PHC 722 - MIDTERM 1 DRUGS

Question 1

Ketamine

Answer 1

Non-Competitive Antagonist of NMDA Receptor

Ketamine prevents, and even reverses, wind-up in som chronic pain situations

Question 2

Benzodiazepine

Answer 2

Anti-epileptic

GABA-A Allosteric Enhancement

Question 3

NSAID

Answer 3

COX 1 and COX 2 Inhibitors
Anti-pyretic
Anti-inflammatory
Analgesic

Question 4

Hydrocodone

Answer 4

Opioid Agonist
Vicadin [Hydrocodone + Acetaminophen]
Hydrocodone and more active metabolite (hydromorphone)
Extensive metabolizers produce more hydromorphone than poor metabolizers

Question 5

Methadone

Answer 5

Opioid Agonist [Full Agonist]
Used for treating heroin addicts
Make the person more addicted to methadone than heroin [Cross-Tolerance: need more of street heroin to activate receptor]
Really long half life [lasts all day]

Question 6

Oxycodone

Answer 6

Opioid Agonist

Percocet [Oxycodone + Acetaminophen]

Question 7

Abciximab

Answer 7

Anti-Platelet
GP IIa/IIIb blocker
Prevents cross-linking/fibrinogen binding between platelets

Question 8

Clopidogrel

Answer 8

Anti-Platelet
ADP Blocker
Keeps the positive feedback loop of ADP from happening therefore no activation of GPIIa/IIIb and no cross-linking/fibrinogen binding between platelets
Reversal Agent: MEDI12452

Question 9

Dabigatran

Answer 9

Anti-coagulant
Taken orally
Direct Thrombin inhibitor
Reversal Agent: Idarucizumab

Question 10

Enoxaparin

Answer 10

Low Molecular Weight Heparin, which will have the same effect as heparin

Question 11

Fondaparinux

Answer 11

Anti-coagulant 
Low-MW heparin 
Binds to AT-III increasing its affinity for Xa
Xa inhibitor
Reversal Agent: Aripazine (PER977)

Question 12

Heparin

Answer 12

Anti-coagulant
Binds to Anti-Thrombin III increasing its affinity for factor X and Thrombin (II)
Reversal Agent: Protamine

Question 13

Prothrombin Complex Concentrate

Answer 13

General antidote used for multiple toxicities of anticoagulants

Question 14

Rivaroxaban

Answer 14

Direct Xa inhibitor

Reversal Agent: Andexanet Alfa

Question 15

Warfarin

Answer 15

Anti-coagulant
Blocks extrinsic pathway of coagulation
Blocks Vitamin K epoxide reductase preventing Vitamin K regeneration
Works in liver to prevent factors II, VII, IX, X from carboxylation
Reversal Agent: Vitamin K

Question 16

MEDI12452

Answer 16

Reversal Agent: Clopidogrel

Question 17

Idarucizumab

Answer 17

Used to treat dabigatran toxicity; it will serve as an Ab and bind to dabigtran directly, preventing it to binding to thrombin

Question 18

Aripazine (PEr977)

Answer 18

Used to treat both enoxaparin, and fondaparinux

Typically a molecule that can bind to many of the anticoagulants

Question 19

Protamine

Answer 19

Heparin emergency reversal

Positively charged salmon sperm that binds heparin to prevent overdose of anti-coagulatory effects

Question 20

Andexanet Alfa

Answer 20

A modified Xa protein reversal agent, for the Xa inhibitors including LMWH, NOT YET APPROVED

Question 21

Vitamin K

Answer 21

Reversal agent for Warfarin
It will take time, since warfarin has a long half life, therefore if you want to have a fast action then you would add prothrombin complex