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Pharmacology > Drugs Used to Treat Diseases of the Blood > Flashcards

Drugs Used to Treat Diseases of the Blood Flashcards

1
Q

HEMATOPOIETIC GROWTH FACTORS

Required for biosynthesis of heme and heme containing proteins – hemoglobin and myoglobin

USES:
IDA
iron supplementation

A 
ORAL:
Ferrous sulfate
Ferrous carbonate
Ferrous fumarate
Ferrous gluconate

PARENTERAL:
Iron dextran
Iron sucrose
Sodium ferric gluconate complex

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2
Q

Acute Iron Intoxication

necrotizing gastroenteritis
shock
metabolic acidosis
coma
death
A

TREATMENT:

removal of unabsorbed tablets form gut
correction of acid base and electrolyte abnormalities
Deferoxamine

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3
Q

Chronic Iron Intoxication

TRIAD:
cirrhosis
DM
skin pigmentation

A

TREATMENT:

phlebotomy
Deferoxamine or Deferasirox

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4
Q

HEAVY METAL CHELATORS

chelates excess iron

USES:
acute iron poisoning
hemochromatosis

A

Deferoxamine
Deferasirox
Deferiprone

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5
Q

ERYTROPOIESIS STIMULATING AGENTS

EPO - produced in kidney
main stimulus:
hypoxia inducible factor 1

agonist of EPO receptors expressed by red cell progenitors

USES:
anemia especially associated with chronic renal failure

A

ERYTROPOIESIS STIMULATING AGENTS

Epoetin Alfa
Darbepoetin Alfa
Methoxy Polyethylene Glycol - Epoetin Beta

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6
Q

MYELOID GROWTH FACTORS

Bind receptors on myeloid progenitors and stimulates cell maturation and proliferation

USES:
neutropenia associated with chemotherapy
myelodysplasia
aplastic anemia

A

MYELOID GROWTH FACTORS

Filgrastim (G-CSF)
Sargramostim (GM-CSF)
Pegfilgrastim
Plerixafor
Lenograstin
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7
Q

MEGAKARYOCYTE GROWTH FACTOR

Recombinant form of an endogenous cytokine
Activates IL-11 cytokine

A

Oprevelkin (IL-11)
Thrombopoietin
Eltrombopag
Romiplastim

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8
Q

ANTIPLATELETS

Nonselective, irreversible COX 1 and 2 Inhibitor

USES:
prevention of arterial thrombosis (MI, TIA, CVD)
RF, Kawasaki disease, JRA

A

COX INHIBITOR

Aspirin (Acetylsalicylic acid, ASA)
Salsalate
Sodium salicylate

SE:
GI toxicity
Nephrotoxicity (AKI, and Interstitial nephritis)

associated with REYE syndrome in children

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9
Q

Mechanisms of Hemostasis

A

Vasoconstriction
Platelet Plug Formation
Formation of Clot via Blood Coagulation
Fibrous Organization

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10
Q

SAMTER TRIAD

A

Asthma
ASA sensitivity
Nasal polyps

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11
Q

ANTIPLATELETS

Inhibits platelet aggregation by interfering with GPIIb/IIIa binding to fibrinogen and other ligands

USES:
PCI - to prevent thrombosis
Adjunct to thrombolysis
ACS (unstable angina, NSTEMI)

prevents vessel restenosis, reinfarction and death

A

GPIIIB/IIIA INHIBITOR

Abciximab
Eptifibatide
Tirofiban

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12
Q

ANTIPLATELETS

Irreversibly inhibits binding of ADP to platelet receptors – reduce platelet aggregation

USES:
Prevention and treatment of arterial thrombosis (stroke, TIA, unstable angina)
Prevention of restenosis after PCI
ACS

Part of the ACS regimen – loading dose of 300 mg Clopidogrel can reduce platelet activity by 80% within 5 hrs of administration

A

ADP INHIBITOR

Clopidogrel
Ticlopidine
Prasugrel
Ticagrelor

SE:
bleeding
nausea
dyspepsia
hematologic (neutropenia, leukopenia)
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13
Q

Salicylate Toxicity

A

nausea
vomiting
tinnitus

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14
Q

ANTIPLATELETS

Inhibits phosphodiesterase III and increases cAMP

Inhibits platelet aggregation – vasodilation

USES:
prevention of thromboembolic complications of cardiac valve replacement

Cilostazol - refractory intermittent claudication in patients with PAD

A

PDE Inhibitor

Cilostazol
Dipyridamole (Persantine)

SE:
headache
palpitations

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15
Q

Aspirin Toxicity

Toxic dose: 100 mg/kg
Lethal dose: 500 mg/kg

A 
HAGMA
Dehydration
Hyperthermia
Collapse
Coma
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16
Q

ANTICOAGULANTS

Binds to THROMBIN (IIa) active site and (-) its enzymatic action

USES:
heparin induced thrombocytopenia (HIT)
percutaneous coronary angioplasty (with aspirin)

A

DIRECT THROMBIN INHIBITORS
-RUDIN

Lepirudin
Bivalirudin
Desirudin
Argatroban
Dabigatran - PO

monitor effect with aPTT

17
Q

Monoclonal antibody used for reversal of Dabigatran toxicity

A

Idarucizumab

18
Q

ANTICOAGULANTS

Inhibit factor Xa in the final common pathway

USES:
Prevention of venous thromboembolism
Prevention of stroke in patients w/ atrial fibrillation
After hip or knee surgery

A

ORAL DIRECT FACTOR XA INHIBITOR
-Xa

Rivaroxaban
Apixaban
Betrixaban
Edoxaban

19
Q

ANTICOAGULANTS

Activates antithrombin III

USES:
DOC for anticoagulation during pregnancy
Deep venous thrombosis
PE
MI
Unstable angina
Adjuvant to percutaneous coronary intervention (PCI) and thrombolytics
Atrial fibrillation
A

INDIRECT THROMBIN INHIBITORS

Heparin

SE:
heparin induced thrombocytopenia (HIT)
OSTEOPOROSIS

monitor with aPTT

20
Q

Antidote for Heparin

A

Protamine sulfate

21
Q

A heparinoid consisting of 80% heparin and 20 % dermatan sulfate

A

Sulodexide

22
Q

ANTICOAGULANTS

Binds and potentiates effects of antithrombin III on factor Xa (more selective)

Less effect on thrombin

Same use with heparin

A

INDIRECT THROMBIN INHIBITORS

Enoxaparin
Fondaparinux
Dalteparin
Tinzaparin
Danaparoid
Nadroparin
23
Q

ANTICOAGULANTS

Binds and potentiates effects of antithrombin III on factor Xa (more selective)

Less effect on thrombin

Same use with heparin

A

INDIRECT THROMBIN INHIBITORS

Enoxaparin
Fondaparinux - SC
Dalteparin
Tinzaparin
Danaparoid
Nadroparin

SE:
less risk of thrombocytopenia

does NOT require aPTT monitoring

24
Q

ANTICOAGULANTS

Inhibit vitamin K epoxide reductase (responsible for y-carboxylation of the vitamin K dependent clotting factors: II, VII, IX, X, Protein C and S)

USES:
chronic anticoagulation - DVT, atrial fibrillation, valve replacement
EXCEPT in pregnancy

A

ORAL ANTICOAGULANT

Warfarin
Dicumarol
Anisindione

SE:
warfarin induced skin necrosis
teratogen (bone defects, hemorrhages)

monitor effects with PT

25
Q

Antidote for Warfarin

A

SLOW - Vitamin K

FAST - FFP

26
Q

ANTICOAGULANTS

Tissue plasminogen activator analog
Converts plasminogen to plasmin – degrades fibrin and fibrinogen – thrombolysis

USES:
acute MI
ischemic stroke
PE

A

FIBRINOLYTIC DRUGS

Streptokinase
Alteplase
Anistreplase
Reteplase
Tenecteplase
Urokinase

SE:
bleeding
cerebral hemorrhage
reperfusion arrhythmias

27
Q

Antidote for fibrinolytics

A

Aminocaproic acid

28
Q

Contraindications to Thrombolysis

A

Hx of cerebrovascular hemorrhage at any time
Non hemorrhagic stroke or other cerebrovascular event within the past year
Marked HPN (>180/110)
Suspicion of aortic dissection
Active internal bleeding (excluding menses)

29
Q

PRO-CLOTTING (PROTHROMBICS)

Competitively inhibits plasminogen activation by inhibiting tPA

USES:
prevention and treatment of acute bleeding episodes in patients with high risk of bleeding (hemophilia, intracranial aneurysms, menstrual, obstetric, thrombolytics, postoperative)

A

ANTIPLASMIN DRUG

Tranexamic acid

SE:
thrombosis
hypotension
myopathy
diarrhea

CI:
DIC

30
Q

PRO-CLOTTING (PROTHROMBICS)

Increases supply of reduced vitamin K – required for synthesis of functional vitamin K dependent clotting and anticlotting factors

USES:
Vitamin K deficiency
Antidote to warfarin
Prevention of hemorrhagic diseases in the newborns

A

VITAMIN K AND DERIVATIVES

Vitamin K1 - Phytonadione
Vitamin K2 - Menaquinone

SE:
severe infusion reaction when given too fast

31
Q

PRO-CLOTTING (PROTHROMBICS)

ADH vasopressin V2 receptor agonist

USES:
Hemophilia A
von Willebrand’s disease
Central Diabetes Insipidus

increases the factor VIII activity of patients with mild hemophilia A or vWF disease

A

ADH Agonist

Desmopressin
Vasopressin
Terlipressin

SE:
headaches
flushing
nausea
hyponatremia
seizure

Pharmacology (72 decks)

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