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Flashcards in Drugs Heme Onc Deck (30)
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1

Direct thrombin inhibitors

Agatroban, bivalirubin, dagatran

2

How do you reverse warfarin

vit K, fresh frozen plasma

3

How do you reverse heparin

protamine sulfate (if HMW heparin, acute duration so can just discontinue) for LMWH and fondaparinaux

4

Thrombolytics

"-plase" Alteplase (tPa) Reteplase (rPa) Streptokinase tenecteplase (TNK-tPA)

5

Aspirin

irreversible COX1 COX2 inhibitor 

6

ADP receptor inhibitors

Clopidogrel, prasugrel, ticagrelor (reversible), ticlopidine

Inhibits ADP receptors and thus blocks appearance of GpIIb/IIIa on cell surface 

7

Cilostazol, dipyridamole

phosphodiesterase III inhibitor, increase cAMP and inhibits platelet aggregation; vasodilator

8

GpIIb/IIIa inhibitors

Abciximab, eptifibatide, tirofiban Prevents platelet aggregation

Abciximab made from monoclonal Fab fragments

9

Clinical use direct Xa inhibitors

DVT PE prophylaxis (rivaroxaban)

Stroke prophylaxis in patients with afib

10

Toxicity of direct Xa inhibitors

bleeding (nor reversal agent)

11

Use of direct thrombin inhibitors

Alternative to heparin for patients with HIT

12

Use of thrombolytics

Early MI, early ischemic stroke, direct thrombolysis in massive PE

13

Toxicity of thrombolytics

bleeding

contradidicated in patients with active bleeds, history of intracranial bleeding, recent surgery, known bleeding diathesis, or severe HT

Treat toxicity with aminocaproic acid

14

Toxicity of aspirin

Gastric ulcers, tinnitus, 

chronic uses can lead to acute renal failure, interstitial nephritis, and upper GI bleeds 

Reyes syndrome in children with flu 

Overdose causes hyperventilation and resp alk --> mixed metabolic acidosis resp alk

15

Uses of ADP receptor blockers

Acute coronary syndrome, coronary stenting , decreases incidence or recurrance of thrombolytic stroke

16

Uses for phosphodiesterase inhibitors

intermittent claudication, cornonary vasodilation, prevent of stroke or TIA (combined with aspiring), angina prophylaxis 

17

Phosphodiesterase inhibitor toxicity

nausea, headache, facial flushing, hypotension, abdominal pain 

18

GP IIb/IIIa inhibitors toxicity

bleeding, thrombocytopenia 

19

Methotrexate (MTX)

Folic acid analog that competitively inhibits dihydrofolate reductase (DHF --> THF) 

THF needs to be methylated to donate to convert dUMP to dTMP 

20

Clinical uses for MTX

ALL, lymphomas, choriocarcinoma, sarcoma 

Ectopic pregnancy, medical abortion, rheumatoid arthritis, psoriasis, IBD, vasculitis 

21

Toxicity for MTX

Myelosuppression reversible with leucovorin rescue 

Hepatoxicity

Mucositis (mouth ulcers)

Pumonary fibrosis 

22

5-flurouracil

pyrimadine analog that is bioactivated to 5F-dUMP which complexes with folic acid and as a complex inhibits thymidylate synthase which converts dUMP to dTMP 

23

5-FU clinical uses

colon cancer, pancreatic cancer, carcinoma (topical)

24

Toxicity of 5-FU

myelosuppression not reversible with luecovorin (folinic acid) 

25

What is the action of prednisone, prednisolone?

glucocorticoid that binds to an intracytosolic receptor and increases transcription of a variety of factors 

26

What is prednisone used in?

Most common glucocorticoid used in cancer treatment

CLL, non hodgkins lymphoma

Autoimmune diseases

27

What is prednisone's toxicity?

Cushing like symptoms, weight gain, cattaracts, acne, osteoporosis, HT, muscle breakdown, peptic ulcers, hyperglycemia, psychosis

Story; "Man complains of 15 lb weight gain and facial acne, has a BP of 142/90 and his glucose is 220"

28

What are the first line drugs for treatment of lead poisoning?

Dimercaprol and EDTA

Succimer for children

29

Which ADP receptor blocker is reversible?

Ticagrelor 

All the rest are irreversible 

30

ADP receptor inhibitor tox

Neutropenia (ticlopidine), TTP