2013 Spring Pharm Durgs

Front 1

Sulfonamide
-how does it cause kernicterus

Back 1

Kernicterus is a rare neurological condition that occurs in some newborns with severe jaundice. Kernicterus is caused by very high levels of bilirubin.
Sulfonamides [suhl-fon-uh-mahyd, -mid, suhl-fuh-nam-ahyd, -id]-->bind with the albumin releasing the Bilirubin. Both use the same receptor site in albumin.
In children the glucoronidation system is not matured to metabolize Bilirubin.
NAT2 polymorphism can affect its toxicity.

Front 2

Thiopental
-use
-mechanism of elimination
-vs. metabolic acidosis

Back 2

a rapid-onset short-acting barbiturate general anesthetic
-redistribution is the mechanism of drug elimination for this highly lipophylic drug.
Thiopental is weak acid. Nonionized form cross BBB. metabolic acidosis increase plasma H+ thus increase HA so more thiopental cross BBB and increase depth of the anesthesia

Front 3

chloramphenicol
-use
-type of metabolic rx
-gray baby syndrome

Back 3

Chloramphenicol (INN) is a bacteriostatic antimicrobial that became available in 1949. a prototypical broad-spectrum antibiotic, alongside the tetracyclines

metabolized through nitroreduction

can induce gray baby syndrome

Front 4

Procaine:
-use
-type of metabolic rx

Back 4

Procaine is a local anesthetic drug of the amino ester group. It was used primarily to reduce the pain of intramuscular injection of penicillin, and it was also used in dentistry.

metabolized through ester hydrolysis

Front 5

Succinycholine
-use
-type of metabolic rx
polymorphism

Back 5

Succinylcholine, is a nicotinic acetylcholine receptor agonist, used to induce muscle relaxation and short-term paralysis, usually to facilitate tracheal intubation.
Serum cholinesterase polymorphism Reduced ability to hydrolyze succinylcholine-->prolonged exposure may lead to death.
Not hydrolyzed by AChE but is hydrolyzed by BChE. Depolarizing blockade. short during.

metabolized by ester hydrolysis

Front 6

procainamide
-use
-type of metabolic rx

Back 6

Procainamide INN (pron.: /proʊˈkeɪnəmaɪd/; trade names Pronestyl, Procan, Procanbid) is a pharmaceutical antiarrhythmic agent used for the medical treatment of cardiac arrhythmias.
Metabolized through amide hydrolysis
NAT2 polymorphism can affect its toxicity.

Front 7

Lidocaine
-use
-type of metabolic rx

Back 7

aine (INN) (pron.: /ˈlaɪdɵkeɪn/), xylocaine, or lignocaine (former BAN) (pron.: /ˈlɪɡnɵkeɪn/) is a common local anesthetic and antiarrhythmic drug. Lidocaine is used topically to relieve itching, burning and pain from skin inflammations, injected as a dental anesthetic or as a local anesthetic for minor surgery.

metabolized by amide hydrolysis

Front 8

Cimetidine
-use
-drug drug interaction

Back 8

Cimetidine INN (pron.: /sɨˈmɛtɨdiːn/ or /saɪˈmɛtɨdiːn/) is a histamine H2-receptor antagonist that inhibits stomach acid production. It is largely used in the treatment of heartburn and peptic ulcers.
Cimetidine is a known inhibitor of many isozymes of the cytochrome P450 enzyme system. This inhibition forms the basis of the numerous drug interactions that occur between cimetidine and other drugs. For example, cimetidine may decrease metabolism of some drugs, such as those used in hormonal contraception. Cimetidine interferes with metabolism of the hormone estrogen, enhancing estrogen activity

Front 9

Azole antifungal drugs: eg. ketoconazole
-drug drug interaction mechanism

Back 9

For example, the azole antifungals such as ketoconazole or itraconazole can be both substrates and inhibitors of the P-glycoprotein, which (among other functions) excretes toxins and drugs into the intestines.Azole antifungals also are both substrates and inhibitors of the cytochrome P450 family CYP3A4, causing increased concentration when administering, for example, calcium channel blockers, immunosuppressants, chemotherapeutic drugs, benzodiazepines, tricyclic antidepressants, macrolides and SSRIs.

Front 10

Macrolide antibotics: eg. erythromycine
-drug drug interaction mechanism

Back 10

It may also alter the effectiveness of combined oral contraceptive pills because of its effect on the gut flora. Erythromycin is an inhibitor of the cytochrome P450 system, which means that it can have a rapid effect on levels of other drugs metabolised by this system, e.g., warfarin.

Front 11

Barbiturates
use
induction of drug metabolism

Back 11

Barbiturates are drugs that act as central nervous system depressants, and can therefore produce a wide spectrum of effects, from mild sedation to total anesthesia

Barbiturate are classical and broad inducers

Front 12

acetaminophen
-toxicity mechanism
-antidote

Back 12

Glutathione conjugation usually first defense: In the case of N-acetyl-p-benzoquinone imine (NAPQI), the reactive cytochrome P450-reactive metabolite formed by paracetamol (or acetaminophen as it is known in the US), which becomes toxic when GSH is depleted by an overdose of acetaminophen, glutathione is an essential antidote to overdose. Glutathione conjugates to NAPQI and helps to detoxify it. In this capacity, it protects cellular protein thiol groups, which would otherwise become covalently modified; when all GSH has been spent, NAPQI begins to react with the cellular proteins, killing the cells in the process

The preferred treatment for an overdose of this painkiller is the administration (usually in atomized form) of N-acetyl-L-cysteine (often as a preparation called Mucomyst[20]), which is processed by cells to L-cysteine and used in the de novo synthesis of GSH.

Front 13

Probenecid
-use
-drug drug rx concern secretion
-type of secretion

Back 13

Probenecid (Lannett's Probalan) is a uricosuric drug that increases uric acid excretion in the urine. It is primarily used in treating gout and hyperuricemia.

depress renal excretion of other weak acids like penicillin and phenobarbital

through active tubular secretion

Front 14

sulfinpyrazone
-use
mechanism
-

Back 14

Sulfinpyrazone is a uricosuric medication used to treat gout, that increases uric acid excretion in the urine.
Like other uricosurics, sulfinpyrazone works by competitively inhibiting uric acid reabsorption in the proximal tubule of the kidney.

Front 15

Phenobarbital
-use
-how does it excreted
-does probenecid increase/decrease the excretion?

Back 15

Phenobarbital is indicated in the treatment of all types of seizures except absence seizures.

weak acid and ionized from is excreted. Alkaline urine increase excretion

Front 16

amphetamine
-use
-how does it excreted.
-does probenecid increase/decrease the excretion?

Back 16

It is a psychostimulant drug that produces increased wakefulness and focus in association with decreased fatigue and appetite

weak base and ionized from is excreted. acidic urine increase the excretion.

Front 17

Isoproterenol
-use
-desensitization

Back 17

used for the treatment of bradycardia (slow heart rate), heart block, and rarely for asthma. It is a non-selective beta-adrenergic agonist and structurally similar to adrenaline.
Polymorphisms in beta-2 adrenergic receptor gene (ADRB2) affect response to bronchodilators such as albuterol and isoproterenol

down regulate the receptor if chronic used

Front 18

propranolol
-use
-super-sensitization

Back 18

a sympatholytic non-selective beta blocker[antagonist]. Sympatholytics are used to treat hypertension, anxiety and panic. It was the first successful beta blocker developed.

chronic use can cause supersensitization b/c up-regulate the receptors

Front 19

Atropine
-type of antagonist
-use

Back 19

cholinergic competitive antagonist , reversible, surmountable, muscarinic receptor blocker. Get rid of all parasympathetic effect.

It is a competitive antagonist for the muscarinic acetylcholine receptor. It is classified as an anticholinergic drug (parasympatholytic).
Working as a nonselective muscarinic acetylcholinergic antagonist, atropine increases firing of the sinoatrial node (SA) and conduction through the atrioventricular node (AV) of the heart, opposes the actions of the vagus nerve, blocks acetylcholine receptor sites, and decreases bronchial secretions.

Front 20

Phenoxybenzamine
-type of antagonist
-use

Back 20

a non-selective, irreversible competitive alpha adrenergic antagonist. non-equilibrium, insurmountable.

used in the treatment of hypertension, and specifically that caused by pheochromocytoma. It has a slower onset and a longer lasting effect compared with other alpha blockers.

Front 21

diazoxide
-type of antagonists

Back 21

Diazoxide is antihypertensive via dilation of arterioles; non- competitive inhibitor of norepinephrine

Front 22

neostigmine
-vs succinylcholine

Back 22

Neostigmine (Prostigmin, Vagostigmin) is a parasympathomimetic that acts as a reversible acetylcholinesterase inhibitor.

potentiation drug drug interaction with succinylcholine

Front 23

Succinylcholine
-vs neotigmine

Back 23

is a nicotinic acetylcholine receptor agonist, used to induce muscle relaxation and short-term paralysis, usually to facilitate tracheal intubation.

potentiation drug drug interaction with neostigmine.

Front 24

Mercaptopurine

Back 24

(also called 6-mercaptopurine, 6-MP or its brand name Purinethol) is an immunosuppressive drug.
It is a thiopurine.
It is used to treat leukemia, pediatric non-Hodgkin's lymphoma, polycythemia vera, psoriatic arthritis and inflammatory bowel disease (such as Crohn's disease and ulcerative colitis).
Thiopurine-S-Methyltransferase (TMPT) Polymorphism. TMPT deactive this drug.

Front 25

irinotecan

Back 25

Irinotecan (Camptosar, Pfizer; Campto, Yakult Honsha) is a drug used for the treatment of cancer.
Irinotecan prevents DNA from unwinding by inhibition of topoisomerase 1
FDA ave explicit recommendations for using pharmacogenetic information to improve drug efficacy/safety
UGT polymorphism is associated with increased toxicity (myelosuppression and diarrhea) following use of irinotecan. [UGT catalyze the Glucuronidation, the addition of glucuronic acid to a substrate]

Front 26

tamoxifen

Back 26

Tamoxifen is an antagonist of the estrogen receptor in breast tissue via its active metabolite, hydroxytamoxifen. In other tissues such as the endometrium, it behaves as an agonist, and thus may be characterized as a mixed agonist/antagonist. Tamoxifen is the usual endocrine (anti-estrogen) therapy for hormone receptor-positive breast cancer
FDA ave explicit recommendations for using pharmacogenetic information to improve drug efficacy/safety.
Tamoxifen is biotransformed to the potent anti-estrogen, endoxifen, by CYP2D6. CYP2D6 polymorphism has poor outcome in tx of breast cancer.

Front 27

Abacavir

Back 27

Abacavir (ABC) i/ʌ.bæk.ʌ.vɪər/ is a nucleoside analog reverse transcriptase inhibitor (NRTI) used to treat HIV and AIDS
FDA ave explicit recommendations for using pharmacogenetic information to improve drug efficacy/safety.
HLA-B polymorphism may lead to severe hypersensitivity.

Front 28

Clopidogrel

Back 28

Clopidogrel (INN) is an oral, thienopyridine class antiplatelet agent used to inhibit blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease. It is under the trade name Plavix. The drug works by irreversibly inhibiting a receptor called P2Y12, an adenosine diphosphate (ADP) chemoreceptor on platelet cell membranes. Adverse effects include hemorrhage, severe neutropenia, and thrombotic thrombocytopenic purpura (TTP).
FDA ave explicit recommendations for using pharmacogenetic information to improve drug efficacy/safety.
CYP2C19 biotransforms many clinically useful drugs including clopidogrel. CYP2C19 polymorphism may cause tx failure.

Front 29

Trastuzumab

Back 29

Trastuzumab (INN; trade names Herclon, Herceptin) is a monoclonal antibody that interferes with the HER2/neu receptor. Its main use is to treat certain breast cancers.
FDA ave explicit recommendations for using pharmacogenetic information to improve drug efficacy/safety

Front 30

Isoniazid

Back 30

soniazid (Laniazid, Nydrazid) is an organic compound that is the first-line medication in prevention and treatment of tuberculosis.

NAT2 polymorphism can affect its toxicity.

Front 31

Hydralazine

Back 31

Hydralazine (apresoline) is a direct-acting smooth muscle relaxant used to treat hypertension by acting as a vasodilator primarily in arteries and arterioles.
NAT2 polymorphism can affect its toxicity.

Front 32

Amonafide

Back 32

Amonafide (originally AS1413) (INN, trade name Quinamed) is a drug that is being studied in the treatment of cancer. It belongs to the families of drugs called topoisomerase inhibitors and DNA intercalators.
NAT2 polymorphism can lead to rapid acetylators..myelosuppression[=bone marrow suppression]

Front 33

Azathioprine

Back 33

Azathioprine (INN, pron.: /ˌæzəˈθaɪɵpriːn/, abbreviated AZA) is an immunosuppressive drug used in organ transplantation and autoimmune diseases and belongs to the chemical class of purine analogues.
Thiopurine-S-Methyltransferase (TMPT) Polymorphism. TMPT eactive this drug.

Front 34

Phenacetin

Back 34

Phenacetin is an analgesic, once widely used; its use has declined because of its adverse effects.
CYP2D6 polymorphism poor metabolite phenotype my lead to more toxic pathway.

Front 35

Phenytoin

Back 35

Phenytoin sodium (/fəˈnɪtoʊɨn/) is a commonly used antiepileptic. Phenytoin acts to suppress the abnormal brain activity seen in seizure
CYP2C9 oxidize this drug

Front 36

Sulfonylurea

Back 36

Sulfonylurea (UK: sulphonylurea) derivatives are a class of antidiabetic drugs that are used in the management of diabetes mellitus type 2. They act by increasing insulin release from the beta cells in the pancreas.
CYP2C9 oxidize this drug

Front 37

Warfarin

Back 37

Warfarin (also known under the brand names Coumadin) is an anticoagulant normally used in the prevention of thrombosis and thromboembolism, the formation of blood clots in the blood vessels and their migration elsewhere in the body respectively.
CYP2C9 oxidize this drug

Front 38

albuterol

Back 38

Salbutamol (INN) or albuterol (USAN) is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease.
Polymorphisms in beta-2adrenergic receptor gene (ADRB2) affect response to bronchodilators such as albuterol and isoproterenol

Front 39

Dopa pathway

Back 39

Ach pathway

Front 40

PNS neuro transmitter

Back 40

table

Front 41

Dopa

Back 41

L-DOPA is the precursor to the neurotransmitters dopamine, norepinephrine (noradrenaline), and epinephrine (adrenaline) collectively known as catecholamines. As a drug it is used in the clinical treatment of Parkinson's disease and dopamine-responsive dystonia.

Front 42

epinephrine vs amphetamine

Back 42

amphetamine is a psychostimulant drug of the phenethylamine class that produces increased wakefulness and focus in association with decreased fatigue and appetite.

Epinephrine (also known as adrenaline or adrenalin) is a hormone and a neurotransmitter. Epinephrine has many functions in the body, regulating heart rate, blood vessel and air passage diameters, and metabolic shifts; epinephrine release is a crucial component of the fight-or-flight response of the sympathetic nervous system

Front 43

adrenergic agonists vs receptor selectivity

phenylephrine
norepinephine

epinephrine
ephedrine
pseudoephedrine
dopamine
[amphetamine]
[methamphetamine]
[Methyphenidate]

Isoproterenol
Albuterol

Back 43

-Phenylephrine is a selective α1-adrenergic receptor agonist used primarily as a decongestant, as an agent to dilate the pupil, and to increase blood pressure
-Ephedrine is a sympathomimetic amine commonly used as a stimulant, appetite suppressant, concentration aid, decongestant, and to treat hypotension associated with anaesthesia.
-Pseudoephedrine is a sympathomimetic drug . It may be used as a nasal/sinus decongestant, as a stimulant, or as a wakefulness-promoting agent.
-Amphetamine is a psychostimulant drug that produces increased wakefulness and focus in association with decreased fatigue and appetite.
-Methamphetamine in treating ADHD and exogenous obesity (obesity originating from factors outside of the patient's control) in both adults and children.
-Methylphenidate is a psychostimulant drug approved for treatment of ADHD or attention-deficit hyperactivity disorder.
-Isoprenaline or isoproterenol is a medication used for the treatment of bradycardia (slow heart rate), heart block, and rarely for asthma. It is a non-selective beta-adrenergic agonist and structurally similar to adrenaline.
-albuterol is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease

Front 44

effect of alpha/beta receptor adrenergic drug on
-cardiovascular system (PVR, CO,BP)
-Eye (Radial, ciliary)
-GI
-Bladder
-Urinary sphincter
-Bronchioles

Back 44

Front 45

adrenergic antagonist drugs
-Phentoloamine
-Tamsulosis

-Propran-olol

Back 45

Phentolamine is a reversible nonselective alpha-adrenergic antagonist.The primary application for phentolamine is for the control of hypertensive emergencies, most notably due to pheochromocytoma

Tamsulosin (pron.: /tæmˈsuːlɵsɨn/ or /tæmsʉˈloʊsɨn/) is a treatment for difficult urination, a common symptom of enlarged prostate.

Propranolol is a sympatholytic non-selective beta blocker. Sympatholytics are used to treat hypertension(beta 1), anxiety and panic. It was the first successful beta blocker developed.

Front 46

Other adrenergic drugs:
-Dopa drugs
Carbidopa
Levodopa (L-Dopa)

-Reuptake blockers
antidepressants
Cocaine

-MAO inhibitors

Back 46

Carbidopa (Lodosyn) is a drug given to people with Parkinson's disease in order to inhibit peripheral metabolism of levodopa. This property is significant in that it allows a greater proportion of peripheral levodopa to cross the blood brain barrier for central nervous system effect.

Front 47

Bethanechol

Back 47

1. Choline Esters
2. Bethanechol is a parasympathomimetic choline carbamate that selectively stimulates muscarinic receptors without any effect on nicotinic receptors. Unlike acetylcholine, bethanechol is not hydrolyzed by cholinesterase and will therefore have a long duration of action.
3. Bethanechol is sometimes given orally or subcutaneously to treat urinary retention resulting from general anesthetic or diabetic neuropathy of the bladder, or to treat gastrointestinal atony (lack of muscular tone). The muscarinic receptors in the bladder and gastrointestinal tract stimulate contraction of the bladder and expulsion of urine, and increased gastrointestinal motility, respectively

Front 48

what type of drugs are these? use?
a.Muscarine
b.Pilocarpine
c.Arecoline

Back 48

1. cholinergic alkaloids.
a. nature produce from mushroom, can not be hydrolyzed by AChE
b.Pilocarpine is a parasympathomimetic alkaloid. It is a non-selective muscarinic receptor agonist in the parasympathetic nervous system, which acts therapeutically at the muscarinic acetylcholine receptor M3 due to its topical application, e.g., in glaucoma and xerostomia.
c. Arecoline is a natural product, an alkaloid found in Betel nut [like chewing cigarette]

Front 49

what type of these inhibitor are these:
1. Edrophonium
2. Donepezil
3. Physostigmine
4. Malathion and nerve gases[VX, Sarin]

Back 49

They are Cholinesterase Inhibitors
1.Short-acting competitive inhibitor [Edrophonium mainly for diagnostic purpose]
2.Noncompetitive inhibitors
Donepezil used in the palliative treatment of mild to moderate Alzheimer's disease. Common side effects include gastrointestinal upset. It has an oral bioavailability of 100% and easily crosses the blood–brain barrier. Because it has a half-life of about 70 hours, it can be taken once a day.
3. Carbamates (intermediate duration)
Physostigmine is used to treat myasthenia gravis, glaucoma, Alzheimer's disease and delayed gastric emptying. It has been shown to improve short term memory (CNS activity). Because it is a tertiary amine (and thus does not hydrogen bond, making it more hydrophobic), it can cross the blood–brain barrier, and physostigmine salicylate is used to treat the central nervous system effects of atropine, scopolamine and other anticholinergic drug overdoses.
4. Organophosphates (long duration – irreversible)
Malathion binds irreversibly to cholinesterase. Malathion is an insecticide of relatively low human toxicity

Front 50

Pralidoxime (2-PA)

Back 50

Cholinesterase reactivator!!
“Rips” the organophospate inhibitor off the ChE enzyme
Most effective within hours of exposure to ChE inhibitor. Before the substrate-enzyme bond stabilize itself.
It is used to combat poisoning by organophosphates or acetylcholinesterase inhibitors (nerve agents) in conjunction with atropine and diazepam.

Front 51

Scopolamine

Back 51

Scopolamine, also known as levo-duboisine and hyoscine, is a tropane alkaloid drug with muscarinic antagonist effects.
Its primary use is for the treatment of post-operative nausea and vomiting, sea-sickness, OTC sleeping pills,

Front 52

four psycho CNS stimulator, how do they work?

Back 52

1. amphetamine: get into brain and release dopamine to pleasure center
2. cocaine: blocking re-uptake of dopamine
3. nicotine: stimulator excitatory receptors. hippocampus improve function
4. Caffeine: Adenosine acts as an inhibitor neurotransmitter that suppresses activity in the central nervous system. Consumption of caffeine antagonizes adenosine and increases activity in neurotransmission including acetylcholine, epinephrine, dopamine, serotonin, glutamate, norepinephrine, cortisol,

Front 53

Tubocurarine

Back 53

Nondepolarizing Ach antagonists
no intial stimulatiion, competitive nondeporlarizing blockade only
ChE inhibitor reverses blockade

Tubocurarine is a skeletal muscle relaxant in the category of non-depolarizing neuromuscular-blocking drugs, used adjunctively in anesthesia to provide skeletal muscle relaxation during surgery or mechanical ventilation.

Front 54

Adrenergic Drugs summary

Green are agonists.
Red are antagonists.

Back 54

cholinergic drugs summary

Green are agonists.
Red are antagonists.

Front 55

Heparin [UFH-generic]

Back 55

antithrombin dependent anticoagulant that inhibit proteases, especially factors IIa and Xa
large molecule, nonspecific
must be given parenterally b/c not absorbed from GI
short half life and cleared by endothelial cells, reticuloendothelial cells which can get saturated thus non linear dose increase effect.

Front 56

Enoxaparin

Back 56

Enoxaparin is a low molecular weight heparin. It is an anticoagulant used to prevent and treat deep vein thrombosis or pulmonary embolism, and is given as a subcutaneous injection. Its use is evolving in acute coronary syndromes (ACS).
cleared primary by kidney.
Advantages vs Heparin: more predictable response; better bioavailability; longer half life; dose independent clearance; w/o lab monitoring; outpatient use possible.

Front 57

Fondaparinux

Back 57

Fondaparinux is an anticoagulant medication chemically related to low molecular weight heparins. It is a synthetic pentasaccharide Factor Xa inhibitor. primarily eliminated by the kidney and require antithrombin like heparin

Front 58

Protamine

Back 58

Protamine sulfate is an antidote for heparin overdose. A chain shortened version of protamine also acts as a potent heparin antagonist. It has positive charge that can attract negative charged UFH.

Front 59

Argatroban

Back 59

Argatroban is an anticoagulant that is a small molecule direct thrombin inhibitor.Do not require antithrombin. inhibit free and clot-bound thrombin.
Indication: pts with HIT or risk of HIT under percutaneous coronary intervention.
No antidote!

Front 60

Desirudin

Back 60

recombinant derivative of the irreversible thrombin inhibitor hirudin.
indication: DVT, PE
No antidote!

Front 61

Bivalirudin

Back 61

Synthetic 20 aa reversible thrombin inhibitors from hirudin
indication: used with aspirin and GPI with PCI/ PTCA
No antidote!

Front 62

Warfarin

Back 62

Vitamin K antagonist. block Vitamin K oxide reductase. non irreversible Vit K competetive inhibitor. slow onset and slow elimination
Warfarin (also known under the brand names Coumadin) is an anticoagulant normally used in the prevention of thrombosis and thromboembolism.
Dose requrie adjust b/c diet, liver disease and medication.
Warfarin crosses placenta, so do not give warfarin to pregnant wemon, especiall 1st trimesters.

Front 63

Dabigatran Etexilate

Back 63

Dabigatran is an oral anticoagulant from the class of the direct thrombin inhibitors, no antidote.
prevent clot forming and prevent already formed clot getting bigger, but can not chew up already formed drug.
no food restriction.

Front 64

Rivaroxaban

Back 64

Rivaroxaban is an oral anticoagulant . reversible factor Xa inhibitor.

Front 65

Alteplase

Back 65

recumbinant tissue plasminogen activator (tPA)
less likely to produce lytic state like Streptokinase do.
primarily used to treat acute MI (PCI is better) and acute ischemic stroke.

Front 66

Aspirin

Back 66

Front 67

Clopidogrel
prasugrel
ticagrelor

Back 67

ADP pathway inhibitors
Indication: heart attack and stroke.

Front 68

Abciximab

Back 68

GP2b/3a antagonists

Front 69

Dipyridamole

Back 69

PDE/Adenosine inhibitor
Dipyridamole inhibits the phosphodiesterase enzymes that normally break down cAMP (increasing cellular cAMP levels and blocking the platelet response to ADP).
Dipyridamole inhibits the cellular reuptake of adenosine into platelets, red blood cells and endothelial cells leading to increased extracellular concentrations of adenosine.
both mechanism increase platelet cAMP, which inhibits aggregation and produces vasodilation.

Front 70

phytonadione

Back 70

vitamine K1

Front 71

de-fero-xamine

Back 71

It has medical applications as a chelating agent used to remove excess iron from the body

Front 72

De-fera-sirox

Back 72

oral chelating agen used for chronic iron overload

Front 73

vitamine B12

Back 73

Cyanocobalamin

Front 74

Erythropoietin (EPO)
-func
-preparation

Back 74

-Erythropoietic GF
-Epoetin Alfa and Darbepoetin[is a synthetic form of erythropoietin. It stimulates erythropoiesis (increases red blood cell levels) and is used to treat anemia]

Front 75

GMCSF(granulocyte/macrophage colony stimulating factor)
fuc
preparations

Back 75

-stimulates proliferation , differentiation and function of neutrophils , monocytes and eosinophils
-Sargramostim:a recombinant granulocyte macrophage colony-stimulating factor (GM-CSF) that functions as an immunostimulator

Front 76

GCSF (granulocyte colony stimulating factor)
-Func
-preparations

Back 76

-stimulate neutrophiles proliferation and differentiation only
-filgrastim and pegfilgrastim[ a PEGylated form of the recombinant human GCSF analog filgrastim. It serves to stimulate the level of white blood cells (neutrophils)]

Front 77

Interleukin 11
-fun
-preparations

Back 77

-stimulate proliferation of platelets
-oprelvekin [is recombinant interleukin eleven (IL-11), a thrombopoietic growth factor that directly stimulates the proliferation of hematopoietic stem cells and megakaryocyte progenitor cells and induces megakaryocyte maturation resulting in increased platelet production.]