PathoPharm II: Exam 2 Medications (Hematologic disorders, Hyperlipidemia, PVD, CAD, HTN, Cardiac- CHF, Dysrhythmias

Treatment for leukopenia/neutropenia (1)

Filgrastim (Neupogen)

Treatment for leukopenia/neutropenia (2)

Pegfilgrastim (Neulasta)

Filgrastim and Pegfilgrastim are...

bone marrow stimulants

Oprelvekin (numgega) is a ....

bone marrow stimulant

Epoetin (Epogen) is a _____, and treats ____

erythropoietin stimulant/chronic anemia

Darbepoetin Alfa (Aranesp) is a ______, and treats ____

erythropoietin stimulant/chronic anemia

when giving epoetin (epogen) and darbepoetin alfa (aranesp) watch for ...

monitor BP, higher risk for MI, CVA, DVT, and seizure

shock treatment...

support bp, 0.9% NS, blood, albumin 5% or 25% IV, epinephrine,

Antifibrinolinolytic plasminogen activator inhibitor..

Tranexamic acid (Lysteda)

Tranexamic acid action

binds plasminogen and plasmin, slows fibrinolysis

Tranexamic acid purpose

treat heavy menstrual bleeding and hypovolemic shock

What routes for tranexamic acid

Oral or IV (weight-based dosing)

Antiplatelet meds (1)

clopidogrel

Antiplatelet meds (2)

Prasugrel

Antiplatelet (3)

Ticagrelor

Antiplatelet (glycoprotein llb/lla receptor agonist)

Eptifibatide

Antiplatelet (protease-activated receptor agonist)

Vorapaxar

Vorapaxar is given...

orally and usually combined with clopidogrel

Antiplatelets stop step ...

1 (suppresses platelet aggeregation)

Antiplatelets reversal ...

Platelets

Direct thrombin inhibitor med (1)

Dabigatron

Direct thrombin inhibitor med (2)

Desirudin

Direct thrombin inhibitor med (3)

Argatroban

Direct thrombin inhibitors stop step ...

2 (directly inhibit thrombin from converting fibrinogen to fibrin)

Direct thrombin inhibitor reversal...

Idarucizumab (praxbind) and FFPs

Anticoagulant med

Heparin

Anticoagulants stop step...

2

Anticoagulatns are administered through what routes?

SubQ and IV

lab values to watch for anticoagulants ___ &___

PTT and aPTT

Anticoagulant reversal...

Protamine sulfate

Low-molecular-weight heparin med (1)

Dalteparin

Low-molecular-weight heparin med (2)

Enoxaparin

Low-molecular-weight heparin stops step...

2 and 3

Low-molecular-weight heparin route and dosing..

weight based dosing and SQ 2x daily

Low-molecular-weight heparin reversal...

Andexanet alfa (factor x) and protamine sulfate

Administering Enoxaparin

don't expel the air bubbles in the syringe, administer 2 inched from the umbilicus

Vitamin K agonist med

Warfarin

Vitamin K agonist stops step..

3

Vitamin K agonist labs to monitor...

PT and INR

Vitamin K agonist antidotes

Vit k for warfarin OD/ for acute bleeding use FFP or whole blood

Select factor Xa inhibitors anticoagulant meds (1)

Apixaban

Select factor Xa inhibitors anticoagulant meds (2)

Rivaroxaban

Select factor Xa inhibitors anticoagulant stops step.....

3

Select factor Xa inhibitors anticoagulant route

oral (no labs needed)

Select factor Xa inhibitors anticoagulant reversal...

Andexant alfa (factor Xa)

Thrombolytic meds (1)

Tenecteplase

Thrombolytic meds (2)

Alteplase (tPA)

Thrombolytic med action..

reverse clotting process, disintegrating the clot

Thrombolytic antidote..

Aminocaproic acid (Amicar)

Inhibit thrombin: reverse w/ Idarucizar (praxbaind), and/or FFP

Dabigatran, Desirudin, Argatroban

Thrombolytics: reverse w/ Aminocarporic acid (amicar)

Tenecteplase, Alteplase (tPA)

Inhibit vitamin K: reverse with vit k, FFP

Warfarin

Block Xa clotting factor: reverse w/ Andexanet alfa (factor Xa)

Rivaroxaban, Apixaban, Fondaparinux

Antiplatelets: reverse w/ platelets

Clopidogrel, Dipyridamole, Prasugrel

Inhibit thrombin and Xa: reverse w/ Andexanet alfa (factor Xa), protamine sulfate

Dalteparin, Enoxaparin

Activates antithrombins and blocks thrombin: reverse w/ protamine sulfate

Antihyperlipidemic meds (1)

Hepatic 3-hydroxy-3-methylglutarly-coenzyme A (HMG-Coa) reductase inhibitors (statins)

Antihyperlipidemic meds (2)

Cholesterol absorption inhibitor

Antihyperlipidemic meds (3)

Bile-acid sequestrants

Antihyperlipidemic meds (4)

Fibrates

Antihyperlipidemic meds (5)

Monoclonal antibodies

Antihyperlipidemic meds (6)

Nicotinic Acid

HMG CoA reductase inhibitors (statins) meds (1)

Atorvastatin (Lipitor)

HMG CoA reductase inhibitors (statins) meds (2)

Simvastatin

HMG CoA reductase inhibitors (statins) meds (3)

Lovastatin

HMG CoA reductase inhibitors (statins) meds (4)

Rosuvastatin (crestor)

HMG CoA reductase inhibitors (statins) action....

Decreases LDLs, VLDL, can increase HDLs

HMG CoA reductase inhibitors (statins) med side effects...

hepatotoxicity and myopathy (rhabdomyolysis)

HMG CoA reductase inhibitors (statins) meds nursing consideration...

NO pregnancy or lactation, evening dosing, treat w/ food, GI upset, monitor CK, report muscle aches

Fibrates meds (1)

Gemfibrozil (Lopid)

Fibrates meds (2)

Fenofibrate

Fibrate med action..

decrease in triglyceride levels, increase HDL

Fibrate med administration..

30 minutes before meals 2x daily

Fibrate med side effects...

myopathy, hepatotoxicity, can cause gallstones, higher risk for pancreatitis

Bile Acid Sequestrants meds (1)

Colesevelam (welchol)

Bile Acid Sequestrants meds (2)

Colestipol

Bile Acid Sequestrants meds action...

decrease in LDL cholesterol, can INCREASE triglycerides (contraindicated for trig >500)

Bile Acid Sequestrants meds side effects...

bowel obstruction, severe constipation

Bile Acid Sequestrants meds may be used alone or as an adjunct with...

HMG-CoA reductase inhibitor (atorvastatin)

Cholesterol Absorption inhibitor med

Ezetimibe (Zetia)

Cholesterol Absorption inhibitor med actions..

triggers the liver to increase LDL receptors/ inhibits reabsorption of cholesterol secreted in bile and absorption of cholesterol from food

Cholesterol Absorption inhibitor med side effects..

hepatotoxicity, myopathy, headache, sore throat, rhinorrhea

Cholesterol Absorption inhibitor med considerations...

NO pregnancy or lactation, evening dosing, treat w/ food

Aldosterone tirphosphate-citrate lyase (ACL) inhibitor med

Bempedoic acid (nexletol)

Aldosterone tirphosphate-citrate lyase (ACL) inhibitor med action...

prevent cholesterol synthesis in liver, decreased LDLs, USED WITH STATINS OR IT CAN'T USE STATIN

Aldosterone tirphosphate-citrate lyase (ACL) inhibitor med side effects...

hepatotoxicity, nephrotoxicity, TENDON RUPTURE, myopathy, gout

Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody inhibitors meds (1)

Alirocumab (praluent)

Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody inhibitors meds (2)

Evolocumab

Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody inhibitors meds action...

DECREASES LDLs

Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody inhibitors meds side effects..

EVOLOCUMAB: LATEX SENSITIVITY (PREFILLED SYRINGE)

Proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody inhibitors med nursing considerations....

check allergies and give SQ

Short interfering RNA (siRNA) med

Inclisiran (Leqvio)

Short interfering RNA (siRNA) med action..

reduces PCSK9 proteins, enhance CHOL elimination, lower LDL

Short interfering RNA (siRNA) med side effects...

SEVERE RASH (REPORT)

Short interfering RNA (siRNA) med considerations...

SQ injection given 3 months apart x2 loading dose, then Q6 months

Antianginal drugs (1)

Nitroglycerine (NTG)

Antianginal drugs (2)

sublingual tablet

Antianginal drugs (3)

ointment

Antianginal drugs (4)

patch

Antianginal drugs (5)

spray