Drugs recognition: chap 16
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
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| warfarin (Coumadin) | Oral Anticoagulants
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| Vitamin K – “antidote for warfarin” | Oral Anticoagulants
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| heparin | Parenteral Anticoagulants
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| enoxaparin (Lovenox) | Parenteral Anticoagulants
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| bivalirudin (Angiomax) | Parenteral Anticoagulants
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| lepirduin (Refludan) | Parenteral Anticoagulants
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| aspirin | Antiplatelet Drugs
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| dipyridamole/aspirin (Aggrenox) | Antiplatelet Drugs
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| clopidogrel (Plavix) | Antiplatelet Drugs
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| (Aggrastat & Intergrilin) – for unstable angina and acute MI | Antiplatelet Drugs
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| abciximab (ReoPro) – for angioplasty and stent placement | Antiplatelet Drugs
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| Alteplase & Streptokinase – for PE, stroke, and acute MI | Fibrinolytics
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| treat hemorrhage caused by coumarin anticoagulants | phytonadione
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| what to monitor when using coumarin coagulants? | PT (prothrombin time)
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| warfarin side effects | birth defects and bleeding
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| PT goal of patient treated with warfarin | 1.3 to 1.5 x PT of the control
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| INR goal of warfarin | normally 2 to 3, in pt with mechanical prosthtic heart valses and systemic embolization: INR = 3 to 4.5
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| drugs increase anticoagulant effect of warfarin | salicylates, cephalosporins
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| drugs decrease anticoagulant effect of warfarin | refampin, barbiturates
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| drug inhibit absorption of warfarin | cholestyramine
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| drugs inhibit metabolism of warfarin and increase bleeding | amiodarone, cimetidine, erythromycin, fluconazole, gemfibrozil, isoniazid, metronidazole, sulfinpyrazone
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| why do warfarin have many drug interactions? | b/c it is almost completely metabolized by CYP enzymes: CYP2C9, CYP1A2, CYP 2C19, Cyp 3A4
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| Warfain indications | deep vein thrombosis, atrial fibrillation, artificial heart valve,
used in combination with heparin for MI
Keep thrombus from extending, cannot dissolve
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| what does dosage of warfarin depend on? | the patient's PT (prothrombi time)
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| what to do when bleeding occur during administration of coumarin anticoagulant? | withheld the drug until Pt determined, reduction in drug dosage, administer phytonadione (vit K). if INR >20, use fresh frozen plasma or factor IX
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| what causes HIT (heparin-induced thrombocytopenia) | heparin administration
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| What causes HIT 1? | heparin-platelet interaction, leading to platelet aggregation, can continue using drugs
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| What causes HIT 2? | immunoglobulin-mediated platelet inactivation, causing mortality and thrombotic complications, discontinued
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| alteplase (Activase) streptokinase (fibrinolytic drugs) indication | degrade thrombus in MI, stroke, PE (pulmonary embolism)
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| alteplase (Activase) streptokinase adverse effects | hemorrhage
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| abciximab indication | for angioplasty and stent placement
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| abciximab adverse effect | bleeding
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| tirofiban (Aggrastat) & eptifibatide (Integrilin)indications | acute coronary syndrome, adverse effect: bleeding
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| dosage of heparin depends on | aPTT (activated partial thromboplastin time
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| adequate level of heparin | aPTT = 1.5 to 2x normmal
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| enoxaparin (Lovenox)indications | DVT, PE, thromboembolic disorders, CV surgeries, atrial fib, unstable angina
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| heparin antidote | protamine sulfate
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| spironolactone (Aldactone)classes | aldosterone antagonists
potassium sparing diuretic
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| eplerenone (Inspra) | aldosterone antagonists
potassium sparing diuretic
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| ethacrynic acid | loop diuretics
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