GU Pharm Mod 9&10

  1. Pro-drug, metabolite inhibits P2Y(ADP)
    • Clopidogrel
    • Ticlopidine
    • Prasugrel
  2. Causes thrombocytopenia and neutropenia
  3. Binds irreversibly
    • Aspirin
    • Abciximab
    • Clopidogrel
    • Ticlopidine
    • Ticagrelor
    • Prasugrel
  4. Coagulation factors affected by unfractionated Heparin.
    • IIa (Thrombin)
    • Xa
  5. Coagulation factors affected by LMWH (enoxaparin, dalteparin).
    • IIa (Thrombin)
    • Xa
  6. Coagulation factors affected by DTI (Argatroban, lepirudin, bivalirudin, dabigatran).
    IIa (Thrombin)
  7. Coagulation factors affected by Fondaparinux, apixaban, rivaroxaban.
  8. Coagulation factors affected by Warfarin.
    • II
    • VII
    • IX
    • X
  9. Why does warfarin have so many drug interactions?
    b/c it is metabolized by CYP450 pathways (specifically CYP2C9) & 99% of it is albumin-bound, so any drug that displaces that affects the INR
  10. How are atorvastatin, simvastatin, & lovastatin metabolized?
  11. Which are the two most potent statins?
    Rosuvastatin, Atorvastatin
  12. What are the adverse effects of statins?
    Rhabdo, myopathy, elevated transaminase
  13. Adverse effects and interactions of bile acid sequestrants?
    • AE: Bloating; Dyspepsia
    • DI: Binding of other drugs (separate dosing)
    • Decreases absorption of fat-soluble vitamins
  14. How do bile acid sequestrants work?
    Increases bile acid synthesis, which decreases cholesterol concentration in the hepatocytes, which then causes increase in LDL receptors, pulling LDL in from systemic circulation.
  15. What are fibrates predominantly used for?
    to tx: high TG or low HDL
  16. What are the side effects of fibrates?
    • GI discomfort,
    • increased transaminases (liver enzymes)
    • Rare - myopathy, arrhythmia
  17. How do fibrates work?
    increase plasma HDL & decrease triglyceride synthesis, which will decrease plasma triglycerides
  18. What are important DI’s with fibrates?
    • Fibrates displace warfarin from albumin binding sites --- increases free warfarin concentrations & cause significant increase in INR
    • Fibrates increase cyclosporin clearance
  19. _____ is most effective at decreasing TG, then increasing HDL
  20. ______ reduces cholesterol absorption in the small intestine
  21. ________ are preferred for LDL lowering.
    HMG CoA reductase inhibitors
  22. ______ can greatly reduce TG levels
  23. _______ are more effective at lowering LDL than ______.
    • Statins
    • fibrates
Card Set
GU Pharm Mod 9&10
Week 3 Synch