Respiratory, ASCVD, prophylaxis, anticoagulant, antiplatelet, thrombolytic agents Flashcards

Question

Montelukast (Singulair) MOA

Answer 1

occupies leukotriene receptors

Answer 2

Asthma maintenance & prophylaxis Prevention of EIB Relief of allergic rhinitis

Answer 3

Generally well-tolerated

Answer 4

Patient education- not used as abortive therapy Cheaper than most inhalers  may increase patient adherence

Answer 5

drying of nasal mucosa and burning or itching sensation adrenal suppression and slowed growth in children- rare

Answer 6

Patient education on relief is greatest if administered daily than PRN Relief may take a week or longer to develop

Answer 7

block histamine receptors, decreases itching, sneezing, and rhinorrhea (not congestion)

Answer 8

prevent or suppress major symptoms due to their actions against histamines

Answer 9

generally mild sedation and anticholinergic effects seen more with 1st gen antihistamine

Answer 10

avoid 1st gen antihistamines if you wanna stay up educate patient that med is most effective if taken daily intranasal doses can cause somnolence with sufficient systemic absorption

Answer 11

activates alpha 1 receptors

Answer 12

allergic rhinitis, congestion with sinusitis and colds

Answer 13

Rebound nasal congestion if topical agents are used for more than a few days CNS excitation (restlessness, irritability, anxiety, and insomnia) CV effects with PO formulations

Answer 14

Monitor vital signs due to potential for increased BP, particularly in those with CV disorders Patient education that topical should not be used for more than 3-5 consecutive days Commonly confused with pseudoephedrine, which can be converted into methamphetamine; placed behind counter in pharmacy

Answer 15

inhibits cholesterol synthesis within liver

Answer 16

Hypercholesterolemia Primary & Secondary CV prevention Post MI Therapy DM/DMII

Answer 17

Myopathy/rhabdomyolysis Hepatotoxicity New onset DM (rare) Teratogenicity (Category X)

Answer 18

Administer in evening Monitor LF and CK Pt education on contraception and myopathy

Answer 19

binds to bile acids to prevent absorption and promote excretion

Answer 20

GI tract- primarily constipation, bloating, indigestion, & nausea

Answer 21

Drug interactions resulting in insoluble complexes (such as meds- thiazides, digoxin, & warfarin) Administer other oral meds 1 hr before or 4 hr after bile-acid sequestrant administration Increase fluids & fiber prior to administering laxatives Take with food and water

Answer 22

Adjunctive therapy in hypercholesterolemia, often with statin medications

Answer 23

lowers VLDLd levels to reduce TG levels, raises HDL, little to no effect on LDL

Answer 24

Hypertriglyceridemia Mixed dyslipidemia

Answer 25

Most common: rash and GI disturbance (nausea, ab pain, diarrhea) Risk of gallstones Myopathy/rhabdomyolysis Hepatotoxicity

Answer 26

Can increase anticoagulant effects in patients on warfarin Monitor for bleeding and INR Periodic liver function test (LFT) Patient education on myopathy and gallstones

Answer 27

Irreversibly inhibits cyclooxygenase to prevent TXA2 synthesis needed to promote platelet activation

Answer 28

Primary & secondary prevention of- Ischemic CVA and TIA Angina and MI-related events

Answer 29

Bleeding, especially in GI Hemorrhagic stroke Salicylism Renal impairment

Answer 30

Dosing 81 mg helps to prevent CV events 325 mg helps in initial treatment of CV events Educate & monitor for signs of bleeding Educate on other sources of aspirin (Excedrin, BC powder, Alka-seltzer) Give PPI if GI bleeding occurs Education on medication use in setting of elective surgery (stopped 7- 10 days before)

Answer 31

Irreversibly prevents ADP-stimulated platelet aggregation and blood clot formation

Answer 32

Combined with ASA, helps to reduce thrombotic events in patients with acute coronary syndrome Prevent blockage of coronary artery stents

Answer 33

Bleeding Thrombotic Thrombocytopenic Purpura (TTP)

Answer 34

Educate & monitor for signs of bleeding and directions for continuing medication Education on medication use in setting of surgery (Hold 5 days before elective surgery) Give PPI if GI bleed occurs

Answer 35

reversible blockade of platelet receptors to inhibit final step of platelet aggregation

Answer 36

Prevent ischemic events with those who with ACS Non-STEMI and Unstable Angina Percutaneous Coronary Intervention (PCI)

Answer 37

Bleeding, particularly PCI insertion site

Answer 38

post procedure cardiac cath monitoring monitor for s/s bleeding

Answer 39

helps antithrombin inactivate thrombin and factor Xa

Answer 40

DVT and PE Open heart surgery and renal dialysis Low dose for DVT prophylaxis Disseminated Intravascular Coagulation (DIC) Adjunct to thrombolytic therapy of acute MI

Answer 41

Bleeding Heparin-induced thrombocytopenia (HIT) Severe neuro injury if given to spinal puncture/epidural anesthesia

Answer 42

Educate & monitor for signs of bleeding Monitor aPTT/anti-Xa (4 to 6 hours) & CBC during therapy Protamine sulfate antidote

Answer 43

enhance activity of antithrombin to preferentially indirectly inhibit activity of thrombin and factor Xa

Answer 44

DVT and PE DVT prophylaxis following THA, TKA, & abdominal sx Off label use for DVT prophylaxis after general sx and in patients with multiple trauma and acute spinal injury

Answer 45

Bleeding Heparin-induced thrombocytopenia (HIT) Severe neuro injury if given to spinal puncture/epidural anesthesia

Answer 46

Educate & monitor for signs of bleeding Monitor CBC during therapy Protamine sulfate antidote

Answer 47

Suppresses production of factors VII, IX, X, and prothrombin

Answer 48

Long-term prophylaxis of thrombosis: DVT and PE In prosthetic heart valves In atrial fibrillation Reduce risk of recurrent stroke and MI

Answer 49

Bleeding Teratogenic

Answer 50

Educate & monitor for signs of bleeding Monitor PT & INR during therapy Vitamin K antidote and intake of green leafy vegetables Numerous medication interactions Much longer half-life than heparin (days vs hours)

Answer 51

direct, reversible inhibitor of free and bound thrombin

Answer 52

Treatment of DVT and PE Prevention of VTE in THA and TKA Prevention of thrombosis in patients with atrial fibrillation

Answer 53

Bleeding GI disturbances- dyspepsia and/or gastritis-like symptoms

Answer 54

Educate & monitor for signs of bleeding No need for monitoring PT/INR Caution for those with renal impairment Antidote: idarucizumab (Praxbind)

Answer 55

Directly inhibits Xa, interfering with thrombin production

Answer 56

For DVT and PE In THA and TKA In non-orthopedic sx For Recurrent DVT and PE Prevention of thrombosis in patients with afib

Answer 57

Bleeding, especially with pre-existing renal impairment Spinal/epidural hematoma Unsafe in pregnancy, only use if benefits outweighs risk

Answer 58

Educate & monitor for signs of bleeding No need for monitoring PT/INR Caution with renal and/or hepatic impairment (dosage adjustment) Antidote for Apixaban: Andexxa

Answer 59

Forms complexes with plasminogen to convert into plasmin, an enzyme that digests fibrin, as well as degrade fibrinogen and other clotting factors

Answer 60

Acute MI, acute ischemic stroke, and acute massive PE Low doses for blocked central venous catheter (CVC)

Answer 61

Bleeding, particularly ICH

Answer 62

Many contraindications and precautions, so obtain thorough history Monitor closely for bleeding during administration and limit potential sources for bleeding Efficacy seen if administered within 2-4 h of symptom onset

Respiratory, ASCVD, prophylaxis, anticoagulant, antiplatelet, thrombolytic agents Flashcards

(88 cards)