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Heart, Blood Vessels

Drugs that affect the heart, vessels and blood

TermDefinition
3 Basic fxn of Renal system cleansing of exracellular fluid (ECF) and maintenance of ECF volume and compostion Maintenance of acid-base balance Excretion of metabolic wastes and foreign subtances
3 basic Renal processes filtration reabsortion tubular secretion
MOA of diuretics blockade of sodium and chloride reabsorption AE: hypovolemia, acid-base imbalance, eletrolyte imbalance
High-Ceiling (Loop) Diuretic Agents FUROSEMIDE (lasix) Bumetanide, Ethacrynic Acid, Toresmide
High-Ceiling (Loop) Diuretics: FUROSEMIDE acts at ascending loop of Henle rapid onset produce more fluid loss than any other diuretic avoid when less efficacious drugs can be used uses: pulmonary edema, edmatous states, HTN
High-Ceiling (Loop) Diuretics: FUROSEMIDE Adverse Effects hyponatremia, hypochloremia, dehydration, hypotenstion, HYPOKALEMIA, OTOTOXICITY, hyperglycemia, hyperuricemia, hyperlipidemia
High-Ceiling (Loop) Diuretics: FUROSEMIDE Drug Interactions DIGOXIN, ototoxic drugs, K+ sparing drugs, LITHIUM, antihypertensive agents, NSAIDS
Thiazide Diuretic Agents HYDROCHLOROTHIAZIDE (HCTZ) Metolazone, Chlorthalaone
Thiazide Diuretic Agents: HCTZ most widely used act at distal convoluted tubule diureses less than loop diuretics onset 4-6 hrs elevate uric acid & glucose NO USE in pts with renal impairment uses: HTN, edematous states, diabetes insipidus, dec risk of post menopausal osteoporsis
Thiazide Diuretic Agents: HCTZ Adverse Effects hyponateria, hypochloremia, dehydration, hypokalemia, hypomagnesia, hypercalcemia, hyperglycemia, hyperuricemia, inc LDL, total CHOL, and Triglycerides, inc excretion of Mag
Potassium-Sparing Diuretic Agents SPIRONOLACTONE Triamterene, Amiloride
Potassium-Sparing Diuretic: SPIRONOLACTONE blocks aldosterone in distal nephron, retention of K+ Uses: HTN, edematus states, severe HF, primary hyperaldosteronism, PMS, PCOS, acne Drug Interaction: Thiazice and Loop diurectics, agents that inc K+, steroid analog
Potassium-Sparing Diuretic: AMILORIDE disrupts sodium-potassium exchange in distal nephron, direct inhibition of exchange mechanism, decrease Na+ reuptake uses: HTN, edema used alone = mild diuresis, used with others= conteract K+ loss Drug Interactions: agents that inc K+ AE: N/V, leg cr
Osmotic Diuretic Agent MANNITOL
Osmotic Diuretic Agent: MANNITOL diuresis in lumen of nephron given parentally ONLY osmotic diuretic in US undergoes minimum tubular reabsorption and metabolism uses: prophylaxis of renal failure, dec intracranial pressure, dec IOP AE: edema, HA, N/V, fluid and electrolyte imbalance
Respiratory Alkalosis caused by hyperventilation, CO2 loss, increase PH Tx: rebreathe CO2
Respiratory Acidosis caused by retention of CO2 s/t hypoventilation, depression of medullary respiratory center, pathologic changes in the lungs Tx: correct resp impairment, infusion of sodium bicarbonate if severe
Metabolic Alkalosis caused by loss of gastric acid (vomiting, suctioning), or administration of alkalinizing salts Tx: solution of sodium chloride + K+ chloride = facilitates excretion of bicarbonate = normalization of pH
Metabolic Acidosis caused by chronic renal failure, metabolic disorders, loss of bicarbonate during severe diarrhea, Methanol and certain medications poisoning (aspirin) Tx: alkalinizing salt if severe (Na+ bicarbonate)
Potassium conduct nerve impulses, maintain electrical excitability of muscles, acid-base balance
Hypokalemia caused by tx with thiazide or loop diuretic, has AE on skeletal muscle, smooth muscle, blood pressure, and heart increases risk of HTN and stroke Prevention/Tx: K+ supplements
Hyperkalemia caused by severe tissue trauma, acute acidosis, untreated Addison's disease, misuse of K+ sparing diurectics, OD with K+ Consequences: disruption of electrical activity of the heart
Hypekalemia Tx and Management Tx: withhold foods that contain K+ and medicines that promote K+ accumulation Mgmt: counteract K+ induced cardiotoxicity, dec K+ levels, SODIUM BICARBONATE, POLYSTYRENE (kayexelate)
Hypomagnesemia caused by diarrhea, hemodialysis, kidney disease, prolonged IV-feeding w/o mag, well water that is low in Mg, causes inc muscle excitability to tetany, seizures, psychoses, nephrocalcinosis Tx: MgOxide, MgSulfate
Hypermagnesemia caused by renal insufficiency causes muscle weakness, hypotension, sedation, ECG changes Tx: IV calcium to tx muscle weakness and paralysis
Aldosterone regulates blood volume and blood pressure enhanced when Na+ is low and K+ is high
Renin decreases blood pressure, blood volume, renal perfusion, causes sodium depletion, and beta1 stimulation
Angiotension-Converting Enzyme Inhibitors (ACE inhibitors) MOA "pril" used for HTN, HF, MI, diabetic and non-diabetic nephropathy, used to prevent MI, stroke, and death in pts with high CV risks MOA: decrease levels of angiotension II by inhibiting ACE, increase levels of bradykinin by inhibiting kinase II
ACE Inhibitors Pharmacokinetics admin orally (exept enalaprilat) admin w/o regard to meal (except coptopril and moexipril) prodrugs that are metabolized to the active drug (except lisinopril) excreted by the kidneys (avoid in renal pts)
ACE Inhibitors Adverse Effects first dose hypotension, fetal injury, COUGH (d/t inc bradykinin), hyperkalemia, renal failure, neutropenia
ACE Inhibitors Drug Interactions diuretics (intensify 1st dose hypotsn), anithypertensive agents, drugs that inc K+, LITHIUM, NSAIDS
ACE Inhibitor Agents "pril" BENAZEPRIL, CAPTOPRIL, ENALAPRIL, FOSINOPRIL, LISINOPRIL, MOEXIPRIL, PERINDOPRIL, QUINAPRIL, RAMIPRIL, TRANDOLAPRIL
Angiotensin Receptor Blockers (ARBs) "sartan" block access of angiotension II to the receptors, cause dilation of arterioles and veins, dec excretion of K+, dec release of aldosterone, inc renal excretion of Na+ and water DO NOT inhibit kinase II, increase levels of bradykinin
Angiotensin Receptor Blockers (ARBs) "sartan" Uses, Adverse Effects uses: HTN AE: angioedema, fetal harm, renal failure
Angiotensin Receptor Blockers (ARBs): VALSARTAN, CANDESARTEN used for heart failure
Angiotensin Receptor Blockers (ARBs): IRBESARTEN, LOSARTAN used for diabetic nephropathy
Angiotensin Receptor Blockers (ARBs): VALSARTAN used for stroke prevention
Angiotensin Receptor Blockers (ARBs): TELMISARTAN used for prevention of MI, stroke, and death in pts with inc CV risk
Angiotensin Receptor Blockers (ARBs): LOSARTAN used for diabetic retinopathy
Angiotensin Receptor Blockers (ARBs) Agents CANDESARTAN, EPROSARTAN, IRBESARTINA, LOSARTAN, OLMESARTAN, TELMISARTAN, VALSARTAN
Renin Inhibitors: ALISKIRN prevent conversion of angiotensinogen to angiotensin I approved ONLY for HTN DOES NOT increase bradykinin so NO Cough!, no angioedma, fetal injury
Aldosterone Antagonists: EPLERENONE, SPRIONOLACTONE used in HTN and HF SPIRONOLACTONE is less effective and has more AEs (hyperkalemia, gynecomastia, mensrual irregularities, impotence, hirsutism, deepening of voice) EPLERENON causes hyperkalemia
Calcium Channel Blockers 2 groups: Agents that act on both vascular smooth muscle and the heart Agents that work just on vascular smooth muscle
Coupling CCBs with Beta 1-Adrenergics calcium influx is enhanced produce same effect...redcuced force of contraction of the heart, slow HR, and suppress conduction thru AV node
CCBs: Dihydropyridines NIFEDIPINE acts primarily on the arterioles
CCBs: Phenylakylamine VERAPAMIL acts on arterioles and the heart
CCBs: Benzothiazepine DILTIAZEM (Cardizem) acts on arterioles and the heart
CCBs: VERAPAMIL & DILTIAZEM MOA/Uses causes vasodilation, decreased arterial pressure, inc. coronary perfusion uses: angina pectoris, essential HTN, cardiac dysrrhythmias IV or oral admin, extensive first pass metabolism
CCBs: VERAPAMIL & DILTIAZEM Adverse Effects, Drug interactions, Toxicity constipation, dizziness, facial flushing, HA, edema of ankle and feet, heart block Drug Interaction: DIGOXIN, beta blockers, GRAPEFRUIT Toxicity: severe hypotension, bradycardia and AV block, ventricular tachydysrhythmias
CCBs: NIFEDIPINE MOA/Uses blocks in the VSM ONLY decreases BP, inc. HR and contractile force, NOT used to tx dysrhythmias uses: angina pectoris, HTN, migraines, suppress PTL
CCBs: NIFEDIPINE Adverse Effects, Drug interactions flushing, dizziness, HA, peripheral edema, gingival hyperplasia, reflex tachycardia Drug interactions: Beta Blockers-combined with nifedipine will decrease reflex tachycardia
CCBs: Dihydropyridines Agents "dipine" NIFEDIPINE, amlodipine, felodipine, isradipine, nicardipine, nimodipine, nisoldipine, clevidipine (ultra short 1/2 life)
Vasodilator Principle Indications essential HTN, hypertensive crisis, angina pectoris, HF, MI, pheochromocytomoa, PVD, pulmonary arterial HTN, control HTN during sx
Vasodialator Adverse Effects postural hypotension, reflex tachycardia, expansion of blood volume
Direct Vasodilators HYDRALZAINE, MINOXIDIL, SODIUM NITROPRUSSIDE
Direct Vasodilators: HYDRALZINE selective dilation of arterioles postural hypotension is minimal uses: essential HTN (w/beta blocker and diuretic), hypertensive crisis (lowers BP rapidly), HF (usually w/isosorbide dinitrate) AE: reflex tachycardia, inc blood vol., systemic lupus synd
Direct Vasodilators: MINOXIDIL dilate arteries rapid onset used for severe HTN AE: reflex tachycardia, Na+ and water retention, usually given w/ beta blocker to decrease effects, hypertrichosis (excessive hair growth (Rogaine)), pericardial effusion
Direct Vasodilators: SODIUM NITROPRUSSIDE fastest acting antihypertensive dilates veins and arteries administer IV infusion, immediate onset used for HTN emergencies AE: excessive hypotension, cyanide poisoning (liver disease pts), thiocyanate toxicity (when used for > 3 days)
Other Vasodilators Ace Inhibitors, ARBS, organic nitrates, CCBs, sympatholytics (alpha blockers, centrally acting agents, adrenergic-neuron blockers), NESITIRIDE, Pulmonary HTN agents
Agents for HTN Emergencies SODIUM NITROPRUSSIDE, FENOLDOPAM, LABETALOL, DIAZOXIDE, CLEVIDIPINE (NEW)
Agent for HTN in pregnancy METHYLDOPA, LABETALOL, MAG SULFATE (for antiseizure use), HYDRALAZINE (for pre-eclampsia and elampsia) Note: any drug that blocks RAAS is contraindicated in pregnancy
Agents used to tx Heart Failure (HF) Diuretics, drugs that inhibit renin-angiotensin aldosterone system (RAAS), inotropic agents, vasodilators
Diuretics in HF reduce blood vol., decrase venous pressue, decrease afterload, decrease pul edema, peripheral edema, and cardiac dilation
Agents that reduce RAAS in HF Ace Inhibitors-dilation of veins and arteries, suppress alsdosterone release AE: COUGH, angioedema, hyperkalemia ARBs-no cough; some hyperkalemia
Beta Blockers in HF CARVIDELOL, METOPROLOL, BISOPROLOL, NEBIVOLOL (NEW) can improve status, AE: fluid retention, fatigue, hypotension, bradycardia, MI
Inotropic Agents in HF Sympathomimetics: DOPAMINE, DOBUTAMINE Phosphodiesterase Inhibitors: MILRINONE Cardiac Glycosides: DIGOXIN
DOPAMINE in HF dilates renal blood vessels, increase myocardial contractility admin: infusion
DOBUTAMINE in HF DOES NOT increase vascular resistence admin: infusion
Phosphdiesterase Inhibitors in HF MILRINONE increase myocardial contractility, promote vasodilation admin: infusion short-term therapy of severe HF
Vasodilators in HF: ISOSORBIDE DINITRATE + HYDRALZINE used as alternative to Ace Inhibitors or ARBs, approve for AA
Vasodilators in HF: NITROGLYCERIN (IV) used for venodilation, acute severe pul edema AE: hypotension, reflex tachycardia
Vasodilators in HF: SODIUM NITROPRUSSIDE dilates arteries and veins AE: profound hypotension
Cardiac Glycosides in HF: DIGOXIN Use/ Toxicity increase myocardial contractility beware of use w/ diuretics increase urine production, slows conduction thru AV node Low Therapeutic Index Toxicity: nausea, visual problems (yellow-green halos), AV block, give DIGIBIND for OD 2nd line drug for HF
Cardiac Glycosides in HF: DIGOXIN Cautions/Concerns K+ level must be kept WNL can cause dysrhythmias, anorexia, N/V, fatigue, visual disturbances (halos) Drug Interactions: diuretics, ACE inhibitors, Sympathomimetics, QUINIDINE, VERAPAMIL Therapeutic range 0.5-1.1 ng/ml
Management of Stage A HF no symp mgmt aimed at reducing risk, use ACEi, ARBs
Management of Stage B HF no symp, some structural heart disease goal: prevent dev of symptomatic HF, retard progression of remodeling thx: ACEi, ARBs, BBs
Management of Stage C HF symptomatic, structural heart disease 4 goals: relieve pul and peripheral congestive symp improve fx capacity and quality of life slow cardiac remodeling and progression of LV dysfxn Prolong life thx: diuretics, ACEi, ARBs, BBs, Aldosterone antagonis
Drugs that make HF worse Antidysrhythmic agents, CCBs, NSAIDs
Anticoagulant & Antiplatelet Therapy in HF ASPIRIN decreases ischemic events WARFARIN recommended for pts who have atrial fibrillation or previous embolic events or marked dilated ventricles
Classification of Antidysrhythmic Drugs: Vaughn Williams Classification Class I: Block Na+ channels Class II: Beta Blockers Class III: K+ Channel Blockers Class IV: Calcium Channel Blockers Other: DIGOXIN, ADENOSINE + IBUTILIDE
Antidysrhythmic: Sodium Channel Blockers: Class IA agents QUINIDINE-can cause digxoin levels to increase PROCAINAMIDE DISOPYRAMIDE
Antidysrhythmic: Sodium Channel Blockers: Class IA Uses/AE supraventricular and ventricular dysrhythmias, block vagal input to heart, delay repolarization (widen QRS, prolng QT interval) AE: diarrhea or costipation, cinchonism (quinidine), cardiotoxicity, arterial embolism, hypotension, lupus like syn (procainam
Sodium Channel Blockers: Class IB agents LIDOCAINE, PEHNYTOIN (dilantin), MEXILITINE
Antidysrhythmic: Sodium Channel Blockers: Class IB agents uses, AE used for ventricular dysrhythmias, slows condution to that atria, ventricles, and His-Purkinje sys, reduces automaticity in ventricles, accerlates repolarization AE: CNS effects w/high doses, confustion, parathesia, GI
Antidysrhythmic: Sodium Channel Blockers: Class IC agents FLECAINIDE PROPAFENONE
Antidysrhythmic: Sodium Channel Blockers: Class IC agents uses, AE used for life-threatening ventricular dysrhythmias, delay repolarization in ventricles (can create new dysrhythmias) AE: severe myocardial depression, potentially make HF worse
Antidysrhythmic: Beta Blocker: Class II agents PROPRANOLOL (oral/IV) ESMOLOL (IV, short acting) ACEBUTOLOL (oral)
Antidysrhythmic: Beta Blocker: Class II agents uses, AE used for tachydysrhythmias AE: potential to make HF worse, AV block, sinus arrest, bronchospasm in asthmatic pts
Antidysrhythmic: Potassium Channel Blocker: Class III agents AMIODARONE DRONEDARONE SOTALOL DOFETILIDE IBUTILIDE
Antidysrhythmic: Potassium Channel Blocker: Class III agents AMIODARONE used for life-threatening ventricular dysrhythmias ONLY AE: pulmonary and cardiotoxicity, photosensitvity, hypo-or hyperthyroidism, toxic in pregnancy and breast feeding, many drug interactions, thyroid function is frequently altered
Antidysrhythmic: Calcium Chanel Blocker: Class IV agents VERAPAMIL DILTIAZEM
Antidysrhythmic: Calcium Chanel Blocker: Class IV agents uses/AE used to slow ventricular rate (atrial fib, atrial flutter), terminate SVT caused by an AV nodal reentrant circut AE: bradycardia, hypotension, potential to make HF worse, peripheral edema, constipation Drug Interactions: DIGOXIN, BBs
Antidysrhythmic: ADENOSINE slows conduction thru AV node, used to convert paroxysmal supraventricular tachycardia to sinus rhythm (DRUG OF CHOICE) very short 1/2 life (10 sec) IVP, IV bolus may cause asystole for a few seconds AE: facial flushing, hypotension Drug Interaction:
Antidysrhythmic: DIGOXIN inhibit sodium ATPase pump, used for HF and atrial dysrhythmias monitor potassium levels, drug levels, and for toxicity
Organic Nitrates for Angina Pectoris NITROGLYCERIN ISOSORBIDE MONOITRATE ISOSORBIDE DINITRATE AMYL NITRATE
Organic Nitrates for Angina Pectoris: NITROGLYCERIN vasodilator, decrease preload, short 1/2 life AE: HA, orthostatic hypotension, reflex tachycardia can develop tolerance Drug Interactions: agents used to treat ED (viagra), BBs, CCBs
Beta Blockers for Angina Pectoris: PROPRANOLOL, METOPROLOL decrease cardiac oxygen demand AE: bradycardia, decreased AV conduction, reduction of contractility, mask hypoglycemia, sexual dysfunction, bizarre dreams use metoprolol for asthmatics
Calcium Channel Blockers for Angina Pectoris VERAPAMIL, DILTIAZEM, NIFEDIPINE used for stable and variant angina AE: hypotension, reflex tachycardia (greatest with Nifedipine), bradycardia, AV block
RAOLAZINE for Angina Pectoris inhibits slow sodium channels, prevents Na+ overlaod during ischemia AE: QT prolongation, raise BP, constipation, N/V, HA Drug interaction: drugs metabolized by CYP34A, drugs that prolong QT interval, CCBs can increase levels
Drugs to prevent MI and Death Antiplatelet (ASPIRIN, CLOPIDOGREL) cholesterol lowering drugs ACEi Antianginal agents: sublingual nitroglycerin, BBs, CCBs, long acting nitrates
HMG-CoA Reductase Inhibitors (Statins) block rate-limiting step in cholesterol syntheis, therby reducing LDL, increase LDL receptors
Statin Agents ATORVASTATIN, FLUVASTATIN, LOVASTATIN, PITAVASTATIN, PRAVASTATIN, ROSUVASTATIN, SIMVASTATIN
Statins can decrease cholesterol and triglycerides and increase HDL, used for hypercholesterolemia, prevention of CV events, post MI tx, diabetes AE: hepatitis, myalgia, rhabdomyolysis, new onset DM, cataracts, not used in preg Drug int: CyP34A inhibitors
Nicotinic Acid: NIACIN oral, decrease LDL and TG, inc. HDL AE: vasodilation, flushing (aspirin helps), hepatitis, peptic ulcers, glucose interolerance Can be used alone or marketed with Lovastatin (ADVICOR)
Bile-Acid Sequestrants decrease LDL, used as adjunct to statins bind to bile acids, prevent absorption uses: hypercholersterolemia AE: constipation, bloating Drug int: admin hiazide diuretics, digoxin, warfarin, antbx 1hr before or 4hrs after
Fibric Acid Derivatives (Fibrates) decrease LDL, increase HDL used for hypertriglyceridemia AE: rash, GI distrubances, gallstones, myopathy, liver injury drug int: displace warfarin increasing anticoagulant effect, can increase statin induced myopathy
Bile-Acid Seuestrant Agents CHOLESTRYRAINE COLESTIPOL COLESEVELAM
Fibric Acid Derivatives (Fibrates) Agents GEMFIBROZIL FENOFIBRATE
EZETIMIBE reduce LDL, slighlty increase HDL, used as combo AE: flatulence, rhabdomyolysis Drug int: statins-inc liver damage, fibrates-inc risk for gallstones, bile-acid sequ-decrease absorption of ezetimibe, cyclosporine-inc bioavailability of ezetimibe VITORIN
Unfractionated Heparin MOA, uses suppress coagulation by inactivating thrombin factors 1/2 life 1-5 hrs IV/SC, does not cross placenta monitor aPTT levels uses: PE, DVT, open heart sx, renal dialysis, prevention of DVT post op, DIC, MI, preferred for use in preg.
Unfractionated Heparin AE, contraindications, Drug Int. hemorrhage-antidote-PROTAMINE SULFATE spinal/epidural hematoma, thrombocytopenia, hypersensitivity Contr: thrombocytopenia and uncontrolled bleeding, after sx of eye, brain, or spinal cord Drug int: aspirin
Low Molecular Weight Heparin "parin" DELTEPARIN, ENOXAPARIN fixed dose, does NOT require monitoring of aPTT levels, can be used at home inactivate factor Xa use: 1st tx for tx and prevention of DVT, prevention of ischemic complications in angina and MI
FONDAPARINUX synthetic anticoagulant admin SC inhibit factor Xa, reduced production of thrombin = decreased coagulation uses: DVT prevention, Acute PE, tx acute DVT AE: same as heparin
Indirect Thrombin Inhibitor Agents RIVAROXAN APIXABAN EDOXABAN
Indirect Thrombin Inhibitors factor Xa inhibitor rapid onset, fixed dose, lower bleeding risk, few drug int, no need for INR monitoring uses: DVT prev, and PE prev follwoing hip/knee replace, Tx DVT, PE AE: altered by drugs that inhibit CYP34A and P-glycoprotein, unsafe in preg
Direct Thrombin Inhibitor Agents DABIGATRAN, DESIRUDIN, BIVALIRUDIN, ARGATROBAN
Direct Thrombin Inhibitors directly bind to and inhibit thrombin uses: prevention of stroke and systemic embolism in A-fib AE: bleeding, GI distrubances Antidote: IDARUCIZUMAB (praxbind)
Anticoagulants: Vitamin K Antagonist: WARFARIN decrease production of vit K, cross placenta, 3-5 days for full effect. uses: DVT, PE prev, A-fib pts to prevent thrombosis, artificial heart valve-to prevent thromboembolism
WARFARIN adverse effects hemorrhage-antidote = PHYTONADIONE (vitamin K) drug int: agents that displace warfarin off albumin, inducers or inhibitors of liver metabolizing enzymes, drugs that dec absorption, inhibitors of platelet aggregation, mayo, canola/soybean oil, green leafy
WARFARIN monitoring monitor INR, sensitive to alterations in vitamin-K dependent factors
Antiplatelet Agent: Cyclooxyenase inhibitor ASPIRIN
Antiplatelet Agent: P2Y12 Adenosine diphosphate receptor inhibitor CLOPIDOGREL PRASUGREL TICAGRELOR TICLOPIDINE
Antiplatelet Agent: Glycoprotein IIb/IIIa receptor inhibitors ABCIXIMAB EPTIFIBATIDE TRIOFIBAN
Antiplatelet Agents suppress platelet aggregation used for prevention of thrombosis in arteries
ASPIRIN irreversibly inhibits cyclooxygenase=prevention of thromboxane production in platelets uses: ischemic stroke, TIAs, unstable angina, coronary stenting, acute MI, previous MI, prevention of MI AE: bleeding (GI & hemorrhagic stroke)
Antiplatelet Agent: P2Y12 ADP receptor antagonist prevent platelet aggregation CLOPIDOGREL, TICLOPIDINE, PRASUGREL, TICAGRELOR
Antiplatelet Agent: P2Y12 ADP receptor antagonist: CLOPIDOGREL pro-drug, irreversible blockade, interacts with PPIs AE: bleeding, thrombotic thrombocytopenia
Antiplatelet Agents: Glycoprotein IIb/IIIa Receptor antagonist "super aspirin" most effective drug on market use alone or in combo with aspirin or heparin very expensive reversible blockade uses: Acute coronary syndromes, angioplasty AE: bleeding
Thrombolytic Agents ALTEPACE, RETEPLASE, TENECTEPLASE remove thrombi that have already formed convert plasminogen to plasmin uses: use within 4-6hrs of acute MI, PE, ischemic stroke AE: bleeding, intracranial hemorrhage
FACTOR VIII CONCENTRATES FACTOR IX CONCENTRATES tx hemophelia can cause allergic rxn slow IVP
DEMOPRESSIN analog of antidiuretic releases stored factor VIII from vascular endothelium can be used in traumas and hemophilia
Antifibrinolytic Agents: AMINOCAPORIC ACID, TRANEXAMIC ACID used to prevent recurrent bleeding in hemophilia
Agents to Tx Anemia FERROUS SULFATE-causes GI disturbances, staining of teeth, toxicity in children IRON DEXTAN (IV only)-used when oral admin is not feasible, can cause fatal anaphylatic shock
CYANOCOBALAMIN tx vitamin B12 deficiency, lifelong tx can be combined with Folic Acid...monitor does Folic Acid can mask Vit B12 deficiency
Erythopoiesis Stimulating Agents: EPOETIN ALPHA, DARBEPOETIN ALFAPOETIN ALPHA stimulate bone marrow IV/SC increase dose slowly AE: HTN, thrombosis
EPOETIN ALPHA used with anemia associated with cancer chemo, HIV pts taking AZT, and chronic renal failure
DARBEPOETIN ALFAPOETIN ALPHA long acting used with chronic renal failure and anemia associated with cancer chemo
Leukopoietic Growth Factors "stim" FILGRASTIM, PEGILGRASTIM, SARGRAMOSTIM Stimulate production of WBCs IV/SC treat neutropenia after chemo or bone marrow transplant AE: bone pain, leukocytosis
Thrombopoietic Growth Factors PORELVKIN ROMIPLOTIM ELTROMBOPAG
OPRELVEKIN stimulate production of thrombocytes only one in its category given SC used in chemo AE: salt and water retention, tachycardia, severe allergic rxn
ROMIPLOTIM given SC tx immune thrombocytopenia, increase platelet production
ELTROMBOPAG used to decrease risks of bleeding in chronic idiopathic thrombocytopenia purpura AE: liver toxicity
Created by: julzbanks
 

 



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