Blood Drugs

Question 1

a decrease in the amount of hemoglobin per RBC

Answer 1

microcytic, hypochromic anemia

Question 2

decrease in the number of mature, circulating RBCs

Answer 2

megaloblastic (macrocytic), hyperchromic anemia

Question 3

loss of RBCs (hemorrhage) or decrease in hematopoietic growth factors, esp erythropoietin

Answer 3

normocytic anemia

Question 4

ferrous sulfate, gluconate, fumarate, iron dextran treat?

Answer 4

microcytic anemia

Question 5

iron antidote?

Answer 5

deferoxamine

Question 6

folic acid, leucovorin, cyanocobalamin, hydroxycobalamin treat?

Answer 6

macrocytic anemia

Question 7

epoetin alfa (EPO) treats?

Answer 7

normocytic anemia

Question 8

iron deficiency –> loss of hemosiderin granules in bone marrow –> serum _____ decreases –>serum iron decreases

Answer 8

ferritin

Question 9

best indicator of iron deficiency is elevation of _________

Answer 9

total iron binding capacity of transferrin

Question 10

• essential for normal synthesis of DNA and normal mitosis of proliferating cells
• conversion to cofactors required for purine and pyrimidine synthesis

Answer 10

folic acid

Question 11

conversion of homocysteine to methionine requires folate as methyl donor with _____ as cofactor

Answer 11

B12

Question 12

• given during pregnancy to prevent neural tube defects (spina bifida)
• -hyperhomocystinuria possible risk factor for coronary heart disease
• low methionine levels in deficiency

Answer 12

folate deficiency

Question 13

• essential for normal synthesis of DNA and for maintenance of myelin throughout nervous system
• required to convert dietary form of folate
• required to convert methylmalonyl coA to succinyl coA
• required to convert homocysteine to methionine

Answer 13

vitamin B12

Question 14

absorption of vitamin B12 requires ______, a glycoprotein synthesized by parietal cells of stomach

Answer 14

intrinsic factor

Question 15

IF binds B12, and complex absorbed in the ______

Answer 15

ileum

Question 16

• usually given parenterally
• does not cause antibody response to complex
• preferred for long term use

Answer 16

cyanocobalamin

Question 17

• highly protein bound and remains in circulation longer
• some patients produce antibodies
• treatment for cyanide poisoning

Answer 17

hydroxycobalamin

Question 18

-megaloblastic anemia due to B12 deficiency resulting from lack of production of intrinsic factor by the parietal cells of the gastric mucosa, accompanied by achlorhydria

Answer 18

pernicious anemia

Question 19

• glycoprotein that stimulates red cell production

- treatment of anemia patients with chronic renal failure and in cancer patients

Answer 19

epoeitn alpha (erythropoietin)

Question 20

• recombinant granulocytic macrophage colony stimulating factor
• promotes myeloid recovery in patients with non hodgkins, ALL, Hodgkin’s undergoing bone marrow transplant
• promotes myeloid recovery after standard dose chemo
• treats drug induced bone marrow toxicity or neutropenia assoc’d with AIDS
• AE incidence and severity

Answer 20

sargramostim (GM-CSF)

Question 21

• recombinant colony stimulating factor

- for chemo related neutropenia, promotion of myeloid recovery in patients undergoing bone marrow transplantation

Answer 21

filgrastim (G-CSF)

Question 22

promotes megakaryopoiesis, increasing peripheral platelets

Answer 22

oprelvekin

Question 23

clopidegrel, ticlodipine, prasugrel, ticagrelor, cangrelor mehanism of action?

Answer 23

ADP antagonists

Question 24

abciximab, tirofiban is a platelet receptor ________ inhibitor

Answer 24

GP2b3a

Question 25

inhibit blood coagulation in vitro

Answer 25

calcium chelators

Question 26

accelerates action of antithrombin III to neutralize thrombin and other coagulation factors

Answer 26

heparins

Question 27

-rudins and -gat drugs

Answer 27

direct thrombin (IIa) inhibitors

Question 28

-xaban drugs

Answer 28

direct Xa inhibitors

Question 29

coumarin derivatives interfere with the hepatic synthesis of functional _______ clotting factors

Answer 29

vitamin K dependent

Question 30

enoxaparin, dalteparin, tinzaparin, nadroparin are ______ heparins

Answer 30

low molecular weight

Question 31

________ for use in patients who are taking the anticoagulant dabigatran during emergency situations when there is a need to reverse the blood thinning effects

Answer 31

praxbind (idarucizumab)

Question 32

rivaroxaban, apixaban, edoxaban class?

Answer 32

direct Xa inhibitors

Question 33

vitamin K epoxide reductase inhibitor?

Answer 33

warfarin

Question 34

- PTT monitoring not required - does not increase vascular permeability - minimal endothelial cell/protein binding - dose independent clearance - 3-6 hours elimination half life

Answer 34

LMWH

Question 35

warfarin has _____ volume of distribution (albumin space), long half life 36 hrs, and metabolized by CYP450

Answer 35

low

Question 36

amiodarone, cimetidine, disulfiram, fluconazole, metronidazole, phenylbutazone, sulfinpyrazone, TMP-SMX and erythromycin ________ warfarin metabolism, requiring a ______ dose

Answer 36

inhibits decreased

Question 37

barbiturates, carbamazepine, primidone, rifampin, St johns wort, cholestyramine _______ warfarin metabolism, requiring ______ dose

Answer 37

induces increased

Question 38

monitor heparin with _______, monitor warfarin with ______

Answer 38

PTT PT (INR)

Question 39

treatment of heparin overdose?

Answer 39

protamine sulfate

Question 40

treatment of warfarin overdose?

Answer 40

vit K, FFP

Question 41

urokinase, alteplase, reteplase, tenecteplase?

Answer 41

fibrinolytic drugs

Question 42

fibrinolytics work by lysing thrombi by catalyzing formation of ______ from its precursor zymogen

Answer 42

plasmin

Question 43

fibrinolytic inhibitor?

Answer 43

aminocaproic acid