digoxin (MOA)
-NA/K ATPase inhibitor, leads to intracellular accumulation of Na, leads to inhibition of Na/Ca antiproton, leads to intracellular accumulation of Ca2+ –> positive inotropy
hydrochlorothiazide (MOA, tx, possible complications)
- inhibits NaCl reuptake in proximal distal tubule
- decreases Ca2+ wasting (positive inotrope effects?)
- tx: HTN, CHF, ***nephrogenic diabetes insipidus
- SE: hyperglycemia, hyperlipidemia, hypercalcemia
Tx for Lead poisoning (adults 2, kids 1)
- adults: dimercaprol and ethelynediamine tetraactic acid (EDTA)
- kids: succimer
protamine sulfate
- tx for heparin overdose
- cation, binds negatively charged heparin, inactivating it
hydroxyurea (MOA, tx)
- MOA: inhibits ribonucleotide reductase, preventing conversion of ribonucleotides to deoxyribonucleotides, effectively inhibiting DNA synthesis
- … because of this it can increase production of fetal hemoglobin (less likely to sickle)
- tx: sickle cell and essential thrombocytosis
chelating agents (deferoxamine, dimercaprol, penacillamine, EDTA/succimer)
- deferoxamine: iron and aluminum
- dimercaprol: arsenic, mercury, gold
- penacillamine: lead and arsenic and COPPER (wilson’s dz)
- EDTA and succimer: lead
filgrastim
- given to patients on myelosuppressive chemotherapy to help bone marrow recover
- also called granulocyte colony stimulating factor (G-CSF)
ribavarin (MOA… leads to SE of hemolytic anemia, which has lab values of…)
- inhibits monophosphate dehydrogenase, effectively inhibiting nucleotide formation– leads to hemolytic anemia
- lab values: decreased hematocrit and haptoglobin, elevated lactate dehydrogenase and indirect bilirubin
abciximab (MOA)
-binds to glycoprotein receptor IIa/IIIb, preventing fibrinogen from binding, interrupting platelet aggregation
clopidogrel (MOA)
-inhibit ADP pathway involved in binding of fibrinogen to platelets
leuprolide (MOA and tx, tricky)
- can act as either GnRH agonist (pulsatile) or antagonist (continuous) depending on administration
- used to treat infertility (agonist) and prostate cancer (antagonist)
vincristine (MOA… tx…)
- microtubule inhibitor
- tx of hodgkin’s lymphoma
ribavirin (MOA… tx… SE…)
- depletes intracellular stores of ATP
- given to chronic HCV, reduce fatigue and hepatic inflammation
- causes non-immune mediated hemolytic anemia
all trans retinoid acid (MOA… tx…)
- induces differentiation of tumor cells
- PML t(15;17) often presents with DIC
abciximab
-antibody against GP IIb/IIIa, prevents aggregation of platelets
clopidogrel/ticlopidine (MOA)
-anti-platelet, works by inhibiting ADP which decreases platelet aggregation and GP IIb/IIIa expression
immunosuppressants that act via IL-2 (one inhibits, one is a receptor antagonist)
- IL-2 is important in T lymphocyte activation
- cyclosporine… inhibitor, SE: renal tox
- daclizumab… monoclonal Ab, generally well tolerated
side effect of cyclophosphamide and tx to prevent this side effect
- SE: hemorrhagic cystitis and myelosupression
- tx: Mensa, neutralizes metabolites in urine and prevents cystitis
tx for severe neutropenia?
- G-CSF: granulocyte colony stimulating factor
- promotes maturation and differentiation of neutrophils
reverse the effects of tPA with…
-aminocaproic acid
celocoxib
-selective COX-2 inhibitor
