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Heme > drugs > Flashcards

drugs Flashcards

1
Q

Deferoxamine

A

IV iron-chelating compound
urine or bile excretion.

tox: tachycardia, hypotension, shock, abdominal discomfort N&V

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2
Q

Ferrous sulfate

A

iron supplement. Oral

tox: nausea, abdominal cramps, constipation

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3
Q

Cobalamin

A

Vitamin B12; needed for DNA synthesis

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4
Q

Cyanocobalamin

A

Vitamin B12 supplement; IM

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5
Q

hydroxycobalamin

A

Vitamin B12 supplement; IM

preferred; more highly protein-bound, remains in circulation longer

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6
Q

folic acid

A

essential for synthesis of AA, purines and DNA; deficiency in alcoholics and liver disease. need in pregnancy; 1 mg oral suppliment

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7
Q

epoetin alfa

A

agonist of EPO; stimulates erythroid proliferation and differentiation;
tox: CV reactions, HTN, thromboitic complications, pure red cell aplasia

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8
Q

darbopoeitin

A

long acting glycosylated form of EPO; administered weekly

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9
Q

Sargramostin

A

GM-CSF; stimulates proliferation of granulocytes, Erythroid and megakaryocyte progenitors;
tox: fever, malaise, myalgia, capillary leak syndrome,

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10
Q

Filgrastim

A

G-CSF; stimulate proliferation of neutrophil progenitors; peripheral blood stem cells; neutrophil recovery after chemo
tox: bone pain, splenic rupture

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11
Q

oprelvekin

A

Interleukin-11; stimulates megakaryocytopoiesis and thrombopoiesis; SC administration
tox: fatigue, headache, dizziness, CV events, anemia, dyspnea

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12
Q

Thrombopoietin

A

Romiplostin; to induce platelet formation.

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13
Q

Iron dextran

A

IV or IM iron supplement;

tox: headache, fever, arthralgias, N&V; back pain, flushing, rare anaphylaxis

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14
Q

Bortezomib

A

Prevents proteasome breakdown of IkB to prevent NF-kB activation

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15
Q

Aspirin

A

irreversibly inhibits COX-1 and reduces TXA2 and PGI2 production
inhibiting platelet aggregation
tox: GI problems, hepatic & renal tox with overdose, allergy

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16
Q

Ibuprofen

A

COX inhibitor. reversible

side effects: GI

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17
Q

Clopidogrel

A

Plavix. oral prodrug; used post-MI, stroke, PAD
inhibit ADP binding–>inhibits GP IIb/IIIa receptor -> fibrinogen binding; irreversible
genetic test for poor CYP2C19 metabolizers

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18
Q

Ticlopidine

A

Ticlid; oral. second line treatment
inhibit ADP binding–>Inhibits GP IIb/IIIa receptor-> fibrinogen binding; irreversible
tox: hematologic toxicities (agranulocytosis, neutropenia, thrombocytopenia, TTP, anemia)

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19
Q

Parsugrel

A

Effient; oral prodrug; acute MI, arterial thromboembolism prophylaxis, unstable angina.
inhibit ADP binding–> inhibits GPIIb/IIIa receptor–> fibrinogen binding; irreversible

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20
Q

Dipyridamole

A

oral/IV; prophylaxis of thrombus in pt with prosthetic heart valves (w/warfarin)
increases cCAMP to block Aracidonic acid to reduce TXA2 activity ; adenosine accumulation (vasodilation in coronary)
hepatic glucuronidation and fecal elimination
don’t give in hypotension or asthma

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21
Q

Abciximab

A

IV, GPIIa/IIIb antagonists; angina, percutaneous transcutaneous coronary angioplasty; MAB binding arginine-glycine-aspartic acid
irreversible
tox: bleeding, thrombocytopenia, anaphylaxis

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22
Q

Eftifibatide

A

IV, GPIIa/IIIb antagonists; angina, percutaneous transcutaneous coronary angioplasty; synthetic snake venom; binds lysine-glycine-aspartic acid
tox: bleeding, anaphylaxis

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23
Q

Tirofiban

A

IV, GPIIa/IIIb antagonists; angina, percutaneous transcutaneous coronary angioplasty; binds arginine-glycine-aspartic acid
tox: bleeding, anaphylaxis

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24
Q

Vorapazar

A

oral, reversible PAR-1 antagonist; long half life (8 days); CYP3A4 metabolised–fecal elimination
tox: bleeding

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25
Q

Herbal products

A

Ginkgo biloba, garlic, ginger

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26
Q

Heparin

A

anticoagulant; binds antithrombin, increasing inactivation of thrombin, Xa
test PTT
tox: bleeding, allergic response, thrombocytopenia, osteoporosis

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27
Q

Protamine sulfate

A

heparin antagonist; IV; ionically binds to heparin

tox: fish hypersensitivity, bleeding, Protamine reaction (in IDDM, vasectomy, fish allergy, prior exposure, rate of IV)

28
Q

Dabigatran

A

anticoagulant; direct thrombin inhibitor; binds to free or clot bound
T&P of DVT, PE, P of stroke
oral
tox: bleeding

29
Q

Bivalrudin

A 
anticoagulant; direct thrombin inhibitor; binds to free or clot bound
T&P of DVT, PE, P of stroke
IV
metabolized by plasma esterases
tox: bleeding
30
Q

Lepirudin

A

anticoagulant; direct thrombin inhibitor; finds to free or clot bound
T&P of DVT, PE, P of stroke
IV
tox: bleeding

31
Q

Enoxaparin

A

anticoagulant; LMW heparin; can only catalyze inhibition of factor Xa by ATIII
monitered by Factor Xa assay
tox: anaphylaxis

32
Q

Apixaban

A

anticoagulant, direct Factor Xa inhibitor-> inhibits thrombin; inhibit prothrombinase activity
oral
treat or prophylaxis of DVT, PE, stroke (p only)
CYP metabolized
tox: bleeding

33
Q

Rivaroxaban

A

anticoagulant, direct factor Xa inhibitor-> inhibits thrombin inhibit prothrombinase activity
oral
treat or prophylaxis of DVT, PE, stroke (p only)
CYP metabolized
tox: bleeding

34
Q

Fondaparinux

A

anticoagulant; antithrombin IIIa binds to ATIII-> inhibits Xa-> inhibits thrombin
IV or SC
treat or prophylaxis of DVT or PE
tox: bleeding

35
Q

Warfarin

A

oral anticoagulant; inhibits C1 subunit of Vitamin K epoxide reductase–> slow effect; CYP metabolized; initial hyper-coagulable state
S-isomer more potent
prolonged PT
tox: teratogenic, purple-toe syndrome, atherosclerosis plaque emboli

36
Q

Prothrombin complex

A

Warfarin antagonist; from human plasma–contains factors 2, 7, 9, 10 C and S
contra: PMH of angina, MI, PVD, stroke, thromboembolic disease

37
Q

Phytonadione vitamin K1

A

Warfarin antagonist; T&P of hemorrhage, hypothrombinemia

38
Q

Alteplase, t-PA

A

thrombolytic; plasminogen activators–hydrolyzing argine-valine bond in plasminogen (only bound)
hepatic clearance

39
Q

Aminocaproic acid

A

thombolytic; fibrinolysis inhibitor–inhibiting activation of plasminogen to plasmin
hemorrhage, hyperfirinolysis
contraindicated: DIC,
tox: hypotension, bradycardia if given IV

40
Q

Streptokinase

A

thrombolytic; plasminogen activator–does not chose between bound or circulation;
leads to systemic lytic state
purified from hemolytic strep
undefined clearance

41
Q

induction therapy

A

high dose combination therapy

42
Q

Consolidation therapy

A

repetition of induction therapy during remission

43
Q

Maintenance

A

long term, lower dose therapy during remission

44
Q

Metronomic dosing

A

daily administration of much lower drug doses; lowers chemo resistance, inhibits angiogenesis

45
Q

AML treatment

A

ARA-C, Thioguanine, Daunorubicin

tox: myelosuppressvie, cardiotox (D)

46
Q

PML treatment

A

ATRA, arsenic trioxide

47
Q

childhood PML treatment

A

ATRA, anthracycline, cytarabine

48
Q

Arsenic Trioxide

A

treatment of PML. unknown MOA.

tox: AV block, QT prolongation, electrolyte imbalance, PML differentiation syndrome

49
Q

ALL treatment

A

CNS prophlyaxis with methotrexate;

prednisone, vincristine, anthracycline

50
Q

Imatinib

A

BCR-ABL tyrosine kinase inhibitor

tox: increased liver enzymes, N&V, “cytopenias”, birth defects

51
Q

CML treatment

A

Imatinib

2nd gen: nilotinib, dasatinib

52
Q

Hairy Cell leukemia treatment

A

Cladribine, Pentostatin, Interferon

53
Q

Hodgkin Lymphoma treatment

A

Doxorubican, vincristine, alkylating agent (cyclophosphamide or bleomycin), “carbazine”, possible corticosteroid.
radiation

54
Q

NHL Low stage Disease treatment

A

COMP: cyclophosphamide, vincristine, methotrexate, prednisone

55
Q

NHL High Stage B cell treatment

A

R-CHOP

Rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone

56
Q

CD20+ targeted therapies

A

Tositumomab, ibritumomab. deliver radiation to marked cells

tox: thrombcytopenia, neutropenia, anemia

57
Q

Burkitt Lympohma treatment

A

cyclophosphamide + methotrexate,

vincristine + doxorubicine

58
Q

HAART CYP inhibiors

A

Delavirdine–3A4, 2D6, 2C9, 2C10
Atazanvir-3A4, UGT
Ritonavir-3A4, 2D6, p-pg, UGT
Saquinavir-3A4, UGT

59
Q

HAART CYP activators

A

efavirenz, nevirapine–3A4, 2B6

60
Q

ATRIPLA

A

tenofovir, emtricitabine, efavirenz

oral daily pill, most common single drug product

61
Q

Recommended ART in pregnancy

A

Lamivudine, AZT, neviarpine, lopinavir/ritonavir

62
Q

Cidofovir

A

for KSHV
IV; intracellular conversion to _TP form; renal clearance
tox: nephro, neutropenia, ocular hypotona, GI, rash/alopecia

63
Q

Cobicistat

A

CYP3A4 inhibitor used to increase levels of ARVs like atazanavir and darunavir

64
Q

Protease inhibitors side effects

A

GI intolerance, lipodystrophy, hyperglycemia/DM, dyslipidemia, nephrolithiasis, rash

65
Q

CLL treatment

A

fludarabine/rituximab/cyclophosphamide

in different combinations or all together

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