Cardio Drugs Flashcards

1
Q

Unfractionated Heparin

A

MOA:
Complex with AT and inhibits factors Xa and IIa.
-Monitored by APTT (2-2.5x PTT is baseline therapeutic)
**Protamine antagonist (hep 2500, prt 25)
Route- IV or Sub Q

Indication-

  • Surgical Anti-coagulation,
  • Does not cross placenta barrier (pregnancy okay)

Adverse-

  • HIT (Hep- PF4 complex, Ab form)
  • Bleeding, osteoporosis, alopecia
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2
Q

Low Molecular Weight Heparins
(Branded and Generic)

Dalteparin
Nadroparin
Tinzaparin
Enoxaparin

A

MOA-
Complex with AT and inhibits factors Xa and IIa-Monitored by anti-Xa
-Kidney Excretion

Route: Subcutaneous-(better bioavailability than heparin)

Indication:
Prophylaxis and Treatment of DVT and ACS, Does not cross placenta barrier

Adverse- Bleeding

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3
Q

Fondaparinux

Pentasaccharide

A

MOA- Complex with AT and inhibits factor Xa

Route- Sub Q

Indication: Management of DVT

Adverse- Bleeding

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4
Q

Argatroban

A

MOA-
Directly Inhibits IIa, liver excretion, short T1/2

Route- Sub Q

Indication- Anticoagulant management of HIT patients

Adverse- Bleeding

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5
Q

Argatroban

A

MOA- Directly Inhibits IIa, liver excretion, short T1/2

Route- IV

Indication- Anticoagulant management of HIT patients

Adverse- Bleeding

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6
Q

Bivalirudin

A

MOA- Directly Inhibits IIa, renal excretion, short T1/2

Route- IV

Indication-Anticoagulant management of HIT patients

Adverse- Bleeding

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7
Q

Hirudin

A

MOA- Directly Inhibits IIa, no cofactor, renal excretion, short T1/2

Route- IV

Indication- Anticoagulant management of HIT patients

Adverse- Bleeding, 40% pt antibodies

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8
Q

Antithrombin Concentrate

A

MOA- Directly Inhibits IIa

Route- IV

Indication-
DIC, Sepsis, thrombophilia, hypercoagulable state

Adverse- none

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9
Q

Protamine Sulfate

A

MOA- Heparin Antagonist

Route- IV

Indication- Antagonist for unfractionated heparin -(only partial for LMW Heparin)

Adverse- bradycardia, hypotension
(needs to be administered slowly)

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10
Q

Warfarin

A

MOA-
Competitive antagonist of vitamin K. Suppresses the synthesis of functional forms of factors II, VII, IX and X by blocking enzyme epoxide reductase in liver

Monitoring- Prothrombin time (INR)

Indications- Prolonged treatment of DVT and Atrial Fibrillation

Adverse-
Bleeding, coumadin induced necrosis
Has interaction with several medications which can either potentiate the effects or inhibit the effects. Crosses placental barrier causing birth defects

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11
Q

Vitamin K

A

MOA- Cofactor in the synthesis of functional forms of factors II, VII, IX and X

Monitoring- not required

Indication-
Hypoprothrombinemia, intestinal disorders and gastrectomy, reverses the effects of warfarin

Adverse- Hemolysis

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12
Q

Oral Anti-Xa

Rivaroxaban (R)
Apixaban (A)
Edoxaban (E)
Betrixaban (B)
A

MOA- inhibits factor Xa

Monitored- not required

Indication-

  • Stroke prevention in pt with AF-R,A,E,B
  • R & A,B also approved for prophylaxis and treatment of DVT.
  • R approved for ACS

Adverse- Bleeding, liver toxicity (R, A, E)

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13
Q

Oral Antithrombin

Dabigatran

A

MOA- inhibits thrombin

Monitoring- not required

Indication-Stroke prevention in pt with AF

Adverse-
Bleeding, liver toxicity,
Cleared by kidney could problems in patients with abnormal kidney function.

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14
Q

Aspirin

A

MOA- COX inhibitor
ORAL

Indication- ACS, stroke, arterial thrombosis

Adverse-
Bleeding, GI irritation

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15
Q

Clopidogrel

A

ADP Receptor Inhibitor
ORAL

Indication- ACS, stroke, in stent thrombosis

Adverse-
Bleeding, TTP (thrombotic thrombocytopenic purpura)

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16
Q

Prasugrel, Ticagrelor

A

ADP receptor inhibitor
ORAL

Indication-
ACS, stroke, in stent thrombosis

Adverse- bleeding

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17
Q

NSAIDs

A

COX Inhibitor
ORAL

Indications- various

Adverse- bleeding

18
Q

Dipyridamole

A

MOA-Phosphodiesterase inhibitor
ORAL

Indication-Arterial thrombosis, stroke
Adverse- Bleeding

19
Q

Cilostazol

A

MOA- Phosphodiesterase inhibitor
ORAL

Indication- intermittent claudicaiton
Adverse- hypotension

20
Q

Abciximab

A

MOA-GP IIb/IIIa inhibitor (IV)

Indication- ACS/ PCI
Adverse- Bleeding

21
Q

Eptifibatide

A

MOA-GP IIb/IIIa inhibitor (IV)

Indication- ACS/ PCI
Adverse- Bleeding

22
Q

Tirofiban

A

MOA-GP IIb/IIIa inhibitor (IV)

Indication- ACS/ PCI
Adverse- Bleeding

23
Q

Monteleukast

A

MOA-Leukotriene receptor inhibitor
ORAL

Indication-allergic reaction

Adverse- hypotension, behavioral changes

24
Q

Zafirleukast

A

MOA-Leukotriene receptor inhibitor
ORAL

Indicaiton- asthma

Adverse- Hypotension

25
Q

Zieuton

A

MOA- Lipoxygenase inhibitor
ORAL

Indication- asthma

adverse- hypotension

26
Q

Streptokinase

A

fibrinolytic (IV)- activates Plasmin, degrades Fibrin and Fibrinogen

Indication- thrombolysis, stroke, MI, PE

Adverse- bleeding

27
Q

Urokinase

A

fibrinolytic (IV)- activates Plasmin, degrades Fibrin and Fibrinogen

Indication- thrombolysis, stroke, MI, PE

Adverse- bleeding

28
Q

Tissue plasminogen activator

(t-PA)

A

fibrinolytic (IV)- single chain
activates Plasmin, degrades Fibrin and Fibrinogen

Indication- thrombolysis, stroke, MI

Adverse- bleeding

29
Q

Epsilon amino caproic acid (AMICAR)

EACA

A

Anti-fibrinolytic
- neutralizes thrombolytics, Inhibits Plasmin

Reversal of Bleeding

Adverse- Hypotension

30
Q

Aprotonin (trasylol)

A

Anti-fibrinolytic

Reversal of Bleeding

Adverse- Graft thrombosis

31
Q

Ancrod

A

fibrinolytic

Indication- stroke

Adverse- allergic reaction

32
Q

Tranexamic acid (AMCHA)

A

Anti-fibrinolytic

Reversal of Bleeding

Adverse- Retinopathy

33
Q

Captopril

A

MOA- ACEi (oral)

use- HTN

Adverse: Severe stomach pain, chest pain, allergic reaction

34
Q

Enalapril

A

ACEi (oral)

use, HTN

Adverse: Hypotension, severe stomach pain

35
Q

Losartan

A

Angiotensin receptor inhibitor (oral)

USE- HTN

Adverse- Diarrhea, insomnia, nasal congestion

36
Q

Valsartan

A

Angiotensin receptor inhibitor (oral)

Use- HTN

Adverse- stomach pain, nausea

37
Q

Icatibant

A

Bradykinin receptor inhibitor (oral)

Use- inflammatory responses

Adverse- stomach pain, nausea

38
Q

Aprotonin

A

Kallikrein inhibitor (IV)

use- Inflammation

adverse-Heart attack, stroke, Renal failure

39
Q

Desmopressin (DDAVP)

A

Vasopressin analog (IV)

use- bleeding

Adverse- headache, stomach pain, nausea

40
Q

Bosentan

A

Endothelin receptor inhibitor (oral)

use- Pulmonary hypertension

adverse- Liver problems, stomach pain, nausea