Week 3 Drugs Flashcards
(37 cards)
1
Q
Fenoldopam
A
Diuretic- DA1 agonist
2
Q
Dopamine
A
Diuretic_ Atrial Natriuretic Peptide (ANP)
:^RBF, reduce FF–> ^ Na and water excretion
(X) ^RBF during shock
3
Q
Atriopeptin
A
Diuretic_ Atrial Natriuretic Peptide (ANP)
:^RBF, reduce FF–> ^ Na and water excretion
(X) ^RBF during shock
4
Q
Mannitol
A
Diuretic _Osmotic (IV)
^ excretion of Na, K, Cl
(X) IV prophylaxis of acute renal failure, severe edema, glaucoma
(-) volume expansion of intravascular fluid volume
5
Q
Acetazolamide
A
Diuretic---/Carbonic Anhydrase ^ urine pH ^ excretion of Na, K, HCO3 (reduced excr of Cl) (X) glaucoma- reduce aq humor - reduce drug toxicity (acidic) -acute altitude sickness (-) metabolic acidosis (loss of HCO3)
6
Q
Furosemide
A
Diuretic_ Loop/High ceiling ---/ Na/K/2Cl symport ^RBF and GFR ^ excretion of Na, K, Cl, Ca (X) rapid/short duration diuresis - edema due to caridac, hepatic, renal disease - acute pulmonary edema -severe HTN episode (-) hypo-kalemia/uricemia/glycemia -ototoxicity, volume depletion
7
Q
Bumetanide
A
Diuretic_ Loop/High ceiling ---/ Na/K/2Cl symport ^RBF and GFR ^ excretion of Na, K, Cl, Ca (X) rapid/short duration diuresis - edema due to caridac, hepatic, renal disease - acute pulmonary edema -severe HTN episode (-) hypo-kalemia/uricemia/glycemia -ototoxicity, volume depletion
8
Q
Ethacrynic Acid
A
Diuretic_ Loop/High ceiling ---/ Na/K/2Cl symport ^RBF and GFR ^ excretion of Na, K, Cl, Ca (X) rapid/short duration diuresis - edema due to caridac, hepatic, renal disease - acute pulmonary edema -severe HTN episode (-) hypo-kalemia/uricemia/glycemia -ototoxicity, volume depletion
9
Q
Chlorothiazide
A
Diuretic_ Thiazide ---/ Na/Cl Symporter reduce GFR hypertonic urine ^ excretion of Na, Cl, K (X) rapid and LONG term diuresis, edema, HTN, Hypercalciuria (-) HYPO kalemia, uricemia, glycemia (O) renal failure
10
Q
Hydrochlorothiazide
A
Diuretic_ Thiazide ---/ Na/Cl Symporter reduce GFR hypertonic urine ^ excretion of Na, Cl, K (X) rapid and LONG term diuresis, edema, HTN, Hypercalciuria (-) HYPO kalemia, uricemia, glycemia (O) renal failure
11
Q
Metolazone
A
Diuretic_ Thiazide ---/ Na/Cl Symporter reduce GFR hypertonic urine ^ excretion of Na, Cl, K (X) rapid and LONG term diuresis, edema, HTN, Hypercalciuria (-) HYPO kalemia, uricemia, glycemia (O) renal failure
12
Q
Spironolactone
A
Diuretic_ K sparing - DISTAL tube--/ aldosterone ^ excr of Na, K excr reduced (X) HTN, edema, 1o aldosteronism (-) HYPERkalemia - gynecomastia
13
Q
Eplerenone
A
Diuretic_ K sparing - DISTAL tube--/ aldosterone ^ excr of Na, K excr reduced (X) HTN, edema, 1o aldosteronism (-) HYPERkalemia - gynecomastia
14
Q
Triamterene
A
Diuretic_ Na channel inhib ^ urine volume ^Na excr, reduced K excr (X) + thiazide diruetic to reduce K loss , edema, HTn (-) HYPERkalemia azotemia
15
Q
Amiloride
A
Diuretic_ Na channel inhib ^ urine volume ^Na excr, reduced K excr (X) + thiazide diruetic to reduce K loss , edema, HTn (-) HYPERkalemia azotemia
16
Q
Tissue Plasminogen Activator (tPA)
A
Thrombolytic (Alteplase) --->+ plasminogen *rapid LIVER elim (IV) (-) hemorrhage (X) manage ST-elevation myocardial infarction (STEMI)- lysis of thrombi in coronary A. - acute ischemic stroke -acute pulmonary embolism (o) active bleeding, surgery, GI bleed, known hemorrhagic disorder, HTN, Pregnancy
17
Q
Alteplase
A
Thrombolytic (tPA) --->+ plasminogen *rapid LIVER elim (IV) (-) hemorrhage (X) manage ST-elevation myocardial infarction (STEMI)- lysis of thrombi in coronary A. - acute ischemic stroke -acute pulmonary embolism (o) active bleeding, surgery, GI bleed, known hemorrhagic disorder, HTN, Pregnancy
18
Q
Aminocaproic Acid
A
PRO-Coagulation ---/ fibrinolysis \:bind Lys of plasminogen---/ fibrin binding (X) reverse excessive brkdown of fibrin -reduce hemorrhage w surgery -UTI bleeding (concent in urine) -hemophilia A and B
19
Q
Heparin
A
UFH- Anti-Coagulant
NEG charge sulfated polysaccharides
^ rate of thrombin>antithrombin--/ coagulation factors
-LIVER clearance
-IV admin= *immediate effect
(X) venous thromboembolism
(X) prophylactic to prevent^
(X) cardiopulmonary bypass
(-) Bleeding
thrombocytopenia
(O) recent surgery, active bleeding, HTN
20
Q
Low Molecular Weight Heparins (LMWH)
A
- Enoxaprin
- Dalteparin
–/ Factor Xa
21
Q
Enoxaparin
A
LMWH- Anti-Coagulant ^ antithrombin---/ Factor Xa KIDNEY clearance IV delivery (-) Bleeding, thrombocytopenia (o) renal impairment, active bleeding, surgery, HTN (X) DVT, angina and MI, hip replacement
22
Q
Dalteparin
A
LMWH- Anti-Coagulant ^ antithrombin---/ Factor Xa KIDNEY clearance IV delivery (-) Bleeding, thrombocytopenia (o) renal impairment, active bleeding, surgery, HTN (X) DVT, angina and MI, hip replacement
23
Q
Lepirudin
A
Direct Thrombin Inhibitor
-bind catalytic site and exosite 1 of thrombin
-KIDNEY, 1.3 hr
(-) bleeding
(o) active bleed, surgery, HTN, Renal disease
(X) alt to heparin: coronary angioplasty or cardiopulmonary bypass
24
Q
Bivalirudin
A
Direct Thrombin Inhibitor
-bind catalytic site with Phe-Pro-Arg_Pro, exosite 1 with 2nd chain
-KIDNEY, 25min
(-) bleeding
(o) active bleed, surgery, HTN, Renal disease
(X) alt to heparin: coronary angioplasty or cardiopulmonary bypass
25
Fondaparinux
```
Direct Factor Xa Inhibitor
KIDNEY, 17hr
(-) bleeding, hemorrhage
(O) active bleed, surgery, HTN, renal impairment
(X) prophylaxis of DVT w surgery
acute PE
acute DVT wo PE
sub for pt with heparin-induced-thrombocytopenia (HIT)
```
26
Protamin Sulfate
Heparin Antagonist
(+) POS charge--/ heparin
(-) anaphylactic reaction with bradycardia, vasodilation, hypotension, pulmonary HTN
(X) reverse heparin following cardiopulmonary bypass
27
Warfarin
```
ORAL Anti-coagulant
antagonist of Vit K ---/ VKORC1===/ activation of clotting factors (trap VitK in epoxide form)(LIVER)
-delayed onset (T1/2 of factors)
(-) bleeding
- CYP2C9 polymorph (*2/*3= poor metab)
-VKORC1 variation
-teratogenic
-purple toe syndrome
(><) drug intxns
(O) Liver, kidney disease, vitK defic
(X)long term thomboembolitic disease
-prophylaxis of atrial fib, prothetic heart valve, dilated cardiomyopathy
```
28
Dabigatran
NOAC(Novel Oral Anti-coagulant)
bind thrombin (free and fibrin-bound) ---/ thrombin effects
(><) Pgp exported
KIDNEY elimn
(X) post-op thromboprophylaxis
-prophyl- stroke and systemic embolism in non-valvular atrial fib
29
Rivaroxaban
NOAC(Novel Oral Anti-coagulant)
Direct Factor Xa inhibitor---/ conversion of prothrombin>thrombin
KIDNEY (1/3) and LIVER (2/3) elim
Pgp efflux
(-) bleeding
(X) reduce risk of stroke and systemic embolism
-prophyl of DVT w surgery
30
Aspirin
```
Anti-Platelet
IRREVERSIBLE---/ COX1
(-) GI sxs
(X) acute/prophyl MI
- acute/prophyl ischemic stroke
-unstable angina
-pre-eclampsia prophyl
```
31
Dipyridamole
Anti-Platelet
---/PDE= ^cAMP=vasoDILATOR
(-) headache, GI upset, dizziness
(X) prevent thromboemboli in prosthetic heart valve
32
Ticlopidine
Anti-Platelet (IRREVERSIBLE)
---/ADP bind to P2yR
prodrug> CYP2C19> active*
(-) bleeding, dyspnea, neutropenia
33
Clopidogrel
```
Anti-Platelet (IRREVERSIBLE)
---/ADP bind to P2yR
prodrug> CYP2C19> active*
(-) bleeding, dyspnea, neutropenia
(O) CYP2C19 inhibitors (proton-pump inhib)
(X) unstable angina, NSTEMI
```
34
Prasugrel
```
Anti-Platelet (IRREVERSIBLE)
---/ADP bind to P2yR
prodrug> CYP> active*
(-) bleeding, dyspnea, neutropenia
(X) reduce thrombotic CV with NSTEMI, STEMI, PCI
```
35
Ticagrelor
```
Anti-Platelet (reversible)
---/ADP bind to P2yR
prodrug> active*
(-) bleeding, dyspnea, neutropenia
(X) +aspirin prevent thrombotic events with UA, NSTEMI, STEMI, PCI, coronary artery bypass graft
```
36
Abciximab
Glycoprotein IIb/IIIa-R blocker
Fab (monoclonal Ab) bind FbIIb/IIIa to prevent fibrinogen binding and cross-link of platelets
NON-competitive
(-) bleeding, thrombocytopenia, HoTN, bradycardia
(X) prevent thrombosis w coronary interventions
37
Eptifibatide
```
Glycoprotein IIb/IIIa-R blocker
---/ fibrinogen cross-linking
COMPETITIVE --/ GPIIa/IIIa-R
(-) bleeding, thrombocytopenia, HoTN, Bradycardia
(O) renal dysfunction
(X) unstable angina w MI
```
