Drugs: Pharm Exam III
Dabigatran: direct thrombin inhibitor (anticoagulant)
o MOA: directly blocks thrombin actions
o Indications: non-valvar afib. OR thromboembolic events, given
when heparin is inappropriate or history of HIT
o Contraindications: internal bleeding, elevated aPTT, mechanical
heart valves, caution with renal disease, GI ulcers, recent
trauma/surgery
o Route: PO
o Onset: 30-90 min
o DOA: half-life 12-17 hrs.
o Adverse effects: bleeding, hypersensitivity, dyspepsia and
gastritis
o Category: C
Heparin: indirect thrombin inhibitor (anticoagulant)
o MOA: indirectly blocks thrombin by activating anti-thrombin III
o Indications: MI or stroke, DVT, PE, unstable angina, thrombosis
prevention in patients with high risk
o Contraindications: active internal bleeding, hemorrhage,
bacterial endocarditis, severe HTN, recent trauma or surgery
o Route: IVPB, SQ
o DOA: 8-12 hrs., half-life of 90min
o Onset: IV immediate, SQ 30-60min
, o Adverse effects: HIT (heparin-induced thrombocytopenia that
triggers the immune system and drops platelet count), abnormal
bleeding, hypersensitivity, long term: osteoporosis, SQ: skin
lesions
o Category: C
Zafirlukast: leukotriene modifier
o MOA: blocks leukotriene receptors in airways
o Indications: prophylaxis of chronic, persistent asthma, allergic
rhinitis, prevention of exercise-induced bronchospasm
o Contraindications: hypersensitivity, caution w/ pre-existing
hepatic impairment
o Route: PO
o DOA: half-life 10 hrs.
o Onset: 1 week
o Adverse effects: headache
o Category: B
Azathioprine: cytotoxic agent & antimetabolite immunosuppressant
o MOA: either kill B and T cells directly or restrict replication
o Indications: prophylaxis of kidney transplant rejection, severe
RA, Crohn’s, autoimmune hepatitis, MG, SLE, UC
o Contraindications: caution with hepatic impairment
o Route: PO, IV
o DOA: half-life 3 hrs.
o Onset: 7-14 days
o Adverse effects: bone marrow suppression (WBCs are
destroyed), hepatotoxicity, N/V, high risk of cancer/infection
o Category: D
2
Dabigatran: direct thrombin inhibitor (anticoagulant)
o MOA: directly blocks thrombin actions
o Indications: non-valvar afib. OR thromboembolic events, given
when heparin is inappropriate or history of HIT
o Contraindications: internal bleeding, elevated aPTT, mechanical
heart valves, caution with renal disease, GI ulcers, recent
trauma/surgery
o Route: PO
o Onset: 30-90 min
o DOA: half-life 12-17 hrs.
o Adverse effects: bleeding, hypersensitivity, dyspepsia and
gastritis
o Category: C
Heparin: indirect thrombin inhibitor (anticoagulant)
o MOA: indirectly blocks thrombin by activating anti-thrombin III
o Indications: MI or stroke, DVT, PE, unstable angina, thrombosis
prevention in patients with high risk
o Contraindications: active internal bleeding, hemorrhage,
bacterial endocarditis, severe HTN, recent trauma or surgery
o Route: IVPB, SQ
o DOA: 8-12 hrs., half-life of 90min
o Onset: IV immediate, SQ 30-60min
, o Adverse effects: HIT (heparin-induced thrombocytopenia that
triggers the immune system and drops platelet count), abnormal
bleeding, hypersensitivity, long term: osteoporosis, SQ: skin
lesions
o Category: C
Zafirlukast: leukotriene modifier
o MOA: blocks leukotriene receptors in airways
o Indications: prophylaxis of chronic, persistent asthma, allergic
rhinitis, prevention of exercise-induced bronchospasm
o Contraindications: hypersensitivity, caution w/ pre-existing
hepatic impairment
o Route: PO
o DOA: half-life 10 hrs.
o Onset: 1 week
o Adverse effects: headache
o Category: B
Azathioprine: cytotoxic agent & antimetabolite immunosuppressant
o MOA: either kill B and T cells directly or restrict replication
o Indications: prophylaxis of kidney transplant rejection, severe
RA, Crohn’s, autoimmune hepatitis, MG, SLE, UC
o Contraindications: caution with hepatic impairment
o Route: PO, IV
o DOA: half-life 3 hrs.
o Onset: 7-14 days
o Adverse effects: bone marrow suppression (WBCs are
destroyed), hepatotoxicity, N/V, high risk of cancer/infection
o Category: D
2
