferritin ⬆️
Transferrin saturation ⬇️ or normal

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19
Q

What are effects of thalassemia on

Serum iron
TIBC
Serum ferritin
Transferrin saturation

A

Serum iron ⬆️ or normal
TIBC = normal
Serum ferritin ⬆️ or normal
Transferrin saturation ⬆️

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20
Q

What are clinical findings of folate deficiency?

A

⬆️ MCV
⬇️ RPI

hypersegmented neutrophils
mild pancytopenia

⬆️ homocysteine
⬆️ LDH, unconjugated BR = mild jaundic

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21
Q

What are clinical findings of B12 deficiency?

A

⬆️ MCV
⬇️ RPI
⬆️ MMA

⚠️Neurological damage⚠️
hypersegmented neutrophils
mild pancytopenia

⬆️ homocysteine
⬆️ LDH, unconjugated BR = mild jaundice

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22
Q

What are the vitamin K dependent factors?

A 
II
VII
IX
X
Protein C + S
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23
Q

What factors does thrombin help activate?

A

VIII (bound to vWF)

V

Thrombin

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24
Q

List PARENTERAL anticoagulants

Study These Flashcards
A

Unfractionated heparin

LMWH: enoxaparin, dalteparin

Fondaparinux

Direct thrombin inhibitors (DTIs): bivalirudin, argatroban

25
List PO anticoagulants
Warfarin Dabigatran Rivaroxaban
26
What are the fibrinolytic drugs?
Alteplase Tenecteplase
27
What drugs are anti-platelets?
Aspirin Thienopyridines: clopidogrel GP2b/3a inhibitors
28
What's the MOA of uFH?
Activates anti-thrombin 3 (AT3), which will inhibit IIa and Xa
29
What are titration labs for uFH?
PTT | Anti-Xa activity
30
What AEs are associated with uFH
Bleeding Heparin induced thrombocytopenia (HIT) Osteoporosis Dec. aldosterone = ⬆️ plasma K Allergic reactions
31
What is the reversal agent for uFH?
Protamine
32
What are the LMWHs?
Enoxaparin | Dalteparin
33
What is the MOA of LMWHs?
Activates AT3, but will lead to greater inhibition of Xa vs. IIa (Due to fewer long saccharide chains)
34
What titration labs are used with LMWHs?
Anti-Xa activity
35
What AEs are associated with LMWHs?
Bleeding HIT (but less vs. uFH)
36
What is the reversal agent for LMWHs?
Protamine
37
What is the MOA of fondaparinux?
Activates AT3, but will only inhibit Xa
38
What titration labs are used for Fondaparinux?
Anti-Xa activity
39
What AEs are associated with fondaparinux?
Bleeding Lowest HIT
40
What are the direct thrombin inhibitors (DTIs)?
Bivalirudin Argatroban Dabigatran (PO)
41
What is the MOA of DTIs?
``` Inhibit IIa (For patients with AT3 deficiency) ```
42
What titration labs are used with DTIs?
PTT
43
What AEs are associated with DTIs?
Bleeding
44
What is the MOA of warfarin?
Inhibits VKOR - resulting in dec. secretion of functional clotting factors
45
What titration labs are needed for warfarin?
INR (involves PT)
46
What AEs are associated with warfarin?
Bleeding Skin necrosis Birth defects
47
What are reversal agents for warfarin?
Vitamin K Kcentra (clotting factors!)
48
What is the MOA of dabigatran?
Inhibits IIa (oral DTI)
49
What AE is associated with dabigatran
Bleeding
50
What reversal agent is used for dabigatran?
Idarucizumab
51
What is the MOA of rivaroxaban?
Inhibit Xa
52
What's the MOA of fibrinolytic agents?
Bind to fibrin and convert plasminogen to plasmin in order to dissolve clot
53
What AE is associated with fibrinolytics?
Bleeding
54
What are absolute CIs for fibrinolytics?
Prior intracranial hemorrhage Ischemic stroke Active bleeding Head trauma
55
Describe the MOA of aspirin
Irreversible COX inhibitor - lasts lifetime of platelet (7 days) @ low doses, can selectively decrease platelet thromboxane 2 (TXA2)
56
What is the MOA of clopidogrel?
Irreversible antagonist of the ADP receptor (P2Y12) on platelets
57
What are the MOA of GP2b/3a inhibitors?
Abiciximab: mAb to platelet GP2b/3a receptor Tirofiban: non-peptide reversible inhibitor for GP2b/3a receptor on platelet
58
What drugs also can be used to decrease platelet function?
SSRIs: deplete 5-HT for platelet activation Garlic: inhibit TXA2 synthesis Ginkobiloba: antiplatelet effects? Fish oil (omega 3): inc. TXA3 to dec. platelet effects + inc. in PGI3 to increase anti-platelet effects

Hematology (2 decks)

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