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2020 Pharmacology I > Classes > Flashcards

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1
Q

H2-receptor antagonists

A
  • block histamine receptors in stomach lining, suppressing gastric acid secretion
  • prototype: raNITIdine (Zantac)
  • onset: within 1 hr
  • duration: 9-12 hr
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2
Q

proton pump inhibitors (PPIs)

A
  • MOA: block exchange of H+ for K+, ↓ acid secretion
  • onset: up to 4 days
  • duration: 24 hr to 3 days
  • greater suppression than H2 blockers
  • prototype: omeprazole (Prilosec)
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3
Q

mucosal protectant

A
  • MOA: changes to thick substance in acidic environment, adheres to ulcer to protect from acid, pepsin
  • duration: up to 6 hr
  • complication: constipation
  • prototype: sucralfate (Carafate)
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4
Q

antacids

A
  • MOA: neutralizes stomach acid
  • onset: 5 min
  • duration: 30-60 min
  • aluminum and calcium: constipation
  • magnesium: diarrhea
  • prototypes
    • aluminum hydroxide (Amphojel)
    • calcium carbonate (Maalox, Tums, Rolaids)
    • magnesium hydroxide (Phillips, Dulcolax)
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5
Q

Prostaglandin E analog

A
  • MOA: mimics prostaglandin, inhibits acid secretion
  • Pregnancy Risk Category X (termination)
  • prototype: misoprostol (Cytotec)
  • onset: 30 min
  • duration: 3-6 hr
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6
Q

antiemetics

A
  • glucocorticoid: dexamethasone (Decadron)
  • substance P/neurokinin 1 antagonist: aprepitant (Emend)
  • serotonin antagonist
    • ondansetron (Zofran)
    • granisetron (Kytril)
  • dopamine antagonist
    • promethazine (Phenergan)
    • metoclopramide (Reglan)
  • cannabinoid: dronabinal (Marinol)
  • anticholinergic: scopolamine (Transderm Scop)
  • antihistamine
    • dimenhydrinate (Dramamine)
    • hydroxyzine (Vistaril)
  • benzodiazepine: lorazepam (Ativan)
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7
Q

osmotic laxatives

A
  • MOA: draw water into intestines to stimulate BM
  • indication: occasional constipation
  • complications
    • diarrhea
    • toxic Mg levels
    • dehydration
  • caution: kidney impairment
  • drugs
    • polyethylene glycol 3350 (MiraLax, GlycoLax)
    • magnesium hydroxide (Phillips, Dulcolax)
    • lactulose
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8
Q

bulk-forming laxatives

A
  • MOA: soften fecal mass, increase bulk (like dietary fiber)
  • indications
    • temp: constipation
    • ↓ diarrhea (diverticulosis and IBS)
    • stool control for ileostomy/colostomy
  • complications: obstruction; drink plenty of water
  • prototype: psyllium (Metamucil)
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9
Q

surfactant laxatives

A
  • MOA: ↓ surface tension of stool, allow penetration of water
  • prototype: docusate sodium (Colace)
  • indications: constipation, softening of fecal impaction
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10
Q

stimulant laxatives

A
  • MOA: stimulates peristalsis, ↑ volume of water and electrolytes in intestines
  • indications: bowel prep (surgery, procedure)
  • short-term Tx of constipation (high-dose opioid use)
  • used inappropriately for wt loss, get good Hx
  • drugs
    • bisacodyl (Dulcolax)
    • senna (Senokot)
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11
Q

antidiarrheals

A
  • MOA: ↓ GI motility
  • complications: constipation
  • drugs
    • diphenoxylate/atropine (Lomotil)
    • loperamide (Imodium)
    • paregoric (off market per Davis)
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12
Q

anti-IBS agents

A
  • alosetron (Lotronex)
    • MOA: antidiarrheal; blocks 5-HT3 receptors that innervate viscera
    • complication: constipation
  • lubiprostone (Amitiza)
    • MOA: laxative; activates intestinal chloride channels, ↑ fluid secretion
    • complication: diarrhea
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13
Q

beta2-adrenergic agonists

A
  • bronchodilator
  • inhaled/oral
  • end with “terol”
  • MOA: activate receptors in smooth muscle to relax, dilate airways; relieve bronchospasm, ↑ ciliary motility
  • short-acting
    • prototype: albuterol (Ventolin, Pro-Air)
    • levalbuterol (Xopenex)
  • long-acting
    • salmeterol and formoterol
    • for significant dz
    • combined with short-acting and corticosteroid
  • often prescribed together; LABA only for asthma not controlled by SABA alone
  • corticosteroid/LABA combos: Advair, Symbicort, Dulera
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14
Q

short-acting beta2-adrenergic agonist

A
  • SABA
  • drugs: albuterol (Ventolin, Pro-Air), levalbuterol (Xopenex)
  • onset: minutes
  • duration: 2-4 hr
  • often in combo with LABA for significant dz
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15
Q

long-acting beta2-adrenergic agonist

A
  • LABA
  • drugs: salmeterol (Serevent), formoterol
  • onset: 10-25 min
  • peak and T½: 3-4 hr
  • duration: 12
  • only used for significant dz
  • available in combo with corticosteroid: Advair, Symbicort, Dulera
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16
Q

complications of beta2-adrenergic agonists

A
  • tachycardia, angina
    • monitor for
      • chest, jaw, arm pain
      • palpitations
    • check pulse, notify of ↑ > 20-30 bpm
    • avoid caffeine
    • possible ↓ dose
  • tremors: usually resolved with continued use
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17
Q

contraindications and precautions for beta2-adrenergic agonists

A
  • pregnancy risk: C
  • contra: tachydysrhythmia
  • caution
    • DM (↑ BG): effects usually transient and slight except with ↑ doses
    • HTN
    • hyperthyroid
    • heart dz
    • angina
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18
Q

interactions with beta2-adrenergic agonists

A
  • ↑ risk of angina and tachycardia: MAOIs and TCAs
  • beta blockers (metoprolol, propranolol): negates effects of both
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19
Q

administering beta2-adrenergic agonists

A
  • pt education: use before using inhaled corticosteroid
  • use SABA for acute episode
  • LABAs
    • Q12H
    • NOT for acute attack
    • always used with inhaled corticosteroid
  • have pt return demonstrate
  • follow manufacturer instructions
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20
Q

evaluation of effectiveness of SABAs and LABAs

A
  • control of asthma
  • improved Sx: clearing/improved breath sounds, ↓ wheezing and coughing, ↓ breathing effort
  • pt able to exercise without dyspnea
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21
Q

anticholinergics

A
  • prototype: ipratropium (Atrovent)
  • end with “pium”
  • oral/inhaled
  • MOA: blocks muscarinic receptors of bronchi; bronchodilation
  • uses: relieves COPD-related and allergen- and exercise-induced bronchospasm
  • off-label: asthma Tx
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22
Q

complications of anticholinergics

A
  • dry mouth, hoarseness: sip fluids, suck on sugar-free hard candy
  • blurred vision
  • ↑ IOP
  • hot, flushed skin
  • dry skin
  • bradycardia → tachycardia, palpitations, aarhythmias
  • urinary retention
  • constipation
  • rare: fever, confusion, mania, hallucinations, rashes
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23
Q

contraindicaitons and precautions for anticholinergics

A
  • pregnancy: B
  • contra: allergy to peanuts
  • caution
    • narrow-angle glaucoma
    • benign prostatic hyperplasia
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24
Q

administering anticholinergics

A
  • rinse mouth after use (bad taste
  • wait 5 min between inhaled meds
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25
methylxanthines
* prototype: theophylline * end with "phylline" * MOA: relax bronchial smooth muscle, bronchodilation * oral, IV (emergency only) * acts like caffeine * for long-term control of chronic asthma, COPD
26
complications of methylxanthines
* mild toxicity: GI distress, restlessness * severe adverse at higher dose * **dysrhythmias**: lidocaine * **sz**: diazepam * **serum monitoring required**, narrow therapeutic range
27
glucocotricoids for respiratory disorders
* steroidal anti-inflammatory * oral, inhaled, IV * end with "one" * prototypes * beclomethasone (Qvar), inhaled * prednisone * inhaled, combo with LABAs * budesonide * fluticasone * mometasone * IV * hydrocortisone * methylprednisolone
28
uses for glucocorticoids in the Tx of respiratory disorders
* prevent inflammation * suppress airway mucus production * reduce airway edema * inhaled: used as prophylaxis * IV: short-term for status asthmaticus * PO * short-term: acute exacerbation * long-term: severe asthma
29
complications of glucocorticoids
* inhaled * difficulty speaking * hoarseness * oral candidiasis: rinse mouth after use, monitor for s/sx of infection and report * ↓ production of glucocorticoids in adrenal gland: **taper, do not stop abruptly** * bone loss * hyperglycemia, glucosuria * PUD: give with food, avoid NSAIDs, watch for GI bleed * ↑ risk of infection * wt/fluid gain * increased hunger
30
contraindications and precautions of glucocorticoids
* pregnancy: C * contra * recent live virus vaccine * systemic fungal infection * caution * children * DM * HTN * heart failure * PUD * osteoporosis * kidney dysfunction
31
interactions with glucocorticoids
* ↑ risk for hypokalemia with K+-depleting diuretics * ↑ risk for ulceration with NSAIDs * in DM: counteracts effects of meds, ↑ blood sugar * may need higher dose of antidiabetics
32
administering glucorticoids
* pt education * use on fixed schedule * NOT for acute asthma episode * use beta2-adrenergic first: bronchodilation → better absorption of glucocorticoid * oral: for short-term use, 3-10 days after acute attack * long-term therapy, switch to inhaled: ↑ dose during stress
33
leukotriene modifiers
* prototype: montelukast (Singulair) * other: zileuton, zafirlukast * MOA: ↓ inflammation, bronchoconstriction, edema, mucus * long-term therapy of asthma in adults, children * prevention of exercise-induced bronchospasm
34
complications of leukotriene modifiers
* **depression, suicidal ideation:** watch for changes, report * liver injury (zileuton and zafirlukast): **get baseline LFTs and monitor**
35
precautions for leukotriene modifiers
* pregnancy: B * liver dysfunction
36
interactions with leukotriene modifiers
* zileuton and zafirlukast * ↑ levels of warfarin: monitor for s/sx of bleeding, PT, INR * ↑ levels of theophylline: monitor level, educate about s/sx of toxicity (N&V, sz) * montelukast: ↓ effects with phenytoin
37
administering leukotriene modifiers
* take as prescribed * montelukast * maintenance: daily HS * prevention, exercise-induced: 2 hr before
38
opioid antitussives
* prototype: codeine * other: hydrocodone * MOA: acts on CNS to increase cough reflex threshold * uses: ↓ frequency, intensity of chronic dry cough
39
complications of opioid antitussives
* dizziness * lightheadedness * drowsiness * respiratory depression * N&V: take with food * constipation: ↑ fiber and fluid intake
40
nursing actions for opioid antitussives
* monitor VS for bradypnea (RR \< 12) * monitor ambulation, assist in and out of bed (**fall risk**) * short-term use only, risk of abuse
41
contraindications and precautions for opioid antitussives
* pregnancy: C * contra * respiratory depression * head trauma * acute asthma * liver and renal dysfunction * acute ETOH disorder * caution * children * older adults * hx of substance abuse
42
pt education for opioid antitussives
* avoid activities requiring alertness * lie down if dizzy * get up slowly * avoid ETOH, other CNS depressants
43
nonopioid antitussives
* prototype: dextromethorphan (Delsym, Robitussin) * MOA: acts on CNS to suppress cough * uses: cough suppression, ↑ pain reduction with opioid * pregnancy: C
44
complications of nonopioid antitussives
* mild nause, dizziness, sedation * **at high dose: euphoria, risk for abuse**
45
interactions with nonopioid antitussives
MAOI: life-threatening serotonin syndrome if taken within 2 wks
46
administering nonopioid antitussives
* some products contain ETOH and/or sucrose * available in capsules, lozenges, liquids, syrups
47
expectorants
* prototype: guaifenesin (Mucinex, Robitussin) * MOA: promotes productive cough, thins secretions * uses: clear airway of mucus * available in combo with antitussives or decongestants
48
complications of expectorants
* GI distress: take with food * drowsiness, dizziness: avoid driving, etc.
49
contraindications and precautions for expectorants
* pregnancy: C * talk with provider if breastfeeding * may be contraindicated in children
50
administering expectorants
* ↑ fluids to thin secretions * available in tablets, capsules, syrups * pt education: **READ LABELS** (often in combos) to avoid unintentional OD
51
mucolytics
* prototype: acetylcysteine (Mycomyst) * other: hypertonic saline * MOA: thin and enhance flow of secretions * use: acute, chronic pulmonary disorders; cystic fibrosis, **antidote for acetaminophen poisoning**
52
complications of mucolytics
* PO: aspiration and bronchospasm * dizziness, drowsiness, hypotension, tachycardia: monitor VS, fall risk * hepatotoxicity: monitor LFTs
53
precautions for mucolytics
* pregnancy: B * asthma * hypothyroidism * CNS depression * renal and liver dz * sz disorder
54
administering mucolytics
* **smells like rotten eggs** * inhaled, PO, IV * in acetaminophen OD, monitor * LFTs * PT * BUN * glucose * electrolytes * acetaminophen level
55
decongestants
* prototype: phenylephrine * other: ephedrine, naphazoline (ophthalmic), pseudoephedrine * MOA: stim of alpha1-adrenergic receptors, ↓ inflammation of nasal membrane * uses: allergic or non-allergic rhinitis, sinusitis, common cold * sympathomimetic
56
complications of decongestants
* rebound congestion (topical use): use 3-5 days max, taper * agitation, nervousness: report and stop med * vasoconstriction: avoid with HTN, cerebrovascular dz, CAD, dysrhythmias
57
contraindications and precautions for decongestants
* contra: closed-angle glaucoma * caution * HTN * cerebrovascular dz * CAD * dysrhythmias
58
administering decongestants
* topical * associated with rebound congestion * work faster * more effective * shorter duration * systemic effects uncommon * oral * effects similar to amphetamine * ID needed to purchase OTC
59
antihistamines
* 1st generation * diphenhydramine (Benadryl) * promethazine (Phenergan) * dimenhydrinate (Dramamine) * 2nd generation * loratadine (Claritin) * cetirizine (Zyrtec) * fexofenadine (Allegra) * desloratadine (Clarinex) * intranasal * azelastine * olopatadine
60
antihistamines MOA, uses
* MOA: act on H1 receptors and block histamine release caused by allergic reaction * uses * mild allergic reaction * anaphylaxis * motion sickness * insomnia * nausea * with sympathomimetic for nasal decongestion
61
antihistamine complications
* sedation: take at night, avoid ETOH/CNS depressants, caution during driving, etc. * dry mouth * GI distress: take with food, ↑ fluids and fiber * acute toxicity, excitation, hallucinations, incoordination, sz, high fever: activated charcoal, cathartic * premoethazine: resp. depression and tissue injury at IV site
62
contraindications and precautions for antihistamines
* contra * 3rd trimester, breastfeeding, newborns * promethazine: children \< 2 yr, liver dz, MAOI use, dysrhythmias * caution * children * older adults * sz disorder * heart dz * renal dz * urinary retention * open-angle glaucoma * HTN * prostate hypertrophy * asthma
63
interactions with
* ETOH * other CNS depressants
64
administering antihistamines
more sedative effect with 1st generation
65
nasal glucocorticoids
* prototype: mometasone (Nasonex) * other: fluticasone (Flonase), triamcinolone (Nasocort), budesonide (Rhinocort) * MOA: ↓ inflammation in allergic rhinitis; first-line Tx * uses: allergic rhinitis (sneezing, itching, drainage, congestion)
66
complications and precautions for nasal glucocorticoids
* SE * sore throat * nosebleed * headache * burning * pregnancy: C
67
administering nasal glucocorticoids
* dosing is daily * seasonal allergies: 7+ days for max benefit * perennial allergies: 21+ days for full effect * may need topical decongestant before using
68
Tx for asthma includes what classes of drugs? (BAM/SLM)
* **B**eta2-adrenergic agonists (bronchodilators) * **A**nticholinergic * **M**ethylxanthines * anti-inflammatories * **S**teroids (glucocorticoids) * **L**eukotriene modifiers * **M**ast cell stabilizers
69
non-opioid analgesics
* acetaminophen, NSAIDs * for mild to moderate pain * also antipyretics
70
non-steroidal anti-inflammatory drugs (NSAIDs)
* MOA: inhibit inflammatory effects of COX-1 and/or COX-2 * ↓ pain, inflammation, fever * 1st-generation (COX-1 and COX-2) * aspirin * ibuprofen (Advil, Motrin) * naproxen (Aleve) * indomethacin * diclofenac * ketorolac * meloxicam * 2nd-generation (COX-2 only) * celecoxib (Celebrex)
71
complications of NSAIDs
* ↑ risk of GI ulcer, bleeding, renal impairment * take with food or adjuvant GI protectant * monitor for s/sx of GI bleed, other bleeding * celecoxib: ↑ risk of MI/stroke * aspirin: ↓ risk of MI/stroke
72
precautions for NSAIDs
* older age * smoking * alcohol use disorder * renal impairment * GI issues * pregnancy * bleeding disorders * use of anticoagulant meds
73
administering NSAIDs
* mostly PO; some IV and IM forms * stop OTC aspirin 1 wk before procedures/surgery * don't crush or chew enter-coated pills * notify provider of bleeding, N&V, abd pain
74
interactions with NSAIDs
* ↑ risk of bleeding with warfarin, glucocorticoids * ↑ all risks: concurrent use of multiple NSAIDs
75
Reye syndrome
* rare but serious * when ASA used in children with viral illness * **DO NOT** treat pediatric fever with ASA * s/sx * diarrhea * tachypnea * vomiting * severe fatigue * fever * hypoglycemia → confusion, sz, LOC
76
salicylism
* mild ASA toxicity * max dose: 4 g/day * s/sx * tinnitus * sweating * HA * dizziness * respiratory alkalosis * stop taking and contact provider * → toxicity
77
aspiring toxicity
* max dose: 4 g/day * s/sx * high fever * sweating * acidosis * dehydration * electrolyte imbalance * coma * respiratory depression * **medical emergency** * Tx * gastric lavage/activated charcoal * hemodialysis * cooling with tepid water * IV fluid correction * bicarb for acidosis
78
acetaminophen
MOA: slows production of prostaglandins in CNS
79
acetaminophen considerations
* max dose: 4 g/day * ETOH * use caution if \> 1-2 drinks/day * max dose: 2 g/day * use cautiously with warfarin: monitor PT, INR * liver dysfunction: check LFTs before giving * pt education: **READ LABELS**, don't accidentally OD by taking multiple acetaminophen combos * monitor for concurrent admin with combos
80
acute acetaminophen toxicity
* rare at therapeutic dose * → liver damage * s/sx * N&V * diarrhea * sweating * abd pain * liver failure * coma * death * max dose: 4 g/day * antidote: acetylcysteine
81
opioid agonists
* **prototype: morphine** * fentanyl * meperidine * methadone * codeine * oxycodone * hydromorphone
82
side effects of opioid agonists
* worse with ETOH, CNS depressants * respiratory depression: monitor VS * sedation: fall risk, avoid driving, etc. * constipation * prevention/mild: ↑ fluid and fiber, docusate sodium * acute: stimulant laxative * long-term opioid use: opioid antagonist * N&V: give antiemetic (promethazine is synergist), worse with antihypertensives * urinary retention * monitor I&O * encourage voiding Q4H * assess for distention * worse with BPH, concurrent anticholinergics
83
opioid agonist long-term use
* physical dependence * can → abuse, illicit use * withdrawal: **taper use** * tolerance * diminished therapeutic response * no relief or SE from normal dose
84
opioid agonist acute overdose
* s/sx * respiratory depression * coma * pinpoint pupils * Tx * stop med * CPR * naloxone * mechanical ventilation
85
administering opioid agonists
* always assess pain level first and medicate per level * reassess an appropriate amount of after admin according to route * monitor respiratory status * do not over-medicate * fixed schedule for severe chronic pain * PRN for acute pain, giving meds before pain is severe
86
agonist-antagonist opioids
* MOA: agonist for Kappa opioid receptors, antagonist for Mu * for moderate to severe pain * ideal for labor pain * compared to opioid agonists * ↓ effective * ↓ respiratory depression * ↓ risk of abuse * drugs * **prototype: butorphanol** * nalbuphine * buprenorphine * penazocine
87
complications of opioid agonist-antagonists
* sedation * respiratory depression * dizziness: fall risk, avoid machinery, etc. * headache * abstinence syndrome * ↓ activity of Mus → withdrawal in opioid-dependent pt * cramping * HTN * vomiting * fever * anxiety
88
contraindications and precautions for opioid agonist-antagonists
* contra: opioid use disorder * caution * chronic dz * head injury
89
opioid antagonists
* MOA: compete for receptors, blocking opioid action * drugs * prototype: naloxone * methylnaltrexone * alvimopan * use: reverses respiratory depression, euphoria, constipation, **and pain control**
90
complications of opioid antagonists
* tachycardia * tachypnea
91
contraindications for opioid antagonists
opioid dependency, except in case of OD
92
tricyclic antidepressants
* uses: depression, adjuvant for fibromyalgia, nerve pain (usually chronic) * prototype: amitriptyline * SE * orthostatic hypotension: avoid falls * sedation: avoid driving, etc. * anticholinergic effect: ↑ fluid, comfort measures * contraindications/precautions * recent MI * taking MAOI * glaucoma * BPH * Sz * liver dz * kidney dz
93
anticonvulsants
* uses: sz prevention, adjuvant for neuropathy pain (common in DM) * drugs: carbamazepine, gabapentin * **lots of interactions**
94
contraindications and precautions for anticonvulsants
* bone marrow suppression * MAOI use * pregnancy
95
interactions with anticonvulsants
* warfarin * oral contraceptives * grapefruit * other anticonvulsants * CNS depressants
96
complications of anticonvulsants
* drowsiness: take at night, avoid driving * GI upset: take with food, ↑ fluid and fiber, stool softener, laxative * bone marrow suppression: monitor for bruising, bleeding, **sore throat,** and **fever** * **rash: HOLD and notify provider**
97
CNS stimulants
* prototype: methylphenidate * MOA: ↑ analgesia, ↓ sedation * monitor for wt loss * SE: insomnia (take before 1600, ↓ caffeine * caution * HTN * Hx of substance use disorder * OTC meds * contra * MAOI use
98
muscle relaxants/antispasmodics
* centrally acting * **diazepam (Valium)** * baclofen * cyclobenzaprine (Flexeril) * tiZANidine (Zanaflex) * peripherally acting * **dantrolene (Dantrium)** * interactions: CNS depressants, additive effects * precautions: liver and kidney impairment, pregnancy
99
migraine medications
* acute: **not more than 2x/wk** * NSAIDs * acetaminophen * triptans * ergots * prophylactic * TCAs * anticonvulsants * beta blockers * estrogens
100
triptans
* for Tx of acute migraine * all names end in "triptan" * contraindications * ischemic heart dz * liver failure * uncontrolled HTN * interactions * do not take with: ergots, MAOIs or below drugs * ↑ risk of serotonin syndrome * St. John's wort * SSRIs, SNRIs, TCAs * other triptans * bupropion (Wellbutrin) * buspirone (BuSpar) * meperidine (Demerol)
101
ergots
* for Tx of acute migraine * all have "ergot" in the name * contraindications: renal, liver dysfunction; CAD; HTN * **pregnancy category X: use contraception**
102
beta blockers
* Tx of HTN, tachyarrhythmias, angina, MI, HF, hyperthyroidism * prevention of migraine * all end in "lol" * monitor for orthostatic hypotension * caution: pregnancy, lactation, lung dz, DM, severe liver dz * do not stop abruptly in pts with CV dz * interactions * bronchodilators: ↓ effect * other meds that slow the heart: + effect * DM meds: alter dose * cimetidine: ↓ metabolism, ↑ effects of beta blocker
103
neuromuscular blockers
* MOA: block ACh at neuromuscular junction → muscle relaxation, hypotension; paralysis without LOC or analgesia * use: facilitate intubation, control muscles during ECT * drugs * **succinylcholine: can cause MH; treat with dantrolene** * pancuronium: reversed by **neostigmine** * **must have airway and mechanical vent stat** * monitor for return of respiratory ftn
104
IV sedatives and anesthetics
* giving in anesthetic context requires **additional training** * non-opioid sedation * barbiturates: phenobarbital * benzodiazepines (preop, conscious sedation) * midazolam (Versed): induces amnesia * diazepam (Valium) * lorazepam (Ativan) * propofol * ketamine * opioid analgesia * fentanyl * morphine
105
anesthesia care
* pt continuously monitored 1-on-1 by RN * RN must be trained in ACLS and admin of sedation * administer slowly * after admin, monitor for * VS return to baseline * orientation x4 * pt can void within 8 hr * control of N&V * no driving for pt
106
anticoagulants
* MOA: activate anti-thrombin, inactivate thrombin and factor Xa * parenteral * drugs * **unfractionated: heparin** * low molecular weight * **enoxaparin** * dalteparin * activated factor Xa inhibitor: fondaparinux
107
vitamin K inhibitors
* prototype: warfarin
108
direct thrombin inhibitors
109
direct factor Xa inhibitors
110
antiplatelets
111
thrombolytic meds
112
contraindications and precautions for anticoagulants
* contra * thrombocytopenia * uncontrolled bleeding * surgery of eyes, brain, spinal cord * lumbar puncture * regional anesthesia * caution * hemophilia * PUD * severe HTN * liver or kidney dz * threatened abortion
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2020 Pharmacology I (21 decks)

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