HEMATOLOGY

MOA: Inhibit platelet aggregation by irreversibly blocking ADP receptors ⇒ prevent expression of glycoproteins IIb/IIIa on platelet surface.

• USE:
• 1. Unstable angina (aspirin + clopidogrel)
• 2. Ischemic stroke
• 3. Acute coronary syndrome
• 4. Coronary stenting
• There is ↓ incidence or recurrence of thrombotic stroke

MOA: Inhibit platelet aggregation by irreversibly blocking ADP receptors ⇒ prevent expression of glycoproteins IIb/IIIa on platelet surface.

• USE: Acute coronary syndrome, coronary stenting.
• There is ↓ incidence or recurrence of thrombotic stroke

MOA: REVERSIBLY Inhibit platelet aggregation by irreversibly blocking ADP receptors ⇒ prevent expression of glycoproteins IIb/IIIa on platelet surface.

• USE: Acute coronary syndrome, coronary stenting.
• There is ↓ incidence or recurrence of thrombotic stroke

MOA: Inhibit platelet aggregation by irreversibly blocking ADP receptors ⇒ prevent expression of glycoproteins IIb/IIIa on platelet surface.

• USE: Acute coronary syndrome, coronary stenting.
• There is ↓ incidence or recurrence of thrombotic stroke
• Toxicity: NEUTROPENIA (↓WBCs, fever, mouth ulcers)

MOA: Phosphodiesterase III inhibitor; ↑cAMP in platelets, resulting in inhibition of platelet aggregation; arteriolar vasodilator

• 1. Intermittent claudication
• 2. Coronary vasodilation
• 3. Prevention of stroke or transient ischemic attacks (combined with aspirin)
• 4. Angina prophylaxis

• SIDE EFFECTS: Nausea, headache, facial flushing, hypotension, abdominal pain.

MOA: Phosphodiesterase III inhibitor; ↑cAMP in platelets, resulting in inhibition of platelet aggregation; arteriolar vasodilator

• 1. Intermittent claudication
• 2. Coronary vasodilation
• 3. Prevention of stroke or transient ischemic attacks (combined with aspirin)
• 4. Angina prophylaxis

• SIDE EFFECTS: Nausea, headache, facial flushing, hypotension, abdominal pain.

• MOA: Bind to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation.
• Abciximab is made from monoclonal antibody Fab fragments.

• USE: 
• 1. Unstable angina
• 2. Percutaneous transluminal coronary angioplasty

SIDE EFFECTS: Bleeding, thrombocytopenia

MOA: Bind to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation.

• USE: 
• 1. Unstable angina
• 2. Percutaneous transluminal coronary angioplasty

SIDE EFFECTS: Bleeding, thrombocytopenia

MOA: Bind to the glycoprotein receptor IIb/IIIa on activated platelets, preventing aggregation.

• USE: 
• 1. Unstable angina
• 2. Percutaneous transluminal coronary angioplasty

SIDE EFFECTS: Bleeding, thrombocytopenia

• Abciximab
• Eptifibatide
• Tirofiban

• Cilostazol
• Dipyridamole

• Clopidogrel
• Prasugrel
• Ticagrelor (reversible)
• Ticlopidine

• Purine (thiol) analog → ↓de novo purine synthesis.
• Activated by HGPRT.

Azathioprine is metabolized into 6 -MP.

• USE:
• 1. Preventing organ rejection
• 2. Rheumatoid arthritis
• 3. IBD especially Chrons
• 4. SLE
• 5. Used to wean patients off steroids in chronic disease and to treat steroid-refractory chronic disease.

• SIDE EFFECTS:
• 1. Myelosuppression
• 2. GI
• 3. Liver (abdominal pain, jaundice).

Azathioprine and 6-MP are metabolized by xanthine oxidase; thus both have ↑toxicity with allopurinol or febuxostat.

• Purine (thiol) analog → ↓de novo purine synthesis.
• Activated by HGPRT.
• USE:
• 1. Preventing organ rejection
• 2. Rheumatoid arthritis
• 3. IBD
• 4. SLE
• 5. Used to wean patients off steroids in chronic disease and to treat steroid-refractory chronic disease.

• SIDE EFFECTS:
• 1. Myelosuppression
• 2. GI
• 3. Liver (abdominal pain, jaundice).

Purine analog Ž

• MOA:
• 1. Inhibition of DNA polymerase
• 2. DNA strand breaks
• 3. Resistant to degradation by adenosine deaminase

USE: Hairy cell leukemia

• TOXICITY:
• Myelo
• Nephro
• Neuro

Pyrimidine analog

MOA: Inhibition of DNA polymerase

USE: Leukemias (AML), lymphomas.

SIDE EFECTS: Leukopenia, thrombocytopenia, megaloblastic anemia.

CYTarabine causes panCYTopenia.

• CYTARABINE
• Pyrimidine analog

MOA: Inhibition of DNA polymerase

USE: Leukemias (AML), lymphomas.

SIDE EFECTS: Leukopenia, thrombocytopenia, megaloblastic anemia.

CYTarabine causes panCYTopenia.

• Pyrimidine analog
• Bioactivated to 5F-dUMP, which covalently complexes folic acid → complex inhibits thymidylate synthase → ↓ dTMP → ↓DNA synthesis.

USE: Colon cancer, pancreatic cancer, basal cell carcinoma (topical).

• SIDE EFFECTS:
• Myelosuppression, which is not reversible with leucovorin (folinic acid).
• Photosensitivity