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Hematology > TBL > Flashcards

TBL Flashcards

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

A

Unfractionated heparin

LMWH: enoxaparin, dalteparin

Fondaparinux

Direct thrombin inhibitors (DTIs): bivalirudin, argatroban

25
Q

List PO anticoagulants

A

Warfarin

Dabigatran

Rivaroxaban

26
Q

What are the fibrinolytic drugs?

A

Alteplase

Tenecteplase

27
Q

What drugs are anti-platelets?

A

Aspirin

Thienopyridines: clopidogrel

GP2b/3a inhibitors

28
Q

What’s the MOA of uFH?

A

Activates anti-thrombin 3 (AT3), which will inhibit IIa and Xa

29
Q

What are titration labs for uFH?

A

PTT

Anti-Xa activity

30
Q

What AEs are associated with uFH

A

Bleeding
Heparin induced thrombocytopenia (HIT)

Osteoporosis
Dec. aldosterone = ⬆️ plasma K

Allergic reactions

31
Q

What is the reversal agent for uFH?

A

Protamine

32
Q

What are the LMWHs?

A

Enoxaparin

Dalteparin

33
Q

What is the MOA of LMWHs?

A

Activates AT3, but will lead to greater inhibition of Xa vs. IIa

(Due to fewer long saccharide chains)

34
Q

What titration labs are used with LMWHs?

A

Anti-Xa activity

35
Q

What AEs are associated with LMWHs?

A

Bleeding

HIT (but less vs. uFH)

36
Q

What is the reversal agent for LMWHs?

A

Protamine

37
Q

What is the MOA of fondaparinux?

A

Activates AT3, but will only inhibit Xa

38
Q

What titration labs are used for Fondaparinux?

A

Anti-Xa activity

39
Q

What AEs are associated with fondaparinux?

A

Bleeding

Lowest HIT

40
Q

What are the direct thrombin inhibitors (DTIs)?

A

Bivalirudin

Argatroban

Dabigatran (PO)

41
Q

What is the MOA of DTIs?

A 
Inhibit IIa
(For patients with AT3 deficiency)
42
Q

What titration labs are used with DTIs?

A

PTT

43
Q

What AEs are associated with DTIs?

A

Bleeding

44
Q

What is the MOA of warfarin?

A

Inhibits VKOR - resulting in dec. secretion of functional clotting factors

45
Q

What titration labs are needed for warfarin?

A

INR (involves PT)

46
Q

What AEs are associated with warfarin?

A

Bleeding
Skin necrosis
Birth defects

47
Q

What are reversal agents for warfarin?

A

Vitamin K

Kcentra (clotting factors!)

48
Q

What is the MOA of dabigatran?

A

Inhibits IIa (oral DTI)

49
Q

What AE is associated with dabigatran

A

Bleeding

50
Q

What reversal agent is used for dabigatran?

A

Idarucizumab

51
Q

What is the MOA of rivaroxaban?

A

Inhibit Xa

52
Q

What’s the MOA of fibrinolytic agents?

A

Bind to fibrin and convert plasminogen to plasmin in order to dissolve clot

53
Q

What AE is associated with fibrinolytics?

A

Bleeding

54
Q

What are absolute CIs for fibrinolytics?

A

Prior intracranial hemorrhage

Ischemic stroke

Active bleeding

Head trauma

55
Q

Describe the MOA of aspirin

A

Irreversible COX inhibitor - lasts lifetime of platelet (7 days)

@ low doses, can selectively decrease platelet thromboxane 2 (TXA2)

56
Q

What is the MOA of clopidogrel?

A

Irreversible antagonist of the ADP receptor (P2Y12) on platelets

57
Q

What are the MOA of GP2b/3a inhibitors?

A

Abiciximab: mAb to platelet GP2b/3a receptor

Tirofiban: non-peptide reversible inhibitor for GP2b/3a receptor on platelet

58
Q

What drugs also can be used to decrease platelet function?

A

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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