Heme/Onc

Question 1

Heparin

Answer 1

cofactor for antithrombin activation
dec thrombin and Xa
used for immediate anticoag; monitor PTT
safe for prego 
treat overdose with protamine sulfate
can cause HIT (IgG mediated)

Question 2

Argatroban

Answer 2

hirudin derivative
direct thrombin inhibitor
use instead of heparin in pt with HIT

Question 3

Bivalirudin

Answer 3

hirudin derivative
direct thrombin inhibitor
use instead of heparin in pt with HIT

Question 4

Warfarin

Answer 4

epoxide reductase inhibitor
affects extrinsic pathway --> inc PT
used for chronic anticoagulation
CI in prego 
can cause skin/tissue necrosis
give vitamin K to reverse

Question 5

Apixaban

Answer 5

factor Xa inhibitor
used for DVT and PE prophylaxis
also for a-fib anti stroke proph
may cause bleeding

Question 6

Rivaroxaban

Answer 6

factor Xa inhibitor
used for DVT and PE prophylaxis
also for a-fib anti stroke proph
may cause bleeding

Question 7

tPA

Answer 7

helps convert plasminogen to plasmin
inc PT and PTT
no change in platelet counts
use in “golden hour” post MI
CI in pt with active bleeding and severe HTN
treat toxicity with aminocaproic acid (fibrolysis inhibitor)

Question 8

Clopidogrel

Answer 8

irrev block ADP receptors –> inhib platelet aggregation
GpIIb/IIIa inhibitor –> inhib fibrinogen binding
use in acute coronary syndrome
reduce chance of stroke recurrence
can cause neutrophenia

Question 9

Toclipidine

Answer 9

irrev block ADP receptors –> inhib platelet aggregation
GpIIb/IIIa inhibitor –> inhib fibrinogen binding
use in acute coronary syndrome
reduce chance of stroke recurrence
can cause neutrophenia

Question 10

Prasugrel

Answer 10

irrev block ADP receptors –> inhib platelet aggregation
GpIIb/IIIa inhibitor –> inhib fibrinogen binding
use in acute coronary syndrome
reduce chance of stroke recurrence
can cause neutrophenia

Question 11

Ticagrelor

Answer 11

irrev block ADP receptors –> inhib platelet aggregation
GpIIb/IIIa inhibitor –> inhib fibrinogen binding
use in acute coronary syndrome
reduce chance of stroke recurrence
can cause neutrophenia

Question 12

Cilostazole

Answer 12

PDE III inhib –> inc cAMP in platelets
inhib platelet aggregation
vasodilator
used for claudication, angina and stroke proph
N/H/facial flushing/hypoTN/abdominal pain

Question 13

Dipyridamole

Answer 13

PDE III inhib –> inc cAMP in platelets
inhib platelet aggregation
vasodilator
used for claudication, angina and stroke proph
N/H/facial flushing/hypoTN/abdominal pain

Question 14

Abciximab

Answer 14

binds GpIIb/IIIa on ACTIVATED platelets –> inhib aggregation
made from monoclonal Fab fragments
used for unstable angina and percutaneous xsluminal coronal angioplasty
can cause bleeding and thrombocytopenia