Study your flashcards anywhere!

Download the official Cram app for free >

  • Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off
Reading...
Front

How to study your flashcards.

Right/Left arrow keys: Navigate between flashcards.right arrow keyleft arrow key

Up/Down arrow keys: Flip the card between the front and back.down keyup key

H key: Show hint (3rd side).h key

A key: Read text to speech.a key

image

Play button

image

Play button

image

Progress

1/74

Click to flip

74 Cards in this Set

  • Front
  • Back
What are the advantages of using streptokinase over other plasminogen activators? (2)
1) Systemic activation

2) relatively inexpensive
Why might a person use a recombinant human tissue plasminogen activator over streptokinase, which is cheaper? (2 reasons)
1) The human versions seem to be more specific for fibrin in clots.

2) The bacterial forms, being foreign protein elicit antibody responses.
What is modified streptokinase called? How is it modified?
Anistreplase -> has an anisoyl moiety
What are the advantages of anistreplase over streptokinin? (3)
1) More specific for fibrin in clots.

2) Slower activation.

3) Longer half-life
What is the -suffix of recombinant human tissue-type plasminogen activator?
-teplase
What are the two names of recombinant human tissue-type plasminogen activator? (2)
1) Tenecteplase

2) Alteplase

Muslim and Hebrew: ALlah and TNK
Which human tissue plasminogen activator has a longer half-life?
Tenecteplase.

(The Hebrew religion has been around much longer than Islam.)
Which human tissue plasminogen activator is more expensive?
Al-teplase

(Um, I once heard a rumor of a stereotype that Hebrews were , um, cheap. I may have made that up though. Thus, TNK-teplase is cheaper.)

(PS, I love Hebrews. I am not anti-Semitic. I just remembered which one was cheaper this way. It works. Just go with it.)
What is the antidote for plasminogen poisoning?
Aminocaproic acid
How does the antidote for plasminogen poisoning work?
Competitively inhibits binding of plasminogen and plasmin and fibrin.
How does aminocaproic acid work?
Competitively inhibits binding of plasminogen and plasmin and fibrin.
How does heparin work?
Activation of endogenous ATIII?
Heparin-ATIII inhibits which molecules in the clotting cascade?
10a and 2a
Lovenox-ATIII inhibits which molecules in the clotting cascade?
10a >>>>> 2a
Fondaparinux inhibits which molecules in the clotting cascade?
10a
Why is fondaparinux preferable to enoxaparin?
1) more effective in preventing post-operative DVTs

2) does not bind platelet factor 4 -> lower risk of HIT
What is the generic name of Lovenox?
Enoxaparin
What is the suffix of the low molecular weight heparins?
-parin
Name the three LMWH's.
Enoxa-parin
Dalte-parin
Arde-parin
What are the major advantages of using LMWH instead of heparin?
1) Better bioavailability
2) Longer duration of action
3) more predictable -> less risk of major bleeding -> NO ROUTINE LAB MONITORING
What is the name of synthetic heparin?
fondaparinux
What is fondaparinux?
synthetic heparin.
What is enoxaparin?
a LMWH
What is dalteparin?
a LMWH
What is ardeparin?
a LMWH
What is bivalirudin?
A direct thrombin (IIa) inhibitor, derived from hirudin of leeches).
What is argatroban?
Argatroban is a small molecule inhibitor of thrombin (IIa). It is less immunogenic than bivalirudin.
What are the classes of antiplatelet drugs?
1) Block synthesis of intermediary factors

2) Block effects of those mediators

3) Block fibrinogen from interacting with platelets, thus preventing aggregation
Name an example of a class 1 anti-platelet drug.
Aspirin
Name an example of a class 2 anti-platelet drug.
Plavix (Clopidogrel)
Name an example of a class 3 anti-platelet drug.
Reo Pro (Abciximab)
What is the generic name of plavix?
clopidogrel
What is the generic name of Reo Pro?
Abciximab
What does abciximab do?
Inhibits platelet interactions with fibrin via GIIb/IIIa inhibition.
What does clopidogrel do?
Inhibits ADP actions on platelets by blocking GpIIb/IIIa receptors.
There are 2 thrombin (IIa) inhibitors. Which is metabolized by the kidney and which is metabolized by the liver?
Bivalirudin -> kidney metabolism.

Argatroban -> liver metabolism
What are the major potential adverse events when taking a statin?
1) rhabdomyolysis
2) liver dysfunction
A patient with familial hypercholesterolemia seeks treatment. What drugs are best?
1) Cholestyramine
2) Ezetimibe (Zetia)
Why isn't ezetimibe used more often?
Only half of patients can tolerate its side effects: HA and diarrhea.
How does cholestyramine work?
Binds bile acids -> bile acid secretion rather than absorption -> hepatocytes make more bile acids -> hepatocytes upregulate LDL to receive more cholesterol from the blood stream
What are the major side effects of cholestyramine? (2)
1) Decreased absorption of fat-soluble vitamins

2) GI side effects: diarrhea/constipation, bloating
What SYSTEMIC side effects does cholestyramine have?
None, all its side effects pertain to the gut
How effective is atorvastatin in lowering LDL?
Lowers LDL by 25-55% (~1/4 to 1/2)
How effective is cholestyramine in lowering LDL?
Lowers LDL by 10-33% (~1/10 to 1/3)
How effective is ezetimibe in lowering LDL?
Lowers LDL by 17%
Which cholesterol-lowering drug is notorious for taking a very long time to work?
cholestyramine
Which cholesterol-lowering drug is notorious for being poorly adhered to because of its side effects?
ezetimibe (Zetia) -> 50% quit due to HA or diarrhea
How does niacin reduce triglyceride levels (4)?
Lowers VLDL by 4 mechanisms

1) Decreases triglyceride synthesis

2) Decreases VLDL production

3) Increases lipoprotein lipase -> increases VLDL destruction

4) Increases HDL
What two drugs bind to PPAR-alpha?
1) Gemfibrozil

2) Omacor (Omega-3-FA's)
What is the trade name of omega-3-fatty acids, when used to lower triglycerides?
Omacor
Binding of PPAR-alpha has what effects on VLDL and triglycerides? (3)
PPAR-alpha activation ->

1) Decreased expression of apoC-III

2) Decreases VLDL production

3) Increases lipoprotein lipase -> increases VLDL destruction
What effects does gemfibrozil have on VLDL and triglycerides? (3)
PPAR-alpha activation ->

1) Decreased expression of apoC-III

2) Decreases VLDL production

3) Increases lipoprotein lipase -> increases VLDL destruction
What effects does Omacor have on VLDL and triglycerides? (3)
1) Decreased expression of apoC-III

2) Decreases VLDL production

3) Increases lipoprotein lipase -> increases VLDL destruction
What drug lowers ApoC-III?
Gemfibrozil
What does ApoC-III do?
ApoC-III inhibits lipoprotein lipase -> increases VLDL levels
What are the side effects of gemfibrozil? (4)
1) myositis, especially when combined with statins

2) gallstones

3) rashes (dermatomyositis?)

4) GI upset
What drug is the most effective at lowering triglyceride levels?
Gemfibrozil (lopid)
What are the side effects of niacin? (2)
1) Intense flushing

2) GI upset
What are the 3 main side effects of cimetidine?
1) Antiandrogenic effect -> gynecomastia
2) Reduces hepatic blood flow
3) Inhibits CYP50

* - It also has a special proclivity for inducing rebound acid secretion.
What GI drugs can't be combined with antacids? Why?
Acid blockers -> Prodrugs require highly acidic env't to be converted to active form
Do the H2-blockers differ in potency?
yes, but not in efficacy.
Do the H2-blockers differ in efficacy?
no, only in potency
Aluminum-containing antacids can cause what serious side effect?
Phosphate depletion -> bone/teeth abnormalities
What is the biochemical nature of sucralfate?
Sucralfate is an aluminum salt of sucrose sulfate.
Which drug is an aluminum salt of sucrose sulfate?
sucralfate
How does sucralfate work? (2)
1) Binds damaged tissue -> protects it from PEPSIN and BILE SALTS

2) Inhibits growth of H. pylori
Which non-antibiotic drug inhibits the growth of H. pylori?
Sucralfate
Which anti-diarrheal opioid crosses the BBB, so it must be combined with atropine to minimize abuse?
Diphenoxylate

Lomotil=diphenoxylate+atropine
What is diphenoxylate?
An anti-diarrheal opioid that crosses the BBB, so it must be combined with atropine to minimize abuse.
Name the three gel-forming absorbants.
Aluminum silicate

Pectin

Kaolin
What do the gel-forming absorbants do?
Increase the viscosity of stool -> Blocks both diarrhea and constipation.
What does aluminum silicate do?
Increases the viscosity of stool -> Blocks both diarrhea and constipation.
What does kaolin do?
Increases the viscosity of stool -> Blocks both diarrhea and constipation.
What does pectate do?
Increases the viscosity of stool -> Blocks both diarrhea and constipation.