Pharm Unit 5-9

Front 1

Antianemic or hemopoietic drugs

Back 1

Mechanism of action

replace missing factors for blood formation

iron
vit. b12
folic acid
red blood cells, whole blood
erythropoietin

Front 2

iron

Back 2

microcytic

necessary component of hemoglobin

Front 3

vitamin b12

Back 3

macrocytic

coenzyme for synthesis of DNA and other cell component

Front 4

folic acid

Back 4

also a B vitamin

macrocytic

needed for A.A. and DNA synthesis

Front 5

treat anemias

Back 5

What are the therapeutic uses for Antianemic or hemopoietic drugs?

Front 6

Antianemic or hemopoietic drugs

Back 6

side or toxic effects

chiefly with iron

headache and GI symptoms

GI- loss of apetite, gastric pain, nausea, vomiting, constipation or diarrhea

some overdoses in children have caused death.

Front 7

Antianemic or hemopoietic drugs

Back 7

Caution:

iron: may injure or stain teeth. Human blood and components may cause Hepatitis or transfusion reactions. (Washing RBCs minimizes reaction but does not eliminate risk of hepatitis or AIDS.)

folic acid use in undiagnosed anemias. If anemia due to B12 deficiency, folic acid relieves anemia but allows nerve damage to progress. Folic acid content is limited in nonprescription medicines

Front 8

iron
Hepatitis
Antianemic or hemopoietic drugs

Back 8

____: may injure or stain teeth. Human blood and components may cause _________ or transfusion reactions. (Washing RBCs minimizes reaction but does not eliminate risk of hepatitis or AIDS.)

Name the drug.

Front 9

folic acid
nerve
Antianemic or hemopoietic drugs

Back 9

_____ ____ use in undiagnosed anemias. If anemia due to B12 deficiency, folic acid relieves anemia but allows _______ damage to progress. Folic acid content is limited in nonprescription medicines

Name the drug.

Front 10

Thrombopoietin

Back 10

a megakaryocyte stimulating factor - not yet in clinical trials.

Front 11

Hemostatic
Anticoagulants
Thrombolytics

Back 11

What are the drugs that affect blood coagulation?

Front 12

Hemostatics

Back 12

hasten (stop) blood cloting

Front 13

Hemostatics

Back 13

Mechanism of action

1. mechanical coagulants (for use during surgery) i.e. gelfoam or oxidized cellulose - cause platelets to disintegrate

2. actual clotting factors - i.e. thrombin (topical application) or platelets (transfusions)

3. Vitamin K - essential to prothrombin synthesis by liver

Front 14

Anticoagulants

Back 14

retards (stops) blood clotting

Front 15

Anticoagulants

Back 15

Mechanism of action

heparin
coumarin derivatives
aspirin
NSAIDs (ibuprofen)

Front 16

heparin

Back 16

must be administered parenterally (too large to be absorbed) interferes with conversion of prothrombin to thrombin and fibrinogen to fibrin. Sometimes given in anaphylaxis - helps prevents mast cell granulation.

Has antidote so _________ can be used for sudden arterial occlusion and yet can be blocked if surgery becomes necessary. Also, ________ too large to cross placental barrier or to get to mother milk.

Front 17

coumarin derivatives

Back 17

may be used orally (will cross GI membranes; also placenta) seem to interfere with vitamin K, i.e. therfore, prevent formation of prothrobin in liver. If bleeding occurs, use vitamin K as antidote. 99% protein plasma bound. hepatic metabolism (P450)

Front 18

aspirin

Back 18

one per two days decreases platelet aggregation. Also used to treat coronary thrombosis. Discontinue 7 days before elective surgery. Long lasting anticoagulant effect because new platelets must be made.

Front 19

NSAIDs

Back 19

Ibuprofen

minor anticogulant and not as long lasting as aspirin. Is 99% plasma protein bound.

Front 20

Anticoagulants

Back 20

Therapeutic uses

1. venous thrombosis - clots in veins
thrombus-stays in place
embolus- travels through circulation

preventative if circulation sluggish, i.e. bed rest, myocardial infarction

2. prevention coronary thrombosis - especially if athersclerosis present

3. atrial fibrillation or valve disease where blood not emptied from heart

Front 21

venous thrombosis

Back 21

clots in veins

Front 22

thrombus

Back 22

stays in place

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embolus

Back 23

travels through circulation

Front 24

hemorrhage

Back 24

What are the side or toxic effects of anticoagulants?

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Cautions or contraindications for anticoagulants

Back 25

1. patients with bleeding tendencies
2. ulcers or carcinomas of GI tract
3. Pregnancy - risk of abortion
4. severe liver or kidney disease
5. Avoid IM injections -- muscle too vascular and may cause hemotoma
6. drug interaction can be very serous

Front 26

True

Back 26

Any drug that binds to plasma proteins. Interaction often occur.

True or false?

Front 27

Fibrinolytic

Back 27

What is another word for Thrombolytic?

Front 28

Thrombolytic drugs

Back 28

recombinant tissue plasminogen activator (rTPA) often called TPA.

These drugs dissolve clots that have already formed.

Front 29

Thrombolytic

Back 29

__________ agents cause plasminogen to convert to plasmin, dissolving the clots and inhibiting further clot formation.

Front 30

Thrombolytic drugs

Back 30

therapeutic uses

Acute pulmonary embolism
Coronary thrombosis
Some strokes
Deep venous thrombosis
Arterial clots

Front 31

Thrombolytic drugs

Back 31

Contraindications:

Any patient with active bleeding tendencies, or cerebrovascular accident over approx. 2 hours old, or tumor.

Extreme caution for any patient with surgery or childbirth in the last few months.

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Thrombolytic drugs

Back 32

General cautions:

1. dangerous bleeding tendencies may result
2. Anaphylactic reaction are possible.

Front 33

Antilipemic agents

Back 33

supposed to decrease blood levels of lipids such as cholesterol

Front 34

False

not guarenteed to reverse

Back 34

True or false?

Antilipemic agents ARE guarenteed to reverse atherosclerosis once begun in most people.

Front 35

Fibroic Acid derivatives
Niacin
Bile sequestrant
Statins

Back 35

What are the names of the different types of antipelmic agents?

Front 36

Niacin

Back 36

Often used in combo to make positive changes in lipid profile. Common skin flushing may be minimized by taking aspirin 30 minutes prior to dose. Watch liver function tests. Watch for rare muscle pain if used in combo with statin.

Front 37

Bile sequestrant

Back 37

This binds cholesterol with bile acids in the intestine: cholestyramine. Effective cholesterol lowering treatment especially if combined with niacin or neomycin. However, side effects are SEVERE.

cardiac arrythmias
liver toxicity
nephrotoxcity
permenant nerve deafness

Front 38

Statins

Back 38

Inhibits enzyme for cholesterol production.

Adverse effect uncommon but may be severe: early cataract formation, abnormal liver function tests
myalgia
rhabomyolysis

Front 39

Policosanol

Back 39

A dietary supplement made from sugar cane wax composed of medium chain alcohols

Says that it is equally effective as statin, but didn't use the same amount statistics.

Front 40

When compared with control groups, drug indicates that FATAL MYOCARDIAL INFARCTION are not decreased. Other fatalities increase also. Unless serum cholesterol levels clearly indicate usage.

Back 40

What is the problem with Antilipemic agents?

Front 41

drug indicates that FATAL MYOCARDIAL INFARCTION are not decreased. Other fatalities increase also.

Back 41

Why are Antilipemic agents so controversial?

Front 42

dietary and lifestyle changes

Back 42

What should a person do for 6 months before considering antilipemic drug therapy?