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58 Cards in this Set
- Front
- Back
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adverse effects of iron
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gi, nv, stool discoloration
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cobalamin
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vit B12
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what is cobalamin made out of
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corrin (porphyrin-like) ringe structure with central co, cofactor with folic acid in DNA synthesis
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cobalamin produced by
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bacteria
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supply of cobalamin in liver normally
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5 yrs
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use b12 to generate what other thing (not main equations)
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tetrahydrofolate --> 5 methyltetrahydrofolate
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length of cobalamin treatment
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life long
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precauation of cobalamin
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hereditary optic nerve atrophy (leber)
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leucovorin
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5 methyl tetrahydrofolic acid used in cancer therapy to blunt adverse effects of methotrexate
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adverse reaction to folic acid
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irriatibility, overactividy, difficulty concentrating, depression in large doses
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treatment of EPO in patients with…
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chronic renal failure, bone marrow depression due to chemo, AIDS, bone marrow transplantation, cancer
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EPO formulated with
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albumin, citric acid, NaCl
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EPO adverse side effects
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headache, seizure, HTN, thrombotic events, edema, allergic reaction with flu-like symptoms (disappear 2-12 hrs)
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EPO precautions
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HTN, hamster/albumin hypersensitivity, immune (anaphlyatic reaction)
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G-CSF same as…
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filgrastim
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use of filgrastim
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reduce duration of neutrophenia and rate of infection in patients receiving myelosuppressive chemo
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filgastrim produced in…
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recombinant human G-CSF produced in E.coli
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filgrastim conjugated to what is pegfilgrastim
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polyethylene glycol
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mechanism of action of filgrastim
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acts on receptor kinase JAK/STAT in hematopoietic progenitor cells + mature neutrophils resulting in increase neutrophil including mature, bandend, and precurosr neutrophili w/out increasing number of basophils, monocotyes, eosinophils
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how to prolong 1/2 life of filgastim
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bind with polyethylene glycol to get pegfilgrastim to get 17+ hr half-life
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filgrastim side effect
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deep, throbbing medullary bone pain. Potential for anaphlyatic rxn
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what is romiplostom
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fusion protein that mimics TPO. C-MPL (TPO receptor) agonist, induces phosphorylation of tyrosine residues in TPO receptor
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romiplostim DOC
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ITP
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patients with high platelet counts on romiplostim
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associated with low serum concentrations
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romiplostim adverse effects
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insomnia, dizziness, pain (muscle, shoulder, abdominal, extremities)
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you get increased risk for bone marrow fibrosis is
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romiplostim
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drug of choice for DVT and PE
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enoxaparin
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drug of choic for pregnancy
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enoxaparin
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drug of choice for surgery to prevent clotting
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enoxaparin
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don't use fondaparinux in patients with
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renal insufficiency
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heparin-induced thrombocytopenia
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lepidurin, argatroban dabigatra, bivariludin
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prostacyclin binds to adenylate cyclase, activates cAMP
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inhibits granules release means no clot! (dipyramidole)
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more prostacyclin
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dipyarmidole - no clot!
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block production of thrombaxine
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aspirin
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expressed in platelet vs. endothelium
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Cox 1 vs Cox 1 + 2
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unstable angina, coronary bypass, angioplasty
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aspirin
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side effects of aspirin
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bleeding, rash, revs up warfarin
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adp inhibitors
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clopidogrel
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use of adp inhibitors
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clopidogrel
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side effects of clopidogrel
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thrombocytopenia, hemorrhage, bleeding
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inhibits cyp
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revs up warfarin. Clopidogrel.
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abciximab
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antibody against gp2b/3a
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epitifbatide
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normall platelet binds rgd domain. Competitive inhibitor to rgd domain
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gp Iib/IIIa
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used during surgery so don't throw clots, not long term
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know already have clots and want to break it down
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thrombolytic/fibrinolytics
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adverse events of thrombolytics
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cerebral hemohhrages - cause systemic fibrionlysis
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tpa converts plasminogen to plasmin. Tpa needs to bind to fibrin to be activated
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extensive fibrionlysis
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tpa
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reteplase alteplase
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fibronlytic agents
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alteplase
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recombinant. Only works with fibrin bound to clot
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someone comes in with stroke
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tpa. Alteplase.
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once clot there
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fibrionlytic
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anti-hemolytic
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give to someone bleeding. Risk factor: thrombosis
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aminocaproic acid
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inhibits plasminogen
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recombinant 7a
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hemophilics
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factor 8a
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tpo
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itp
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vit k
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combant warfarin
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