Thomas First Aid Heme/onc Pharm

Front 1

Heparin vs warfarin, which does not cross placenta?

Back 1

Heparin is safe to use in pregnancy

Front 2

enoxaparin

Back 2

low molecular weight heparin, acts on Xa to inactivate

Front 3

2 advantages of low molecular weight heparin over normal heparin, 1 disadvantage

Back 3

advantages = delivered subcutaneously, do not need to be followed by laboratory monitoring
disadvanage - not as easily reversible

Front 4

what is mechanism of Heparin-Induced Thrombocytopenia?

Back 4

Heparin binds to platelet factor IV, ab to this complex and causes activation, clearance, leading to both thrombocytopenia and hypercoagulable state

Front 5

what anticoagulant can cause osteoporosis?

Back 5

heparin

Front 6

Lepirudin

Back 6

directly inhibits thrombin, alternative to heparin (for patients with HIT)

Front 7

Bivalirudin

Back 7

directly inhibits thrombin, alternative to heparin (for patients with HIT)

Front 8

warfarin:
metabolized by?
for rapid overdose, give?

Back 8

metabolized by cytochrome p-450 (can have drug-drug interactions)
rapid overdose tx - fresh frozen plasma. for less rapid treatment, use vitamin K

Front 9

heparin action

Back 9

activates antithrombin which decreases activity of factors IIa and Xa

Front 10

site of action of heparin, warfarin?
speed of onset?
duration of onset?

Back 10

heparin - blood, onset in seconds, lasts hours
warfarin - liver, onset slow (because limited by half lives of clotting factors) duration of days

Front 11

streptokinase

Back 11

thrombolytic (activates plasmin)
antidote is aminocaproic acid

Front 12

urokinase

Back 12

thrombolytic (activates plasmin)
antidote is aminocaproic acid

Front 13

alteplase

Back 13

tPA, activates plasmin
antidote is aminocaproic acid

Front 14

APSAC (anistreplase)

Back 14

thrombolytic (activates plasmin)
antidote is aminocaproic acid

Front 15

aspirin effects on: BT,pT, pTT

Back 15

increases Bleeding time only (inhibits formation of thromboxane a2 which aggregates platelets

Front 16

thrombolytics increase what?
BT, pT, pTT?

Back 16

pT and pTT

Front 17

5 toxicities of aspirin

Back 17

bleeding, GI ulcers, Reye's syndrome, tinnitus, hyperventilation

Front 18

ticlopidine and clopidogrel mech

Back 18

block ADP receptors,inhibit expression of gpIIb/IIIa on platelets so fibrinogen can't bind them together.

Front 19

ticlopidine toxicity

Back 19

neutropenia

Front 20

abciximab mech, toxicity (2)

Back 20

ab to gpIIb/IIIa

toxicities- bleeding, thrombocytopenia

Front 21

2 cancer drug classes that inhibit mitosis

Back 21

toxols (paclitoxol), vinca alkaloids (vincristine, vinblastine)

Front 22

Bleomycin blocks what part of cell cycle

Back 22

G2

Front 23

Etoposide blocks what part(s) of cell cycle

Back 23

S and G2

Front 24

Methotrexate:
analog of what, mechanism
inhibits what two cellular processes?

Back 24

folic acid analog
inhibits dihydrofolate reductase
inhibits both DNA and protein synthesis

Front 25

methotrexate toxicities (4)

Back 25

myelosuppression (reversible with leucovorin)
macrovesicular fatty liver change
mucositis
teratogen

Front 26

5-FU mechanism, 2 toxicities, overdose tx

Back 26

pyrimidine analog, inhibits thymidylate synthase (inhibits both DNA and protein synthesis)
toxicities - myelosupression and photosensitivity
overdose - thimidine

5-Fuck U sun! (photosensitivity)

Front 27

6-MP mech, 3 toxicities, toxicities worse with what drug?

Back 27

purine analog that decreases purine synthesis (like 6 thioguanine)
toxicities- bone marrow suppression, GI, liver toxicity. worsened with allopurinol (because metabolized by xanthine oxidase)

Front 28

HGPRTase needed to activate what antimetabolites?

Back 28

6-MP and 6-TG

Front 29

6-thioguanine mech, 2 toxicities

Back 29

same as 6-MP, purine analog that decreases purine synthesis
toxicity - bone marrow suppression, liver toxicity

Front 30

what drug cannot be used with allopurinol, what drug with same mechanism can?

Back 30

6-MP cannot be used with allopurinol, but 6-thioguanine can

Front 31

cytarabine mech, 3 toxicities

Back 31

pyrimidine antagonist, inhibits DNA polymerase
toxicities - neutropenia, thrombocytopenia, megaloblastic anemia

"Don't want ARABs inCYTing (thrombocytopenia hysteria by making NEUTROn bombs BLAST

Front 32

what antitumor drugs (3) intercalates DNA

Back 32

Dactinomycin (Actinomycin D), Doxyrubicin (Adriamycin), Daunarubicin (doxyrubicin and daurnarubicin also generate free radicals)

Front 33

Dactinomycin (Actinomycin D) mech, toxicity, use for what tumors

Back 33

intercalates DNA, myelosuppression
Kid tumors (children ACT out)

Front 34

bleomycin mech

Back 34

generates free radicals that cause DNA strand breaks

Front 35

Etoposide mech, 3 toxicities

Back 35

inhibits topoisomerase II (which causes DNA degredation)

toxicities (myelosuppression, GI irritation, alopecia)

Front 36

Draw cancer toxicity person!

Back 36

really!

Front 37

what drug rxn can be partially relieved by mensa

Back 37

hemorrhagic cystitis from cyclophosphamide and ifosfamide

Front 38

Busulfan mech, 2 toxicities

Back 38

alkylates DNA
pulmonary fibrosis and hyperpigmentation

If JFK hadn't had addison's, hed have been using busulfan

Front 39

Vinblastine mech, toxicity

Back 39

alkaloid that inhibits microtubule formation

bone marrow suppression (vinblastine BLASTS bone marow)

Front 40

what cancer drug can cause paralytic ileus?

Back 40

vincristine (along with peripheral neuropathy)

Front 41

Vincristine mech

Back 41

alkaloid, inhibits microtubule polymerization

Front 42

paclitaxol mech, 2 toxicities

Back 42

microtubules can't depolymerize
toxicity- myelosupression, hypersensitivity

PAC man was hypersensitive to ghosts touching him

Front 43

2 drugs that cross-link DNA

Back 43

cisplatin
carboplatin

Front 44

cisplatin mech, 2 toxicities

Back 44

crosslinks DNA

toxicities - nephrotoxicity, acoustic nerve damage (think cancer drawing)

Front 45

carboplatin mech, 2 toxicities

Back 45

crosslinks DNA

toxicities - nephrotoxicity, acoustin nerve damage

Front 46

cancer drug that inhibits ribonucleotide reductase?
2 toxicities

Back 46

hydroxyurea

toxicities - myelosupression, GI upset

Front 47

how does prednisone work in cancer?
9 toxicities

Back 47

induces apoptosis, may even work on non dividing cells

osteoporosis
cushing's
cataracts
immunosupression
acne
HTN
peptic ulcers
hyperglycemia
psychosis

Front 48

tamoxifen and raloxifene
different action where?
agonist where?
antagonist where?

Back 48

raloxifene antagonist to ER in endometrium, tamoxifen is agonist
both antagonize ER in breast,
agonist in bone (used for osteoporosis)

Front 49

Erb-B2 ab drug?
toxicity?

Back 49

Herceptin (anti HER-2)

toxicity- cadriotoxicity

Front 50

2 indications for imatinib, toxicity

Back 50

CML, GIST tumors

toxicity- fluid edema

Front 51

streptazocin class

Back 51

nitrosourea

alkylate DNA

Front 52

carmustine, lomustine, semustine (-mustine)

Back 52

nitrosoureas

alkylate DNA