Heart Failure, Diuretics, Hyperlipidemia, Allergy, Asthma, Anemia, Coagulation Flashcards
1
Q
cardiac glycoside, inhibits Na/K ATPase, increases intracellular Ca, increasing cardiac contractility
A
digoxin
2
Q
visual changes (yellow halos in vision)
A
digoxin
3
Q
arrhythmogenesis in digoxin increased by
A
hypokalemia, hypomagnesemia, hypercalcemia
4
Q
drugs with narrow therapeutic index
A
warfarin, aminoglycosides, lithium, ampho B, carbamazepine, phenobarbital, phenytoin, vanco, theophylline, digoxin (WALA na Cyang PaPa! VasTeD na!)
5
Q
DOC antiarrhythmic drug in digitalis toxicity
A
lidocaine
6
Q
digoxin antibodies
A
Fab fragments; Digibind
7
Q
first line therapy for both systolic and diastolic failure
A
furosemide
8
Q
aldosterone antagonist
A
eplerenone
9
Q
first-line drugs for chronic heart failure, decrease ventricular remodeling (cardioprotective)
A
ARBs/ACEIs
10
Q
reduce progression of CHRONIC heart failure, may be detrimental if systolic dysfunction is marked in acute failure
A
Carvedilol, Labetalol, Metoprolol
11
Q
iminarone, milrinone
A
phosphodiesterase inhibitor
12
Q
associated with increased morbidity and mortality in chronic heart failure
A
phosphodiesterase inhibitor
13
Q
vasodilators for acute severe failure with congestion
A
nitroprusside or nitroglycerin
14
Q
shown to reduce mortality in African-Americans with CHF
A
hydralazine, ISDN
15
Q
class of drugs w/o value in CHF
A
CCB
16
Q
improved survival in cases of heart failure
A
ACEIs, beta-blockers, aldosterone antagonists (ABA buhay ka pa!)
17
Q
prolonged QT interval, polymorphic Vtach
A
Torsades de Pointes
18
Q
anti-arrhythmics class 1; phase
A
sodium channel blockers; phase 0
19
Q
anti-arrhythmics class 2; phase
A
beta-adrenoceptor blockers; phase 4
20
Q
anti-arrhythmics class 3; phase
A
potassium channel blockers, phase 3
21
Q
anti-arrhythmics class 4
A
calcium channel blockers
22
Q
more selective anti-arrhythmic drug group (specific) with significant effects on ISCHEMIC tissue but negligible effects on NORMAL cells
A
group 1B
23
Q
selectively depress tissue that are frequently depolarizing
A
use dependent anti-arrhythmic
24
Q
selectively depress tissue that are relatively depolarized during rest
A
state dependent anti-arrhythmic
25
anti-arrhythmic which cuts across all classes, most efficacious, for refractory arrhythmia, causes microcrystalline deposits in cornea and skin, thyroid dysfunction, paresthesia, tremors, pulmonary fibrosis
amiodarone/ dronedarone
26
class 1a antiarrhythmic. lupus-like syndrome
procainamide
27
class 1a antiarrhythmic. marked antimuscarinic effects (atropine toxicity symptoms)
disopyramide
28
class 1a antiarrhythmic also used in malaria; but may cause torsades, cinchonism (headache, vertigo, tinnitus), autoimmune reactions (ITP), GI upset, reduced clearance of digoxin
quinidine
29
treatment of class 1A overdose: reverses drug-induced arrhythmias
sodium lactate
30
treatment of class 1A overdose: reverses drug-induced arrhythmias
pressor sympathomimetics
31
class 1b antiarrhythmic DOC for post MI ventricular arrhythmias, digoxin-induced arrhythmias; SE: CNS stimulation, agranulocytosis
lidocaine, mexiletine, phenytoin, tocainamide causes agranulocytosis
32
mnemonic for class 1a antiarrhythmics
I am the queen who proclaimed diso's pyramids (quinidine, procainamide, disopyramide)
33
mnemonic for class 1b antiarrhythmics
I buy mexican tacos from lily (mexiletene, tocainide, lidocaine)
34
mnemonic for drugs that can cause agranulocytosis
agranulocytosis! CCCAPPIT (clozapine, cotri, colchicine, aminopyrine, phenylbutazone, PTU, indomethacin, tocainide)
35
class of antiarrhythmics that can be proarrhythmic, used as last resort for refractory arrhythmias
class 1c antiarrhythmics
36
class 1c antiarrhythmic, highest risk for Torsades, contraindicated for post MI arrhythmias
flecainide, propafenone, encainide, moricizine
37
mnemonic for class 1c antiarrhythmics
chicken ay pagkain for enrico mmm(propafenone, flecainamide, encainide, moricizine)
38
antiarrhythmic of choice for WPW
procainamide, amiodarone
39
antiarrhythmic of choice for acute ventricular arrhythmias, esp. post-MI, atrial arrhythmia due to digitalis
class 1b antiarrhythmic
40
nonselective B-blockers
propranolol, timolol
41
B1-selective B-blockers
Bet ko mag-ace sa ateneo si Esme (betaxolol, acebutolol, atenolol, esmolol, metoprolol)
42
B blockers with intrinsic sympathomimetic activity (partial agonist)
pindolol, acebutolol
43
B blocker lacking local anes effect, can be used for glaucoma
timolol, betaxolol
44
B blocker with low lipid solubility
atenolol
45
shortest and longest acting B blocker
esmolol, nadolol
46
B blocker with combined a and b blockade
carvedilol, labetalol
47
B blocker used for pheochromocytoma
labetalol
48
in CHF, this class 2 antiarrhythmic reduces progression and decreases incidence of potentially fatal arrhythmias
propranolol
49
B blocker for SVT, acute perioperative and thyrotoxic arrhythmias
esmolol
50
B blocker anti-arrhythmic with Class 3 properties
sotalol
51
anti-arrhythmic class with highest propensity to cause Torsades, prolongs AP duration increasing QT interval
Class 3
52
class 3 antiarrhythmic examples
AIDS (amiodarone, ibutilide, dofetilide, dronedarone, sotalol)
53
ECG morphology in class 4 antiarrhythmics
prolonged PR interval
54
type of CCB which are proarrhythmic; evokes compensatory sympathetic discharge
dihydropyridine CCBs
55
examples of class 4 antiarrhythmics; MC side effect
verapamil, diltiazem; flushing
56
miscellaneous antiarrhyhtmic; DOC for paroxysmal supraventricular tachycardia; SE: flushing, affects K channels prolonging hyperpolarization, reduces Ca channels
adenosine
57
ions with depressant effects on digitalis-induced arrhythmias
K, Mg (can be effective in Torsades)
58
carbonic anhydrase inhibitor acts on _____; example
PCT; acetazolamide, dorzolamide, brinzolamide, dichlorophenamide, methazolamide
59
uses of acetazolamide
diuretic, glaucoma, mountain sickness
60
NAGMA mnemonic
HARDUP (hyperalimentation, acetazolamide, RTA, diarrhea, ureteral diversion, pancreatic fistula)
61
loop diuretic toxicities mnemonic
OH DANG (ototoxicity-with aminoglycosides, hypoK, dehydration, allergy to sulfa, nephritis, gout-hyperuricemia)
62
____ decrease the efficacy of loop diuretics by inhibiting ______
NSAIDs (also decrease effect of thiazides), prostaglandins
63
Loop diuretics act on _____ at the ____; examples
Na-K-2Cl transporter; TAL, furosemide, bumetanide, torsemide, ethacrynic acid
64
thiazides act on___ transporter at the ____; examples
Na-Cl carrier; DCT; HCTZ, (padapain, itali, lasunin) indapamide, chlorthalidone,metolazone
65
Thiazide diuretic effects
HyperGLUC (gylcemia, lipidemia, uricemia, calcemia)
66
thiazides act on___ transporter at the ____; examples
Na-Cl carrier; DCT; HCTZ, (padapain, itali, lasunin) indapamide, chlorthalidone,metolazone
67
Thiazide diuretic effects
HyperGLUC (gylcemia, lipidemia, uricemia, calcemia)
68
primary site of acidification of urine; last site of Na reabsorption and K secretion
cortical collecting duct
69
use of spironolactone
hyperaldosteronism (Conn's syndrome), hypertension, heart failure, hypokalemia
70
SE of spironolactone
gynecomastia, hyperchloremic metabolic acidosis, BPH
71
advantages of spironolactone (specifically eplerenone)
reduces progression of DM nephropathy, reduces mortality post-MI
72
mnemonic for K-sparing diuretics
The K STAEs with K-sparing diuretics (spironolactone, triamterene, amiloride, eplerenone)
73
drugs causing gynecomastia
Some drugs create awesome knockers (spironolactone, digoxin, cimetidine, alcohol, ketoconazole)
74
SE of amiloride
kidney stones, acute renal failure (with indomethacin)
75
mannitol is used for
rhabdomyolysis, hemolysis, inc ICP, acute glaucoma
76
osmotic diuretics
mannitol, glycerin, isosorbide, urea
77
ADH agonists act on ___ receptors at the _______;example
V1 and V2 ADH receptors; medullary collecting duct, ADH, desmopressin
78
ADH, desmopressin used for
central DI, nocturnal enuresis, hemophilia, von Willebrand's dse
79
ADH antagonists act on ___ receptors at the _______;example
V1a and V2 ADH receptors; medullary collecting duct, conivaptan, tolvaptan, lixivaptan, demeclocycline, lithium
80
Conivaptan is used for
SIADH, hyponatremia
81
Conivaptan may cause
nephrogenic DI, renal failure, bone and teeth abnormalities
82
short acting benzodiazepines w/mnemonic
bro, try mo etox! (brotizolam, triazolam, midazolam, etizolam, oxazepam)
83
benzodiazepines cause ____ amnesia and ____ sedation
anterograde; unwanted daytime sedation
84
midazolam causes rebound _____
insomnia/anxiety
85
benzodiazepines increase the ____ of chloride channel opening while barbiturates incease the ______; which has more dependence liability?
frequency, duration; barbiturates
86
part of brain responsible for anterograde amnesia; retrograde
hippocampus (HATER), thalamus
87
intermediate acting benzodiazepines w/mnemonic
si ACE NaTaLo (alprazolam, clonazepam, estazolam, nitrazepam, lormetazepam, lorazepam, temazepam)
88
abnormal sleep pattern from benzodiazepine use?
decreased REM sleep
89
long-acting benzodiazepines
diazepam, quazepam, chlorazepate, chlordiazepoxide, flurazepam, flunitrazepam
90
special use of long-acting benzodiazepines
alcohol withdrawal
91
benzodiazepine used as a date-rape drug
flunitrazepam
92
benzodiazepines w/ longest half-life
chlordiazepoxide (longest spelling)
93
date-rape drugs
alcohol, flunitrazepam, gamma hydroxybutyrate
94
DOC for status epilepticus
lorazepam, diazepam
95
benzodiazepine also used for bipolar disorder
clonazepam
96
toxic dose of benzodiazepines; treatment
1000x therapeutic dose; flumazenil
97
with flumazenil, ____ and ____ may occur when administered in Pts who take both TCAs and benzodiazepines
seizures and arrhythmia
98
ultrashort acting barbiturates
may taya tayo (methohexital, thiamylal, thiopental)
99
thiopental
ultrashort acting (tayo agad!), acute intermittent porphyria, used for inc ICP
100
cyp450 inducers mnemonic
ethel booba takes phen-phen and refuses greasy carb shakes (ethanol, barbiturates, phenytoin, rifampicin, griseofulvin, carbamazepine, st. john's wort/ smoking)
101
short and intermediate-acting barbiturates
pentobarbital (and all other barbitals except pheno and mephobarbital)
102
long-acting barbiturates
phenobarbital, mephobarbital, primidone
103
special use of long-acting barbiturates
hyperbilirubinemias (Gilbert syndrome)
104
enzyme deficient in acute intermittent porphyria
hmb synthase (porphobilinogen deaminase)
105
acts like benzodiazepine, used for sleep disorders only, effects reversed with___
zolpidem; flumazenil
106
partial agonist of 5-HT1a receptors and possibly D2 receptors used for generalized anxiety disorder
buspirone
107
enzyme used to metabolize low to moderate doses of ethanol
alcohol dehydrogenase
108
enzyme used to metabolize ethanol at blood levels higher than 100mg/dl
microsomal ethanol oxidizing system
109
blood alcohol concentration causing sedation, "high", slow reaction times
50-100mg/dL
110
blood alcohol concentration causing impairment of drivinig ability
60-80mg/dL
111
blood alcohol concentration causing emesis, stupor
200-300mg/dL
112
blood alcohol concentration causing coma
300-400mg/dL
113
MC neurologic abnormality in chronic alcoholics
peripheral neuropathy
114
syndrome characterized by ataxia, confusion, paralysis of EOM; dreaded emergency of alcohol intoxication
Wernicke-Korsakoff syndrome (Weird ACO- ataxia, confusion, ophthalmoplegia; Korsakoff- confabulation, hallucination, amnesia)
115
Wernicke-Korsakoff syndrome: vitamin deficiency, CT scan findings
thamine; hemorrhagic necrosis of mamillary bodies
116
most catastrophic symptom of sedative-hypnotic withdrawal
rebound suicide
117
alcohol increases incidence of _____ cardiomyopathy; doxorubicin increases incidence of _____
reversible dilated; irreversible dilated
118
level of alcohol consumption increasing HDL levels
10-15 mg/dL
119
mental retardation, growth deficiencies, microcephaly, midfacial underdevelopment associated with heavy consumption of alcohol during T1 of pregnancy
fetal alcohol syndrome
120
microorganism associated with alcohol-induced infection
Klebsiella pneumoniae (currant jelly sputum)
121
HAD-48
delirium tremens (hallucinations, autonomic instability, delirium, 48-72 hours postdiscontinuation of alcohol)
122
scale used to monitor patients who are possibly having alcohol withdrawal
CIWA- Clinical institute withdrawal for alcohol
123
benzodiazepine with less complex metabolism for pts with compromised liver function exhibiting alcohol withdrawal
lorazepam
124
opioid receptor antagonist used for tx of alcoholism
naltrexone
125
NMDA receptor antagonist used for tx of alcoholism
acamprosate
126
these inhibit aldehyde dehydrogenase causing hang-over like sx
disulfiram, (Clara took the Pre-Medical Test in the PM) chlorpropamide, cefoperazone, cefomandaole, cefotetan, procarbazine, metronidazole)
127
distinct manifestation of methanol toxicity
visual dysfunction
128
electrolyte disturbance of methanol toxicity
acidosis (due to accumulation of formaldehyde and formic acid)
129
tx of methanol poisoning
ethanol, fomepizole (inhibitor of alcohol dehydrogenase)
130
manifestation of ethylene glycol toxicity
HAGMA (due to accumulation of oxalic acid), renal damage
131
tx of ethylene glycol poisoning
ethanol, fomepizole
132
hyper___ is associated with a high incidence of acute pancreatitis
chylomicronemia
133
MOA of statins
inhibit hepatic cholesterol synthesis by reversible competitive inhibition of Hmg-Coa reductase; liver compensates by increasing LDL receptors; plaque stabilization
134
notable SE of statins; especially when used with ____
myopathy, rhabdomyolysis; fibrates
135
MOA of resins
bind bile acids and prevent intestinal absorption, hepatic cholesterol is used to synthesize new bile acids, compensatory increase in LDL receptors
136
resin example; mnemonic
ang cholet, colet, colet mo! BAR this from people with high TGs! (cholestyramine, colesevalam, colestipol)
137
lipid-lowering drugs with GI SE
cholestyramine (BAR), sitosterol (sterol absorption blocker)
138
given at bedtime because cholesterol synthesis predominantly occurs at night
statins
139
notable SE of cholestyramine
GI sx, increases TG and VLDL
140
MOA of ezetimibe
cholesterol absorption blockers, inhibit NPC1L1 transporter in jejunal enterocyte which mediates cholesterol and phytosterol uptake, compensatory increase in LDL receptors
141
lipid lowering agent combination with synergistic LDL lowering effect but with increased hepatotoxicity.
statin + ezetimibe
142
MOA of sitosterol
cholesterol analog which decreases intestinal absorption of cholesterol
143
MOA of niacin
inhibits hormone sensitive lipase, reduces VLDL synthesis, increases clearance of VLDL by lipoprotein lipase, reduces catabolism of HDL, decreases fibrogen, increases tPA
144
most effective agent for increasing HDL
niacin
145
MC SE of niacin; reduced by
flushing; aspirin intake
146
lipid lowering agent which must be avoided in Pts with PUD; potentiates effects of antihypertensives (vasodilators, ganglion blockers)
niacin
147
drugs that cause flushing
(VANC) Vancomycin, adenocine, niacin, CCB
148
MOA of fibrates
ligand for PPAR-alpha protein-->inc synthesis of lipoprotein lipase, stimulate fatty acid oxidation, decrease expression of apo-CIII-->impeding clearance of VLDL and increasing apo A1 and A2 which increases HDL
149
DOC for hypertriglyceridemia/ high VLDL
fibrates
150
SE of gemfibrozil
cholesterol gallstone, nausea, rashes, leukopenia, hemoconcentration
151
best synergistic combination for hypercholesterolemia
statin + niacin (or ezetimibe but increased hepatotoxicity)
152
combination of lipid lowering agents which increases risk of cholelithiasis
fibrates + resin
153
endogenous molecules with powerful pharmacologic effects that do not fall into traditional autonomic groups
autacoids
154
histamine is from what amino acid?
histidine
155
enzymes metabolizing histamine
monoamine and diamine oxidase
156
excess production of histamine detected by
imidazole acetic acid in urine
157
classic demonstration of histamine effect
triple respones: wheal, flush, flare
158
first generation H1 receptor antagonist examples
MINE and ZINE (diphenhydramine, chlorpheniramine, cyclizine, meclizine, promethazine)
159
MOA of promethazine
competitive inhibition of peripheral and central H1 receptors+ alpha and M receptor, with anti-motion sickness effect
160
SE of cyclizine
drowsiness
161
2nd generation H1 receptor antagonist examples
cetirizine, loratadine, fexofenadine, desloratidine, terfenadine, astemizole
162
MOA of astemizole
competitive inhibition of peripheral H1 receptors; no anti-motion sickness effect
163
H2 receptor antagonist examples
ranitidine, famotidine, cimetidine, nizatidine
164
serotonin is produced from aa
tryptophan (5-hydroxytryptamine)
165
excess serotonin production is detected by ____ which is also a marker for
5-hydroxyindole acetic acid (5-HIAA); carcinoid tumor in GI tract
166
MOA of sumtriptan; DOC for
5-HT ID receptor agonist (brain), causes vasoconstriction; acute migraine, cluster headache
167
MOA of granisetron; DOC for
5-HT3 antagonist, blocks chemoreceptor trigger zone and enteric nervous system; chemo and postop vomiting
168
DOC for irritable bowel disease which may cause constipation
alosetron
169
5-HT3 antagonist wihich may cause QRS and QT prolongation
dolasetron
170
produced from a fungus in wet or spoiled grain, partial agonists at alpha-adrenoceptors and 5-HT receptors
ergot alkaloids
171
classification of ergot alkaloids with examples
vasoselective (ergotamine), uteroselective (ergonovine)
172
MOA of ergotamine
partial agonist of 5-HT and alpha adrenoceptors causing marked smooth muscle contraction but blocks alpha agonist vasoconstriction, used for migraine and cluster headache (vasoselective)
173
classification of methysergide; side effect
ergot alkaloids (vasoselective), retroperitoneal fibrosis
174
antidote of ergotamine
nitroprusside
175
MOA of ergonovine
partial agonist of 5-HT and alpha adrenoceptors causing marked smooth muscle contraction but blocks alpha agonist vasoconstriction, used for migraine and cluster headache (uteroselective)
176
partial agonist of 5-HT and alpha adrenoceptors used for postpartum bleeding, migraine
ergonovine, methylergonovine (methergine)
177
cyclooxygenase isoform found in normal physiologic processes
cox-1
178
cyclooxygenase isoform found in inflammatory cells
cox-2
179
endogenous fatty acid derivatives that are produced from arachidonic acid
eicosanoids
180
prostaglandin E1 analogue used for PUD, prevention of NSAID-induced gastric mucosal injury and abortifacient
misoprostol/gemeprost
181
SE of misoprostol
teratogenic (moebius sequence)
181
prostaglandin E1 analogue used for maintenance of PDA, erectile dysfunction; notable SE
alprostadil; priapism
181
prostaglandin E1 analogue used for maintenance of PDA, erectile dysfunction; notable SE
alprostadil; priapism
182
prostaglandin E2 analogue used induction of labor(cervical ripening) and abortifacient
dinoprostone/sulprostone
182
prostaglandin I2 analogue used for pulmonary HPN, reduced plt aggregation in dialysis
epoprostenol, beraptost, iloprost, treprostinil
182
prostaglandin F2A analogue used for glaucoma, causes permanent eye color change
latanoprost, bimatoprost, ravoprost, unoprostone
182
prostaglandin F2A analogue used for control of postpartum hemorrhage, abortifacient
carboprost, bimatoprost, ravoprost, unoprostone
182
prostaglandin F2A analogue used for glaucoma, causes permanent eye color change
latanoprost, bimatoprost, ravoprost, unoprostone
183
major risk factor of asthma
atopy
190
DOC for acute asthma attacks
SABA (Albuterol, salbutamol, levabuterol, terbutaline, metaprotenerol, pirbuterol, procaterol, fenoterol)
191
Seretide
Salmeterol+Fluticasone
192
Symbicort
Budesonide+Formoterol
193
for asthma prophylaxis which increases asthma mortality when used alone; may precipitate arrhythmias
LABA (Formoterol, Salmeterol, Cleneterol Bambuterol)
194
Ipatropium/Tiatropium MOA
muscarinic receptor antagonist preventing vagal-stimulated bronchoconstriction
195
more effective and less toxic for patients with COPD
Iatropium
196
drip used in status asthmaticus
aminophylline drip
197
MOA of theophylline/aminophylline/ pentoxifylline; use; SE
methylxantine; phosphodiesterase inhibition, adenosine receptor antagonist; prophylaxis against nocturnal attackes; may cause tremors, seizure, narrow therapeutic window
198
antidote in overdosage of B blockers
theophylline
199
MOA of cromolyn;use; similar drugs
mast cell stabilizer;causes ca influx, release of leukotrienes, histamine, and other mediators; asthma prophylaxis (not for acute control); nedocromil, lodoxamide
200
DOC for BA prophylaxis
ICS (fluticasone, beclomethasone, budesonide, ciclesonide, flunisolide, mometasone, triamcinolone)
201
MOA of mometasone; SE
corticosteroid, inhibitase phospholipase A2; oral candidiasis, mild growth retardation
202
can be used for severe refractory asthma (status asthmaticus)
IV hydrocortisone
203
ICS with lowest systemic steroid toxicity
Ciclesonide
204
MOA of zileuton; unique indication; SE
leukotriene synthesis inhibitor (specifically 5-lipoxygenase); BA prophylaxis, exercise, antigen and ASA-induced bronchospasm; elevation of liver enzymes
205
MOA of montelukast, unique indication, rare SE
leukotriene synthesis inhibitor (specifically cysteinyl leukotriene-1 receptor for SRSA, antigen and ASA-induced bronchospasm; Churg-strauss syndrome, neuropsych effects
206
MOA of omalizumab
anti-IgE antibody, binds IgE antibodies on mast cells; prophylaxis of severe, refractory asthma not responsive to other drugs
207
oral iron supplement with lowest elemental iron (36mg)
ferrous gluconate
208
oral iron supplement with highest elemental iron (106mg)
ferrous fumarate
209
triad of hemochromatosis; aka; tx
cirrhosis, DM, skin pigmentation; bronze diabetes; phlebotomy, deferoxamine or deferasirox
210
cause of megaloblastic anemia with neurologic defects; w/o neurologic defects
vitamin B12 deficiency; folic acid deficiency
211
neurologic defects of Vit B12 deficiency
ataxic gait, impaired position and vibratory sense, spasticity
212
reactions where vit B12 is essential
methylmalonyl CoA to succinyl CoA; homocysteine to methionine; folic acid metabolism, synthesis of deoxythmidylate (dTMP), a precursor for DNA synthesis
213
administration of ____ to patients with vit B12 deficiency helps refill tetrahydrofolate pool and corrects anemia but not neurologic defects
folic acid
214
vit B12 synthesis
cyanocobalamin, hydroxocobalamin
215
MOA of folic acid; similar drugs
precursor of essential donor of methyl groups used for synthesis of aa, purines and DNA
216
agonist of erythropoietin receptors; SE; associated with blood doping
epoietin alfa, darbepoietin alfa, methoxypolyethylene glycol-epoietin beta
217
myeloid growth factor; indication; SE
G-CSF, sargramostim (GM-CSF), Pegfilgrastim; neutropenia associated w/chemo, myelodysplasia, aplastic anemia, mobilization of peripheral blood cells for hematopoietic stem cell transplantation; bone pain
218
megakaryocyte growth factor; indication; SE
oprelvekin (IL-11) or thrombopoietin; prevention of thrombocytopenia in pts under chemo for nonmyeloid cancer; fluid accumulation, transient atrial arrhythmias
219
local autocoid factors responsible for vasoconstriction
TXA2, endothelin
220
causes platelet aggregation
adenosine diphosphate, serotonin (also causes vasoconstriction)
221
net result of coagulation pathways
prothrombin activator
222
arterial vs venous thrombosis
red and platelet rich; fibrin-rich
223
MOA of ASA; toxic dose, lethal dose, SE (regarding aerobic metab), associated syndrome
nonselective, irreversible cox1 and 2 inhibitor, reduces platelet production of TXA2; 150mg/kg; 500mg/kg; uncoupler of oxidative phosphorylation; Reye syndrome
224
indication for ASA in pedia
RF, Kawasaki dse, JRA
225
triad of aspirin hypersensitivity
SAMTER triad (asthma, aspirin sensitivity, nasal polyps)
226
salicylate intoxication acid-base abnormality in children; adults
HAGMA; respi alkalosis with HAGMA (lactic acidosis due to anaerobic metab)
227
MOA of abciximab; similar drugs; similar to this congenital deficiency
interferes with gpIIB/IIIa binding to fibrinogen; eptifibatide, tirofiban; Glanzmann's thrombastenia
228
MOA of clopidogrel; similar drugs; SE
irreversibly inhibits binding of ADP to platelet receptors; ticlopidine, prasugel; TTP (more with ticlopidine)
229
inhibits phosphodiesterase III and inc cAMP in plt and BVs, used for prophylaxis in cardiac valve displacement; similar drug used for intermittent claudication (but contraindicated in heart failure)
dipyridamole; cilostazol
230
heparin is a (direct/indirect) thrombin inhibitor; activates ______, which complexes with Factors _____; most popular SE; monitor using; antidote
indirect; antithrombin III; IIa, IXa and Xa; heparin-induced thrombocytopenia; PTT; protamine
231
enoxaparin is a (direct/indirect) thrombin inhibitor; activates ______, which complexes with Factor _____; monitoring; antidote
indirect; antithrombin III; Xa; does NOT require PTT monitoring; protamine only partially effective
232
derived from saliva of medicinal leech
lepirudin
233
MOA of lepirudin; indication; monitoring; antidote
direct thrombin inhibitorl; binds to thrombin's active site; HIT; PTT; no reversal agent
234
Warfarin is a (direct/indirect) thrombin inhibitor; activates ______; most popular SE; CI; monitor using; antidote
direct; vitamin K epoxide reductase (responsible for carboxylation of vit K dependent clotting factors [1972, protein C and S]); warfarin induced skin necrosis; pregnancy; PT; vit K (slow), FFP (fast)
235
MOA of alteplase, special note, allergy observed with ____, antidote
fibrinolytic, tPA analog; loses effectiveness on 2nd use; streptokinase; aminocaproic acid
236
MOA of aminocaproic acid; similar drug; CI (2)
competetive inhibitor of plasminogen activator; tranexamic acid; DIC and GU bleeding
237
names of vit K1, 2, 3; CI; among these, which must never be used as tx due to ineffectiveness?
phytonadione, menaquinone, menadione; severe infusion reaction when administered too fast (dyspnea, chest and back pain); vit K2
238
MOA of desmopressin
vasopressin V2 agonist; increases
| FVIII activity for Hemophilia A, vW disease
