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Heart, Blood Vessels
Drugs that affect the heart, vessels and blood
| Term | Definition |
|---|---|
| 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 |
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julzbanks
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