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Pharm > Cortico/AntiThrombo > Flashcards

Cortico/AntiThrombo Flashcards

1
Q

MOA of corticosteriods

A

inhibit phospholipase A2

  • decreases arachidonic acid
  • inhibits lipooxygenase which decreases leukotrienes
  • inhibits cycloxygenase which decreases prostaglandins
  • suppresses IL1,3,4,5
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2
Q

How long before you should start a taper

A

7-14 days

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3
Q

Short term adverse effects of corticosteriods

A

hyperglycemia, elevated WBC, GI lbleeding, sodium retenstion, hypokalemia, metabolic acidosis, euphoria

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4
Q

Long term Ads of corticosteriods

A

Cushingoid features, muscle weakness, myopathy, protein wasting, osteoporosis

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5
Q

Thrombus

A

blood clot formed inset with in the vascular system and impedes blood flow

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6
Q

embolus

A

blood clot, air bubble, piece of fatty deposit, or other object that has been carried through the bloodstream to lodge in a vessel and cause an embolism

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7
Q

antiplatelet

A

breaks down fibrin; inhibit activation or aggreagation of platelets
Used for: prevention of arterial events: MI, stroke
Not: DVT

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8
Q

atithrombotic

A

inhibits clot formation or propagation by inhibiting vitamin K
Used for: DVT, PE, MI
Not for: strokes

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9
Q

thrombolytic

A

lyses or breaks up a clot by converting inactive proenzyme plasminogen into the active enzyme plasmin that degrades fibrin
Massive PE, acute MI, acute stroke
NOT when you are concerned of intracranial hemorrhage

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10
Q

Prednisone

A

pro drug for prednisolone

duration of action: 18-36 hours (short acting)

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11
Q

Cortisone/hydrocortisone

A

interchangeable

8-12 hours (short acting)

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12
Q

methylprednisolone

A

can be given orally or IV
historically used for asthma
18-36 hours

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13
Q

dexamethasone

A

historically used for cerebral edema

36-54 hours

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14
Q

physiologic dose

A

dose your body produces on a normal day

cortisone: 20-25mg
prednisone: 5mg
methylprednisolone: 4mg
dexamethisone: 0.75mg

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15
Q

HPA axis

A

Hypothalmus: cortocotropin releasing factor
Pituitary: corticotropin
Adrenals

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16
Q

Adverse effects of corticosteroids (short-term)

A 
Hyperglycemia, 
elevated WBC, 
GI bleeding
sodium retention
hypokalemia
euphoria
17
Q

Warfarin/Coumadin

A 
MOA: Inhibits synthesis of Vitamin K
prevents vitamin K recycling
Route: Oral
Delayed onset, 4-5 days
Use: stroke prevention (in absence of A-fib)
DVT prevention
Side E:
18
Q

Heparin

A

MOA: Inhibits formation of fibrin clots
inhibits factors 2 and 10 so fibrin can’t be activated
Route of A: IV
Use: limit expansion of thrombi, DVT, PE, post ops prophylaxis
AE: heparin induced thrombocytopeia

19
Q

Low-molecular weight heparin/LMWH

A

MOA: complex with antithrombin 3 and inactivate Factor Xa
Use: same as heparin without intensive monitoring
SE: Bleeding, thrombocytopenia, longer half-life than heparin

20
Q

Dabigatran/pradaxa

A

MOA: direct thrombin inhibitor, both clot bound and free thrombin are inhibited
Route: IV/SubQ
Use: stroke prevention, heparin alternative
AE: bleeding but no INR checks

21
Q

Rivaroxaban/xarelto

A

MOA: Inhibits Factor Xa
Route: oral
use: DVT, PE, stoke patients with non-valvular A fib
AE: bleeding

22
Q

aspirin

A

MOA: blocks Cox1 inhibiting thromboxane A2, blocks platelet aggregation
Use: prophylactic treatment for transient ischemia, reduces incidence of recurrent MI, treats mild pain…
AE: hemorrhagic stroke, GI bleeding

23
Q

ticlopidine (Ticlid)

A

MOA: blocks platelet aggregation by rirreversibly inhibiting the binding of ADp on platelet receptors required for platelets to bind fibrinogen
Use: prevention of transient ischemic attacks and strokes, prevents stenosis
AE: neutropenia, agranulocytosis, thrombolytic thrombocyteopenic purpura, aplastic anemia

24
Q

clopidogrel (Plavix)

A

MOA: blocks platelet aggregation by inhibiting the binding of ADP on platelet receptors required for platelets to bind fibrinogen
Use: prevention of atherosclerotic events following recent MI, stroke
AE:hemorrhage, epistaxis, GI bleeding, pruritus

25
Q

dipyridamole (persantine)

A

MOA: increases intracellular cAMP resulting in decreased thromboxane A2; decreasing platelet stickiness
Use: coronary vasodilator; angina, stroke prevention
AE: dizziness, HA, abdominal distress

26
Q

alteplase (ativase, tPA)

A

half-life 5-30 minutes
MOA: rapidly activates plasminogen which is bound to fibrin in a thrombus
Use: MI, massive PE, acute ischemic strokes
AE: GI issues, cerebral bleeds

27
Q

urokinase (Abookinase)

A

Half-life: 20 minutes
MOA: naturally occurring in human urine, converts plasminogen to plasmin (clot retractor protein)
Use: only approved for PE lysis; off label use MI, DVT,

Pharm (4 decks)

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