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First AID;Heme Pharm


thrombolytics Alteplase (tPA), reteplase (rPA), streptokinase, tenecteplase (TNK-tPA) aids plasminogen to plasmin -> cleaves thrombin and fibrin clots. -PT, PTT, no change in platelet count RX: Early MI, early ischemic stroke, direct thrombolysis of severe PE Nonspecific reversal with - anti fibrinolytics (eg, aminocaproic acid, tranexamic acid), - platelet transfusions, - factor corrections (eg, cryoprecipitate, FFP, PCC).
ADP (P2Y12) receptor blockers Clopidogrel, prasugrel, ticagrelor (reversible), ticlopidine. irreversibly block --> Prevent expression of glycoproteins IIb/IIIa on platelet surface. RX; Acute coronary syndrome; coronary stenting. - incidence or recurrence of thrombotic stroke. AVR; Neutropenia (ticlopidine). TTP may be seen.
Phosphodiesterase inhibitors Cilostazol, dipyridamole. > cAMP in platelets --> inhibition of platelet aggregation; - vasodilators. RX; Intermittent claudication, - coronary vasodilation - (dipyridamole used for cardiac stress testing), - prevention of stroke or TIAs (combined with aspirin) AVR; Nausea, headache, - facial Flushing, - hypotension, - abdominal pain
glycoprotein receptor IIb/IIIa inhibitors Abciximab, eptifibatide, tirofiban. Abciximab is made from monoclonal antibody Fab fragments. RX; Unstable angina, percutaneous coronary intervention. AVR; Bleeding, thrombocytopenia.
Dactinomycin (actinomycin D) Intercalates into DNA ---> preventing RNA synthesis. RX; Wilms tumor, Ewing sarcoma, rhabdomyosarcoma. Used for childhood tumors. Myelosuppression.
free radical formation Doxorubicin, daunorubicin - Solid tumors, leukemias, lymphomas. - AVR; CARDIOTOXIC -Dexrazoxane (iron chelating agent) used to prevent cardiotoxicity Bleomycin - Induces free radical formation breaks in DNA strand RX; Testicular cancer, Hodgkin lymphoma. What is AVR of Bleomycin Pulmonary brosis, skin hyperpigmentation. Minimal myelosuppression.
microtubules inhibitors Paclitaxel, other taxanes -Hyperstabilize polymerized microtubules - Ovarian and breast carcinomas. AVR; Myelosuppression, neuropathy, hypersensitivity. Vincristine, vinblastine - bind β-tubulin and inhibit its polymerization into microtubules Vincristine, vinblastine -Solid tumors, - leukemias, - Hodgkin and non-Hodgkin lymphomas.
Drugs for Solid tumors Doxorubicin, daunorubicin Vincristine, vinblastine Etoposide, teniposide BeVacizumab
CISPLATIN RX; Testicular, bladder, ovary, GI, and lung carcinomas. Cross-link DNA. AVR; Nephrotoxicity, Fanconi syndrome, peripheral neuropathy, ototoxicity. Prevent nephrotoxicity with - amifostine (free radical scavenger) - chloride (saline) diuresis.
Testicular CANCER Bleomycin Cisplatin Etoposide, teniposide
BeVacizumab Monoclonal antibody against VEGF. Inhibits angiogenesis (inhibits Blood Vessel formation). RX; Solid tumors (eg, colorectal cancer, renal cell carcinoma), - wet age-related macular degeneration. AVR;- Hemorrhage, blood clots, and impaired wound healing.
ERLOTINIB EGFR tyrosine kinase inhibitor. RX; Non-small cell lung cancer. . AVR; Rash
CETUXIMAB, PANITUMUMAB Monoclonal antibodies against EGFR. Stage IV colorectal cancer (wild-type KRAS), head and neck cancer. AVR; Rash, elevated LFTs, diarrhea
IMATINIB and DASATINIB Tyrosine kinase inhibitor of bcr-abl (encoded by Philadelphia chromosome fusion gene in CML) and c-kit (common in GI stromal tumors). RX; CML, GI stromal tumors (GIST). AVR; Fluid retention.
RITUXIMAB Monoclonal antibody against CD20, RX; Non-Hodgkin lymphoma, CLL, ITP, rheumatoid arthritis. AVR; risk of progressive multifocal leukoencephalopathy.
BORTEZOMIB Proteasome inhibitors, - induce arrest at G2-M phase - apoptosis. RX; Multiple myeloma, RX; mantle cell lymphoma. AVR; Peripheral neuropathy, herpes zoster reactivation.
VEMURAFENIB Small molecule inhibitors of BRAF oncogene ⊕ melanoma. VEmuRAF-enib is for V600E- mutated BRAF inhibition. co-administered with MEK inhibitors (eg, trametinib). RX; Metastatic melanoma
Heparin Immediate anticoagulation for pulmonary embolism (PE), - acute coronary syndrome, - MI, - deep venous thrombosis (DVT). Used during pregnancy (does not cross placenta). - Follow PTT. AVR: Bleeding, thrombocytopenia (HIT), osteoporosis, drug-drug interactions antidote; use protamine sulfate
Direct thrombin inhibitors Bivalirudin, Argatroban, Dabigatran (only oral agent in class). RX; - Venous thromboembolism, atrial fibrillation. - Can be used in HIT, when heparin is BAD for the patient. AVR; Bleeding; can reverse dabigatran with idarucizumab. Consider PCC and/or anti brinolytics (eg, tranexamic acid) if no reversal agent available
Warfarin Inhibits epoxide reductase, interferes with γ-carboxylation of vitamin K–dependent clotting factors II, VII, IX, X, and proteins C, S. RX; Chronic anticoagulation; - venous thromboembolism prophylaxis, - prevention of stroke in atrial fibrillation) Metabolized by cytochrome P-450.
Created by: beccao



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