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HemeOnc Pharm

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gsafsaf's version from 2015-06-04 18:41

Coagulation and Platelet Drugs

Question Answer
HeparinCofactor for antithrombin (III)/decreases thrombin (IIa)/decreases Xa
HeparinAnticoagulant/rapid/pregnancy okay (doesn't cross placenta)
HeparinBleeding/HIT/Osteoprosis/drug-drug interactions
HeparinPTT
HeparinProtamine sulfate (has + charge/binds - heparin)
EnoxaparinReduce Xa more/better bioavailability/longer half life (not easily reversible)
DalteparinReduce Xa more/better bioavailability/longer half life (not easily reversible)
LepirudinHirudin (leech anticoagulant) derivative/inhibits thrombin (IIa)
BivalirudinHirudin (leech anticoagulant) derivative/inhibits thrombin (IIa)
LepirudinAnticoagulant/for patients w/HIT
BivalirudinAnticoagulant/for patients w/HIT
FondaparinuxSelective Xa inhibitor
FondaparinuxAnticoagulant/for patients w/HIT
Warfarin/CoumadinInterferes w/normal synthesis/gamma carboxylation of vit K dep (II/VII/IX/X)
Warfarin/CoumadinAnticoagulant/chronic/not pregnant (crosses placenta)
Warfarin/CoumadinMonitor PT/INR
Warfarin/CoumadinBleeding/Teratogenic/skin-tissue necrosis/drug-drug interactions (P450)
Warfarin/CoumadinVitamin K/fresh frozen plasma (rapid)
Alteplase (tPA)Directly or indirectly converts plasminogen to plasmin (cleaves thrombin/fibrin)/increases PT/PTT
Alteplase (tPA)Thrombolytic
Alteplase (tPA)Bleeding
Alteplase (tPA)Aminocaproic acid (fibronolysis inhibitor)
Reteplace (rPA)Directly or indirectly converts plasminogen to plasmin (cleaves thrombin/fibrin)/increases PT/PTT
Reteplace (rPA)Thrombolytic
Reteplace (rPA)Bleeding
Reteplace (rPA)Aminocaproic acid (fibronolysis inhibitor)
Tenecteplase (TNK-tPA)Directly or indirectly converts plasminogen to plasmin (cleaves thrombin/fibrin)/increases PT/PTT
Tenecteplase (TNK-tPA)Thrombolytic
Tenecteplase (TNK-tPA)Bleeding
Tenecteplase (TNK-tPA)Aminocaproic acid (fibronolysis inhibitor)
AspirinIrreversibly inhibits COX1-2/decreases TXA-PG/increases bleeding time
AspirinGastric ulceration (upper GI bleed)/tinnitus (CN VIII)/renal failure in chronic use (nephritis)/Reye's syndrome in children/respiratory alkalosis/metabolic acidosis
ClopidogrelBlock ADP receptors/inhibit platelet aggregation/block GpIIb/IIIa from linking fibrinogen
ClopidogrelACS/coronary stenting
TicagrelorBlock ADP receptors/inhibit platelet aggregation/block GpIIb/IIIa from linking fibrinogen
TicagrelorACS/coronary stenting
PrasurgrelBlock ADP receptors/inhibit platelet aggregation/block GpIIb/IIIa from linking fibrinogen
PrasurgrelACS/coronary stenting
TiclopidineBlock ADP receptors/inhibit platelet aggregation/block GpIIb/IIIa from linking fibrinogen
TiclopidineACS/coronary stenting
TiclopidineNeutropenia
CilostazolPDE 3 inhibitor/increases cAMP in platelets/inhibits platelet aggregation/vasodilates
CilostazolClaudication/angina
CilostazolNausea/headache/facial flushing/hypotension/abdominal pain
DipyramidolPDE 3 inhibitor/increases cAMP in platelets/inhibits platelet aggregation/vasodilates
DipyramidolClaudication/angina
DipyramidolNausea/headache/facial flushing/hypotension/abdominal pain
AbciximabBind GpIIb/IIIa/prevent aggregation
AbciximabACS
AbciximabBleeding/thrombocytopenia
EptifibatideBind GpIIb/IIIa/prevent aggregation
EptifibatideACS
EptifibatideBleeding/thrombocytopenia
TirofibanBind GpIIb/IIIa/prevent aggregation
TirofibanACS
TirofibanBleeding/thrombocytopenia
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Anticancer Drugs

Question Answer
MethotrexateFolic acid analog/inhibits DHF reductase/reduce DNA synthesis
MethotrexateLeukemias/lymphomas/choriocarcinoma/sarcomas/noncancers
MethotrexateMyelosuppression/macrovesicular fatty change in liver/mucositis/teratogenic
MethotrexateLeucovorin (folinic acid) reverses myelosuppression
5 fluorouracilPyramidine analog/inhibits thymidylate synthase/reduces DNA synthesis
5 fluorouracilColon cancer/basal cell carcinoma (topical)
5 fluorouracilMyelosuppression/photosensitivity
5 fluorouracilThymidine
Cytarabine (arabinofuranosyl cytidine)Pyramidine analog/inhibits DNA polymerase
Cytarabine (arabinofuranosyl cytidine)Leukemias/lymphomas
Cytarabine (arabinofuranosyl cytidine)Leukopenia/thrombocytopenia/megaloblastic anemia
Azathioprine/6 mercaptopurine/6 thioguaninePurine (thiol) analogs/inhibit purine synthesis
Azathioprine/6 mercaptopurine/6 thioguanineLeukemias
Azathioprine/6 mercaptopurine/6 thioguanineBone marrow/GI/liver (intrahepatic cholestasis/focal centrilobular necrosis)
Dactinomycin (actinomycin D)Intercalates in DNA between guanine/cytosine
Dactinomycin (actinomycin D)Wilms' tumor/Ewing's sarcoma/rhabdomyosarcoma/childhood tumors
Dactinomycin (actinomycin D)Myelosuppression
Doxorubicin (Adriamycin)/DaunorubicinGenerates free radicals/noncovalently calates with DNA
Doxorubicin (Adriamycin)/DaunorubicinLeukemias/lymphomas/solid tumors
Doxorubicin (Adriamycin)/DaunorubicinCardiotoxicity (DCM)/myelosuppression/alopecia
Doxorubicin (Adriamycin)/DaunorubicinDexrazoxane (iron chelating agent) prevents cardiotoxicity
BleomycinInduces free radical formation/breaks DNA strands
BleomycinTesticular cancer/Hodgkin's lymphoma
BleomycinPulmonary fibrosis/skin changes/minimal myelosuppression
Cyclophosphamide/ifosfamideAlkylates DNA/Covalently X link DNA strands at guanine N-7
Cyclophosphamide/ifosfamideLeukemias/lymphomas/solid tumors/some brain
Cyclophosphamide/ifosfamideMyelosuppression/hemorrhagic cystitis
Cyclophosphamide/ifosfamideMesna partially prevents hemorrhagic cystitis
NitrosureasCarmustine/lomustine/semustine/streptozocin
NitrosureasAlkylates DNA/crosses BBB
NitrosureasBrain tumors (including glioblastoma multiforme)
NitrosureasCNS toxicity (dizziness/ataxia)
BusulfanAlkylates DNA
BusulfanCML/pre BMXplant ablation
BusulfanPulmonary fibrosis/hyperpigmentation
Vincristine/vinblastine (alkaloids)Bind tubulin in M phase/prevent mitotic spindle
Vincristine/vinblastine (alkaloids)Leukemias/lymphomas/solid tumors
VincristineNeurotoxicity (areflexia/peripheral neuritis)/paralytic ileus
VinblastineBone marrow suppression
Paclitaxel/other taxolsHyperstabilize polymerized microtubuls in M phase/mitotic spindle can't break down
Paclitaxel/other taxolsOvarian/breast carcinomas
Paclitaxel/other taxolsMyelosuppression/hypersensitivy
Cisplatin/carboplatinCross link DNA
Cisplatin/carboplatinTesticular/bladder/ovary/lung carcinomas
Cisplatin/carboplatinNephrotoxicity/acoustic nerve damage
Cisplatin/carboplatinNephrotoxicity by amifostine (free radical scavenger) and chloride diuresis
Etoposide/teniposideInhibit topoisomerase II/increase DNA degredation
Etoposide/teniposideLeukemias/lymphomas/solid tumors
Etoposide/teniposideMyelosuppression/GI irritation/alopecia
HydroxyureaInhibit ribonucleotide reductase/decreases DNA synthesis (S phase specific)
HydroxyureaMelanoma/CML/sickle cell disease (increases HbF)
HydroxyureaMyelosuppression/GI irritation
Prednisone/prednisoloneMay trigger apoptosis/may work on nondividing cells
Prednisone/prednisoloneCLL/Non Hodgkin's Lymphoma
Prednisone/prednisoloneCushing-like/psychosis
Tamoxifen/raloxifeneSERMS/antagonist in breast/agonist in bone
Tamoxifen/raloxifeneBreast cancer/osteoporosis
TamoxifenEndometrial agonist (endometrial carcinoma)/hot flashes
RaloxifeneEndometrial antagonist (no endometrial carcinoma)
Trastuzumab/HerceptinHER-2 (c-erbB2) monoclonal antibody/kills specific breast cancer cells/possibly ADCC
Trastuzumab/HerceptinHER-2 positive breast cancer
Trastuzumab/HerceptinCardiotoxicity
Imatinimb/GleevecPhiladelphia chromasome bcr-abl tyrosine kinase inhibitor
Imatinimb/GleevecCML/GI stromal tumors
Imatinimb/GleevecFluid retention
RituximabCD20 monoclonal antibody/on most B cell neoplasms
RituximabNon Hodgkin's lymphoma/RA w/MTX
VemurafenibSmall molecule inhibitor of forms of B-Raf kinase w/V600E mutation
VemurafenibMetastatic melanoma
BevacizumabVEGF monoclonal antibody/inhibits angiogenesis
BevacizumabSolid tumors
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Common SE

Question Answer
CisplatinNephrotoxic/acoustic nerve damage
CarboplatinNephrotoxic/acoustic nerve damage
VincristinePeripheral neuropathy
BleomycinPulmonary fibrosis
BusulfanPulmonary fibrosis
DoxorubicinCardiotoxicity
TrastuzumabCardiotoxicity
CyclophosphamideHemorrhagic cystitis
5FUMyelosuppression
6MPMyelosuppression
MethotrexateMyelosuppression
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