-
Pro-drug, metabolite inhibits P2Y(ADP)
- Clopidogrel
- Ticlopidine
- Prasugrel
-
Causes thrombocytopenia and neutropenia
Ticlopidine
-
Binds irreversibly
- Aspirin
- Abciximab
- Clopidogrel
- Ticlopidine
- Ticagrelor
- Prasugrel
-
Coagulation factors affected by unfractionated Heparin.
-
Coagulation factors affected by LMWH (enoxaparin, dalteparin).
-
Coagulation factors affected by DTI (Argatroban, lepirudin, bivalirudin, dabigatran).
IIa (Thrombin)
-
Coagulation factors affected by Fondaparinux, apixaban, rivaroxaban.
Xa
-
Coagulation factors affected by Warfarin.
-
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
-
How are atorvastatin, simvastatin, & lovastatin metabolized?
CYP3A4
-
Which are the two most potent statins?
Rosuvastatin, Atorvastatin
-
What are the adverse effects of statins?
Rhabdo, myopathy, elevated transaminase
-
Adverse effects and interactions of bile acid sequestrants?
- AE: Bloating; Dyspepsia
- DI: Binding of other drugs (separate dosing)
- Decreases absorption of fat-soluble vitamins
-
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.
-
What are fibrates predominantly used for?
to tx: high TG or low HDL
-
What are the side effects of fibrates?
- GI discomfort,
- increased transaminases (liver enzymes)
- Rare - myopathy, arrhythmia
-
How do fibrates work?
increase plasma HDL & decrease triglyceride synthesis, which will decrease plasma triglycerides
-
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
-
_____ is most effective at decreasing TG, then increasing HDL
Niacin
-
______ reduces cholesterol absorption in the small intestine
Ezetimibe
-
________ are preferred for LDL lowering.
HMG CoA reductase inhibitors
-
______ can greatly reduce TG levels
Omega-3’s
-
_______ are more effective at lowering LDL than ______.
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