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Pharm 22
Golan Second Edition
36
Pharmacology
Graduate
02/11/2011

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Term
Cyclooxygenase Inhibitors
Definition
Aspirin
Term
Aspirin
Definition
Coronary syndromes, arthritis, pain. (GI bleed, renal insufficiency, thombocytopenia, hepatitis, angioedema, Reye's syndrome) [children, G6PD deficiency, bleeding disorders] Nonselective, potentiates ototoxic effects, toxicity with urine acidifiers.
Term
Phosphodiesterase Inhibitors
Definition
Dipyridamole
Term
Dipyridamole
Definition
Prophylaxis against thromboembolic disorders. (Exacerbation of angina, MI, arrhythmia, bronchospasm) weak antiplatelet, often with warfarin, coronary steal phenomenon
Term
ADP receptor Pathway Inhibitors
Definition
Ticlopidine, Clopidogrel
Term
Ticlopidine
Definition
Secondary prevention of thrombotic strokes. Stent w/aspirin (Aplastic anemia, neutropenia, TTP) [Bleeding, neutropenia or liver dysfunction] myelotoxicity, loading dose required
Term
Clopidogrel
Definition
Secondary prevention of atherosclerotic events w/ MI, stent w/ aspirin. (Atrial fibrillation, HF, erythema multiforme, GI hemorrhage, neurtropenia, renal dysfunction] Less myelotoxic.
Term
GIIb-IIIa Antagonists
Definition
epitifibatide, abciximab, tirofiban.
(Bleeding, intracerebral, thrombocytopenia) [bleeding disorders, HTN]
Term
Eptifibatide
Definition
Acute coronary, percutaneous cornary intervention. Don't mix with another in same class. Synthetic peptide.
Term
Abciximab
Definition
Adjunct to percutaneous coronary intervention, unstable unresponsive angina. chimeric mouse-human monoclonal antibody
Term
Tirofiban
Definition
Acute coronary dyndromes w/ angioplasty. nonpeptide tyrosine analogue
Term
Anticoagulants
Definition
Warfarin, Heparin, Fondaparinux, Hirudins, Argatroban, r-APC
Term
Factor Xa Inhibitors
Definition
Fondaparinux
Term
Direct Thrombin Inhibitors
Definition
hirudins (lepirudin, desirudin, bivalirudin), argatroban
Term
Warfarin
Definition
Embolic Prophylaxis (Cholesterol embolization syndrome, necrosis, mehorrhage, hepatitis, hypersensitivity) [pregnancy, hemorrhage, bleeding, anesthesia] Monitor PT and INR, FFP antidote.
Term
Unfractionated Heparin
Definition
Anticoagulant, DIC. (Hemorrhage, heparin-induced thrombocytopenia, anaphylactoid reactions) [coagulative concerns, HTN] Higher thrombocytopenic rates. Counteracted by antihistamines, nicotine, tetracyclines etc. Avoid dong quai, garline, ginger etc.
Term
Enoxaparin, Dalteparin, Tinzaparin
Definition
LMW haparines, same as heparin but more edema. Tinzaparin not for percutaneous coronary intervention.
Term
Fondaparinux
Definition
DVT, PE. (Typical anticoagulant adversia) [etc] pentasachride for binding antithrombin III. Cleared Renally.
Term
Lepirudin
Definition
Heparin-induced thrombotytopenia, inhibits both free and fibrin-bound thrombin.
Term
Herudin
Definition
Leech protein. (HF, GI hemorrhage, bleeding, liver dysfunction, anaphylaxis, hypotension, renal failure) Cleared renally. All derivatives share all traits
Term
Desirudin
Definition
DVT
Term
Bivalirudin
Definition
coronary angiography/angioplasty. thrombin slowly cleaves allowing reactivation.
Term
Argatroban
Definition
Coronary artery thrombosis, heparin-induced thrombocytopenia (Cardiac arrest, tachycardia, hypotension) Binds only the active site. Liver excretion.
Term
r-APC
Definition
Recombinant Activated Protein C: Severe sepsis with organ dysfunction. (Hemorrhage) [Intracranial anything, stroke recently] aPTT but little PT affect
Term
Thrombolytic Agents
Definition
Streptokinase.
t-PA (Alteplase).
Tenecteplase, Reteplase
Term
Alteplase
Definition
t-PA
Term
Streptokinase
Definition
STEMI, thrombosis, DVT, PE, catheter occlusion. (Typical thrombolytic adversia) [Bleeding etc] Builds immunity. Causes systemic fibrinolysis
Term
t-PA
Definition
MI, Stroke, PE, catheter occlusion. (Typical thrombolytic adversia) Binds to newly formed thrombi.
Term
Typical thrombolytic adversia
Definition
(Cardiac arrhythmia, cholesterol embolus syndrome, GI hemorrhage, allergic reaction, intracranial hemorrhage)
Term
Tenecteplase and Reteplase
Definition
MI. (Typical thrombolytic adversia) genetically engineered t-PA variant
Term
Anti-anticoagulatives
Definition
Protamine.
Aprotinim.
Aminocaproic acid, tranexamic acid
Term
Lysine analogues
Definition
Aminocaproic acid, Tranexamic acid
Term
Protamine
Definition
Heparin overdose (Bradyarrhythmia, hypotension, circulatory collapse, edema) cannot affect fondaparinux
Term
Aprotinin
Definition
Serine-Protease Inhibitor: reduce perioperative bleeding (HF, MI, shock, blooding etc) high doses paradoxical. renal failure risk
Term
Aminocaproic acid
Definition
fibrinolytic disorders, hemorrhage from fibrinolysis. (Bradyarrhythmia, hypotension, myopathy, renal failure) [DIC] Less renal failure than Aprotinin
Term
Tranexamic Acid
Definition
fibrinolytic disorders, hemorrhage from fibrinolysis. (Bradyarrhythmia, hypotension, renal failure) [DIC] Less renal failure than Aprotinin
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