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42 Cards in this Set

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Antianemic or hemopoietic drugs
Mechanism of action

replace missing factors for blood formation

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

necessary component of hemoglobin
vitamin b12
macrocytic

coenzyme for synthesis of DNA and other cell component
folic acid
also a B vitamin

macrocytic

needed for A.A. and DNA synthesis
treat anemias
What are the therapeutic uses for Antianemic or hemopoietic drugs?
Antianemic or hemopoietic drugs
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.
Antianemic or hemopoietic drugs
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
iron
Hepatitis
Antianemic or hemopoietic drugs
____: 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.
folic acid
nerve
Antianemic or hemopoietic drugs
_____ ____ 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.
Thrombopoietin
a megakaryocyte stimulating factor - not yet in clinical trials.
Hemostatic
Anticoagulants
Thrombolytics
What are the drugs that affect blood coagulation?
Hemostatics
hasten (stop) blood cloting
Hemostatics
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
Anticoagulants
retards (stops) blood clotting
Anticoagulants
Mechanism of action

heparin
coumarin derivatives
aspirin
NSAIDs (ibuprofen)
heparin
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.
coumarin derivatives
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)
aspirin
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.
NSAIDs
Ibuprofen

minor anticogulant and not as long lasting as aspirin. Is 99% plasma protein bound.
Anticoagulants
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
venous thrombosis
clots in veins
thrombus
stays in place
embolus
travels through circulation
hemorrhage
What are the side or toxic effects of anticoagulants?
Cautions or contraindications for anticoagulants
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
True
Any drug that binds to plasma proteins. Interaction often occur.

True or false?
Fibrinolytic
What is another word for Thrombolytic?
Thrombolytic drugs
recombinant tissue plasminogen activator (rTPA) often called TPA.

These drugs dissolve clots that have already formed.
Thrombolytic
__________ agents cause plasminogen to convert to plasmin, dissolving the clots and inhibiting further clot formation.
Thrombolytic drugs
therapeutic uses

Acute pulmonary embolism
Coronary thrombosis
Some strokes
Deep venous thrombosis
Arterial clots
Thrombolytic drugs
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.
Thrombolytic drugs
General cautions:

1. dangerous bleeding tendencies may result
2. Anaphylactic reaction are possible.
Antilipemic agents
supposed to decrease blood levels of lipids such as cholesterol
False

not guarenteed to reverse
True or false?

Antilipemic agents ARE guarenteed to reverse atherosclerosis once begun in most people.
Fibroic Acid derivatives
Niacin
Bile sequestrant
Statins
What are the names of the different types of antipelmic agents?
Niacin
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.
Bile sequestrant
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
Statins
Inhibits enzyme for cholesterol production.

Adverse effect uncommon but may be severe: early cataract formation, abnormal liver function tests
myalgia
rhabomyolysis
Policosanol
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.
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.
What is the problem with Antilipemic agents?
drug indicates that FATAL MYOCARDIAL INFARCTION are not decreased. Other fatalities increase also.
Why are Antilipemic agents so controversial?
dietary and lifestyle changes
What should a person do for 6 months before considering antilipemic drug therapy?