Term
|
Definition
immediate anticoagulation
cofactor to activate antithrombin |
|
|
Term
|
Definition
bleeding
thrombocytopenia
HIT - look for in first 4 days
rapid reversal with protamine sulfate |
|
|
Term
HIT
heparin induced thrombocytopenia |
|
Definition
+/- 4 days into treatment
heparin binds to platelet factor IV causing antibody production that binds to and activates platelets --> clearance of platelets - thrombocytopenia, hypercoagulable state
tx with direct thrombin inhibitors (hirudin derivatives) |
|
|
Term
| direct thrombin inhibitors |
|
Definition
lepirudin
bilvalirudin
argatroban
--hirudin inhibitors |
|
|
Term
direct thrombin inhibitors
mech/uses |
|
Definition
lepirudin, bilvalirudin, argatroban
directly inhibit thrombin without the needing antithrombin
an alt to heparin for anticoagulating patients with HIT |
|
|
Term
warfarin/coumadin
mech/uses |
|
Definition
interferes with normal synthesis and gamma-carboxylations of vitamin K dependent clotting factors: II, VII, IX, X, protein C, protein S
used for chronic anticoagulation |
|
|
Term
|
Definition
bleeding
teratogenic
skin/tissue necrosis (w/in 1st week, from inhibtion of prot C activity)
reverse toxity with vitamin K, rapid reversal with FFP
drug0drug interactions (P450) |
|
|
Term
| thrombolytics/fibrinolytics |
|
Definition
streptokinase
urokinase
tPA (alteplase)
APSAC (antistreplase) |
|
|
Term
|
Definition
directly or indirectly help convert plasminogen-->plasmin to cleave thrombin and fibrin clots
increase clot lysis by increased formation of plasmin
used in early MI, early ischemic stroke |
|
|
Term
|
Definition
bleeding...duh
reverse with aminocaproic acid, an inhibitor of fibrinolysis |
|
|
Term
|
Definition
| inhibits COX-1 and 2 to prevents conversion of arachidonic acid-->thromboxane A2 |
|
|
Term
|
Definition
gastric ulceration, bleeding, hyperventiliation, tinnitus
Reye's syn if given to kids with viral illness |
|
|
Term
cilostazol, dipyridamole
mech, uses |
|
Definition
phosphodiesterase III inhibitor
increases cAMP in platelets = inhibition of platelet aggregation
used in intermittent claud, coronary vasodilation, prevent stroke/TIAs, angina prophylax |
|
|
Term
cilostazol, dipyridamole
tox |
|
Definition
| nausea, HA, facial flushing, hypotension, ab pain |
|
|
Term
clopidogrel, ticlopidine
mech, use |
|
Definition
inhibits platelet aggregation by irreversibly blocking ADP receptors
inhibits fibrinogen binding by blockingh expression of GPIIb/IIIa
can combine with aspirin to get an additive antiplatelet effect
used in acute coronary syndrome and coronary stenting |
|
|
Term
clopidogrel, ticlopidine
tox |
|
Definition
| 1% of ticlopidine patients may experience neutropenia, presenting as fevers and mouth sores |
|
|
Term
|
Definition
monoclonal antibody that binds to GPIIb/IIIa on activated platets thuis preventing aggregation
uaes in acute coronary syndromes, percutaneous transluminal coronary angioplasty |
|
|
Term
|
Definition
|
|
Term
DDVAP-desmopressin acetate
mech/use |
|
Definition
synthetic vasopressin analog that releases vWF and factor VIII from endothelium
used in the tx of mild-moderate hemophilia A |
|
|
Term
antimetabolites
names and general mech |
|
Definition
inhibit S phase = DNA synthesis
methotrexate (MTX)
5-flurouracil )5-FU)
6-mercaptopurine (6-MP)
6-thioguanine (6-TG)
cytarabine (ara-C) |
|
|
Term
|
Definition
FOLIC ACID ANALOG that inhibits dihydrofolate reductase --> inhibits DNA and protein synthesis
accumulation of dihydrofolic acid within treated cells
oncologic and non-neoplastic uses (ie abrotion/ectopic preg) |
|
|
Term
|
Definition
myelosuppression <-- reversible with LEUCOVORIN (folinic acid)
macrovesicular fatty change in liver
mucositits
teratogenic (duh, it's used to cause abortion!) |
|
|
Term
|
Definition
pyrimidine analog that covalently bonds folic acid creating a complex that inhibits thymidylate synthase --> inhibit DNA and protein synthesis
synergy with MTX |
|
|
Term
|
Definition
myelosuppression (NOT reversible with leucovorin)
phtosensitivity |
|
|
Term
|
Definition
purine analog that decreases de novo purine synthesis
activated by HGPRTase |
|
|
Term
|
Definition
bone marrow, liver, GI
increased toxicity with allopurinol because it is metabolized by xanthine oxidase |
|
|
Term
|
Definition
| pyrimidine analog that inhibits DNA polymerase |
|
|
Term
|
Definition
leukopenia
thrombocytopenia
megaloblastic anemia |
|
|
Term
antitumor antibiotics
names |
|
Definition
dactinomycin
doxorubicin, daunorubicin
bleomycin
etoposide, teniposide |
|
|
Term
|
Definition
intercalates in DNA
used for childhood tumors |
|
|
Term
|
Definition
|
|
Term
doxorubicin
daunorubicin
mech |
|
Definition
generates free radicals
noncovalently intercalate in DNA causing breaks in DNA and thus decreasing replication |
|
|
Term
|
Definition
cardiotoxicity (dilated cardiomyopathy)
myelosuppression
alopecia
iron chelation to prevent cardiotoxicity |
|
|
Term
|
Definition
| induces free radical formation, causing breaks in DNA strands |
|
|
Term
|
Definition
pulmonary fibrosis
skin changes
(minimal myelosuppression) |
|
|
Term
etoposide (VP-16)
teniposide
mech |
|
Definition
| inhibits topoisomerase II, decreasing DNA degradation |
|
|
Term
|
Definition
myelosuppression
GI irritation
alopecia |
|
|
Term
|
Definition
cyclophosphamide, ifosamide
nitrosoureas
busulfan |
|
|
Term
cyclophosphamide
ifosfamide
mech |
|
Definition
covalently cross link (interstrand) DNA at guanine N-7
requires bioactivation by liver |
|
|
Term
|
Definition
myelosuppression
hemorrhagic cystitis (partially prevented with mesna) |
|
|
Term
nitrosoureas
(carmustine, lomustine, semustine, streptozocin)
mech |
|
Definition
cross blood-brain barrier
require bioavtivation |
|
|
Term
|
Definition
CNS toxicity
(dizziness, ataxia) |
|
|
Term
|
Definition
|
|
Term
|
Definition
pulmonary fibrosis
hyperpigmentation |
|
|
Term
microtubule inhibitors
names and general mech |
|
Definition
inhibit M phase of cell cycle = cellular division
vincristine, vinblastine
pacitaxel, other taxols |
|
|
Term
vincristine
vinblastine
mech |
|
Definition
block POLYMERIZATION of microtubules so that spindle cannot form
alkaloids that bind to tubulin in M-phase |
|
|
Term
vincristine
vinblastine
tox |
|
Definition
vincristine - neurotoxicity, paralytic ileus
vinblastine - bone marrow suppression |
|
|
Term
|
Definition
| HYPERSTABILIZE polymerized microtubules in M-phase so that mitotic spindle cannot break down (aka anaphase can't occur) |
|
|
Term
|
Definition
myelosuppression
hypersensitivity |
|
|
Term
|
Definition
|
|
Term
|
Definition
nephrotoxicity
acoustic nerve damage |
|
|
Term
|
Definition
| inhibits ribonucleotide reductase --> decreases DNA synthesis (S-phase specific) |
|
|
Term
|
Definition
bone marrow suppression
GI upset |
|
|
Term
|
Definition
may trigger apoptosis
may even work on non-dividing cells |
|
|
Term
|
Definition
Cushing-like symtoms
immunosuppression
cataracts, acne, osteoporosis, HTN, peptic ulcers, hyperglycemia, psychosis |
|
|
Term
|
Definition
SERMs - receptor antagonists in breast and agonists in bone
block the binding of estrogen to estrogen-receptor-positive cells |
|
|
Term
|
Definition
tamoxifen ONLY may increase risk of endometrial carcinoma via partial agonist effects
(ralox is an endometrial antagonist) |
|
|
Term
trastuzumab
(Herceptin)
mech |
|
Definition
monoclonal antibody against HER-2 (erb-B2), a tyrosine kinase
helps kill breast cancer cells that overexpress HER-2 (up to 30% of invasive cases), possibly through antibody-dependent cytotoxicity |
|
|
Term
trastuzumab
(Herceptin)
tox |
|
Definition
|
|
Term
|
Definition
| Philadelphia chromosome bcr-abl tyrosine kinase inhibitor |
|
|
Term
|
Definition
|
|
Term
|
Definition
| monoclonal antibody against CD20 - found on most B-cell neoplasms |
|
|
Term
|
Definition
|
|
