Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
114 Cards in this Set
- Front
- Back
|
heparin moa
|
activation of antithrombin
v thrombin & Xa |
|
|
heparin Rx
|
PE, stroke, acute coronary syndrome
MI, DVT can be used during pregnancy (does not cross placenta) |
|
|
heparin vs. warfarin monitoring & pathway
|
heparin: intrinsic; PTT
warfarin: extrinsic, PT/INR the EX-PresidentT went to WARfarin H is next to I alphabetically |
|
|
heparin s/e
|
Disgusting Horrible BO
drug-drug interactions HIT bleeding osteoporosis |
|
|
heparin antidote
|
protamine sulfate
positively charged, binds negatively charged heparin |
|
|
low-molecular-weight heparins
e.g. advantages/differences disadvantage |
enoxaparin
--act more on Xa --better bioavailability --2-4 times longer half-life --can give subQT --can coag monitoring *not easily reversible* |
|
|
HIT
|
heparin binds platelet factor IV
--> antibodies against heparin/PF IV --> they activate platelets --> hypercoagulability, thrombocytopenia |
|
|
heparin alternatives
|
lepirudin
bivalirudin |
|
|
lepirudin, bivalirudin
|
hirudin derivatives
inhibit thrombin alternative to heparin for pts. with HIT |
|
|
what drugs to use for anticoagulating pts. with HIT
|
lepirudin
bivalirudin |
|
|
warfarin moa
|
inhibits synthesis & gamma-carboxylation of
factors 2, 7, 9, 10, proteins C & S |
|
|
warfarin s/e
heparin s/e |
Both:
--bleeding --drug-drug interactions Warfarin: --teratogenic --skin/tissue necrosis Heparin: HIT osteoporosis |
|
|
warfarin o/d
|
vitamin K
rapid reversal: fresh frozen plasma |
|
|
heparin vs. warfarin structure
|
large anionic polymer
small, lipid-soluble |
|
|
thrombolytics
|
streptokinase
urokinase tPA (alteplase) APSAC (anistreplase) |
|
|
anistreplase =
|
streptokinase
plasminogen |
|
|
treat thrombolytic o/d with
|
aminocaproic acid
|
|
|
plasmin not only cleaves _ but also _
|
fibrin clots
thrombin |
|
|
thrombolytics effects on PT, PTT, PC
|
^ PT
^ PTT = PC |
|
|
aspirin moa
|
acetylates and irreversibly inhibits cyclooxygenase (both COX-1 and COX-2)
to prevent formation of thromboxane A2 |
|
|
aspirin effect on PT, etc.
|
= PT, PTT
^ bleeding time |
|
|
aspirin Rx
|
v fever, pain, platelets, inflammation
an FP is the PI |
|
|
aspirin s/e
|
gastric ulcers
bleeding hyperventilation Reye's syndrome tinnitus |
|
|
besides aspirin...
|
clopidogrel
ticlopidine |
|
|
clopidogrel, ticlopidine
moa |
inhibit platelet aggregation and fibrinogen binding
blocking ADP receptors, thereby preventing ADP-receptor-linked glycoprotein IIb/IIIa expression |
|
|
clopidogrel, ticlopidine Rx
|
acute coronary syndrome
coronary stenting v incidence or recurrence of thrombotic stroke |
|
|
ticlopidine s/e
|
neutropenia
|
|
|
abciximab moa
|
binds GpIIb/IIIa on activated platelets
--> prevents aggregation |
|
|
abciximab Rx
|
acute coronary syndromes
percutaneous transluminal coronary angioplasty |
|
|
abciximab s/e's
|
bleeding
thrombocytopenia |
|
|
cancer drugs--cell cycle
|
stage; what inhibits it
G1 S antimetabolites; etoposide G2 bleomycin; etoposide M vinca alkaloids; taxols |
|
|
antineoplastics:
____ inhibit nucleotide synthesis |
methotrexate, 5-FU
v thymidine 6-MP v purine |
|
|
antineoplastics:
____ inhibit DNA |
cross-link DNA
--alkylating agents --cisplatin intercalate DNA --dactinomycin --doxorubicin inhibit topoisomerase II --etoposide |
|
|
antineoplastics:
____ inhibit cellular division |
vinca alkaloids
--inhibit microtubule formation paclitaxel --inhibit microtubule disassembly |
|
|
methotrexate moa
|
folic acid analog
inhibits dihydrofolate reductase |
|
|
methotrexate rx
|
leukemias
lymphomas choriocarcinoma sarcomas PEAR psoriasis ectopic abortion rheumatoid arthritis |
|
|
methotrexate s/e
|
MMMT
--myelosuppression (reversible with leukovorin rescue) --macrovesicular fatty liver --mucositis --teratogenic |
|
|
leukovorin is aka
|
folinic acid
|
|
|
5-FU moa
|
pyrimidine analog
bioactivated to 5F-dUMP covalently complexes folic acid together inhibit thymidylate synthase |
|
|
5-FU rx
|
colon cancer
solid tumors basal cell carcinoma (topical) synergy with methotrexate |
|
|
5-FU s/e
|
myelosuppression
--not reversible with leukovorin --treat overdose with thymidine photosensitivity |
|
|
antimetabolities
|
methotrexate
5-fluorouracil (5-FU) 6-mercaptopurine (6-MP) 6-thioguanine (6-TG) cytarabine (ara-C) |
|
|
_ has same mechanism as 6-MP
|
6-thioguanine
|
|
|
6-MP moa
|
purine analog
--> v de novo purine synthesis activated by HGPRTase |
|
|
6-MP moa
|
purine analog
--> v de novo purine synthesis activated by HGPRTase |
|
|
6-MP rx
|
leukemias, lymphomas
(not CLL or Hodgkin's) |
|
|
6-thioguanine (6-TG) rx
|
acute lymphoid leukemia
|
|
|
ara-C is aka
|
cytarabine
|
|
|
cytarabine (ara-C) moa
|
pyrimidine antagonist
--> inhibition of DNA polymerase |
|
|
cytarabine (ara-C) rx
|
AML
ALL high-grade non-Hodgkin's |
|
|
6-MP s/e
|
bone marrow
GI liver metabolized by xanthene oxidase --> ^ toxicity with allopurinol |
|
|
6-thioguanine (6-TG) s/e
|
bone marrow depression
liver can be given with allopurinol |
|
|
cytarabine (ara-C) s/e
|
MALT =
megaloblastic anemia leukopenia thrombocytopenia |
|
|
dihydrofolate reductase moa
|
DHF --> THF
|
|
|
thymidylate synthase moa
|
dUMP --> dTMP
|
|
|
dactinomycin moa
|
intercalates in DNA
|
|
|
doxorubicin/daunorubicin moa
|
generate free radicals
noncovalently intercalate in DNA --> breaks in DNA |
|
|
doxorubicin aka
|
adriamycin
|
|
|
antitumor antibiotics
|
dactinomycin
doxorubicin/daunorubicin bleomycin etoposide/teniposide |
|
|
etoposide/teniposide moa
|
inhibit topoisomerase II
|
|
|
etoposide aka
|
VP-16
|
|
|
VP-16 aka
|
etoposide
|
|
|
bleomycin moa
|
induces free radical formation
--> breaks in DNA |
|
|
dactinomycin rx
|
Wilm's tumor
Ewing's sarcoma rhabdomyosarcoma |
|
|
dactinomycin s/e
|
myelosuppression
|
|
|
doxorubicin/daunorubicin rx
|
HMS BOL
hodgkin's myelomas sarcomas solid tumors of breast, ovary, lung |
|
|
bleomycin rx
|
testicular
Hodgkin's |
|
|
etoposide/teniposide rx
|
small cell carcinoma of lung and prostate
testicular carcinoma |
|
|
doxorubicin/daunorubicin s/e
|
CAME
cardiotoxicity alopecia myelosuppression extravasation |
|
|
bleomycin s/e
|
PMS
pulmonary fibrosis minimal myelosuppression skin changes |
|
|
etoposide s/e
|
GAMe
GI irritation alopecia myelosuppression |
|
|
aklylating agents
|
cyclophosphamide/ifosfamide
nitrosoureas busulfan |
|
|
nitrosoureas
|
carmustine
lomustine semustine streptozocin |
|
|
cyclophosphamide/ifosfamide moa
|
covalently X-link
(interstrand) DNA at guanine N-7 bioactivation by liver |
|
|
cyclophosphamide/ifosfamide rx
|
Non-Hodgkin's
breast & ovarian carcinomas immunosuppressants |
|
|
cyclophosphamide/ifosfamide s/e
|
myelosuppression
hemorrhagic cystitis partially prevented with mesna (which binds toxic metabolite) |
|
|
nitrosoureas moa
|
require bioactivation
cross BBB |
|
|
nitrosoureas rx
|
brain tumors including glioblastoma multiforme
|
|
|
nitrosoureas s/e
|
dizziness
ataxia |
|
|
busulfan moa
|
alkylates DNA
|
|
|
busulfan rx
|
CML
ablate marrow before transplantation |
|
|
busulfan s/e
|
pulmonary fibrosis
hyperpigmentation |
|
|
vincristine/vinblastine
|
alkaloids that bind tubulin in M-phase
block polymerization of microtubules so that spindle cannot form |
|
|
vincristine/vinblastine Rx
|
hodgkin's
Wilms' tumor choriocarcinoma |
|
|
three drugs listed for hodgkin's
|
doxorubicin/daunorubicin
bleomycin vincristine/vinblastine |
|
|
two drugs listed for Wilms' tumor
|
dactinomycin
vincristine/vinblastine |
|
|
drug for ablation of bone marrow before transplantation
|
busulfan
|
|
|
two drugs listed for choriocarcinoma
|
methotrexate
vincristine/vinblastine |
|
|
vincristine/vinblastine s/e
|
cristy wrote an APP
vinblastine blasts bone marrow vincristine --areflexia --peripheral neuritis --paralytic ileus vinblastine --bone marrow suppression |
|
|
paclitaxel/other taxols moa
|
it is TAXing to stay polymerized
hyperstabilize microtubules in M-phase. spindle cannot break down anaphase cannot occur |
|
|
paclitaxel/other taxols rx
|
ovarian & breast carcinomas
|
|
|
paclitaxel/other taxols s/e
|
myelosuppression
hypersensitivity |
|
|
cisplatin/carboplatin moa
|
cross-link DNA
|
|
|
cisplatin/carboplatin rx
|
the platinum cars(inomas) park in the B-LOT
Bladder Lung Ovary Testicular |
|
|
cisplatin/carboplatin s/e
|
cisplatiN/carboplatiN
Nephrotoxicity acoustic Nerve damage |
|
|
hydroxyurea moa
|
inhibits Ribonucleotide Reductase -->
v DNA Synthesis (S-phase specific) |
|
|
hydroxyurea rx
|
melanie has chronic sickle cell disease
melanoma CLL sickle cell disease (^ HbF) |
|
|
hydroxyurea s/e
|
bone marrow suppression
GI upset |
|
|
prednisone moa
|
may --> apotosis
may work on nondividing cells |
|
|
prednisone rx
|
the most commonly used glucocorticoid in cancer chemo
CLL Hodgkin's (as part of the MOPP regimen) autoimmune disease |
|
|
prednisone s/e
|
CHOP HPI
sugar sugar sour sour cataracts (~sugar connection) hyperglycemia (sugar) osteoporosis ("acid leaches") peptic ulcers ("sour stomach") hypertension psychosis immunosuppression mnemonic: hypertension --> strokes --> psychosis. immune system is suppressed so it can't clean up after the strokes. |
|
|
tamoxifen/raloxifene moa
|
SERMs
antagonists in breast agonists in bone block the binding of estrogen |
|
|
tamoxifen, raloxifene rx
|
breast cancer
prevent osteoporosis |
|
|
tamoxifen, raloxifene s/e
|
THE RN
Tamoxifen: --Hot flashes --may ^ risk of Endometrial carcinoma (partial agonist) Raloxifene --No ^ in endometrial carcinoma (antagonist) |
|
|
herceptin =
|
trastuzumab
|
|
|
trastuzumab moa
|
antibody against HER-2 (erb-B2)
helps kill breast cancer cells that... overexpress HER-2 possibly by antibody-dependent cytotoxicity |
|
|
trastuzumab rx
|
metastatic breast cancer
|
|
|
trastuzumab s/e
|
cardiotoxicity
|
|
|
gleevec =
|
imatinib
|
|
|
gleevec moa
|
(philadelphia chromosome)
inhibits **bcr-abl tyrosine kinase** |
|
|
gleevec rx
|
CML
GI stromal tumors |
|
|
gleevec s/e
|
fluid retention
|
|
|
rituximab moa
|
antibody against CD20
(found on most B-cell neoplasms) |
|
|
rituximab rx
|
non-hodgkin's
rheumatoid arthritis (with methotrexate) |
