Oral preparations
Ferrous sulfate
Ferrous gluconate
Ferrous fumarate
* Iron is absorbed in the duodenum and proximal ileum,
so it is important that these supplements be taken on
an empty stomach, and not given in enteric-coated
preparations!
Parental preparations
Iron dextran -- used to treat iron def. after GI resections
in IBD involving the proximal bowel.
Iron Chelator
Desferal -- used in iron toxicity
Dihydrofolate reductase inhibitors
Trimethoprim
Pyrimethamine
Methotrexate
Inhibitors of folate absorption
Anticonvulsants
Oral contraceptives
Isoniazid
Platelet aggregators
Collagen
Thromboxane
Thrombin
* Prostacyclin (PGI
2
) is an inhibitor of platelet
aggregation
* White thrombi form in arteries (platelets and fibrin)
* Red thrombi form in veins (mainly fibrin, w/ trapped
platelets and RBCs)
* PTT is used to measure integrity of the intrinsic pathway
* PT is used to measure integrity of the extrinsic pathway
* Intrinsic pathway begins with activation of factor XII
by collagen
* Extrinsic pathway begins with activation of factor VII
by tissue thromboplastin
Protease inhibitors


1
2
-antitrypsin
-macroglobulin

2
-antiplasmin antithrombin III
Platelet inhibitors
Aspirin -- irreversible inhibitor of cyclooxygenase
Ticlopidine -- inhibits ADP-induced platelet aggregation
Dipyridamole -- potentiates the effects of Prostacyclin
Sulfinpyrazone
Anticoagulants
Heparin -- NOT administered IM; only IV or SQ; binds to
antithrombin III & increases its actions; use
to prolong PTT; does not cross placenta
Warfarin -- can be give orally; inhibits Vit. K epoxide
reductase; use to prolong PT; will cross the
placenta
Dextran -- used to prevent postop venous thrombosis
* Heparin overdose is treated with protamine sulfate
* Warfarin overdose is treated with Vitamin K
Drugs that alter Warfarin’s effects
P-450 inducers(attenuate): P-450 inhibitors(potentiate):
Barbiturates
Glutethimide
Griseofluvin
Phenytoin
Amiodarone
Cimetidine
Chloramphenicol
Cotrimoxazole
Disulfiram
Metronidazole
Miconazole
Phenylbutazone
Sulfinpyrazone
Trimethoprim/sulfa
Rifampin
Thrombolytic agents
Tissue plasminogen activator (TPA) -- preferentially
activates plasmin in thrombi, and not
free plasmin
Streptokinase -- activates plasma plasmin
Anistreplase -- also activates plasmin in thrombi and
not free plasmin; longer 1/2-life than the
others
Urokinase -- activates plasma plasmin
Fibrinolytic inhibitors
Antiplasmins
Aminocaproic acid
Tranexamic acid
Hemophilia drugs
Desmopressin acetate
Danazol -- both of these increase factor VIII activity
Corticosteroids

Prednisone -- these are non-toxic to marrow stem cells
Dexamethasone
Cytotoxic agents
Azathioprine -- an antimetabolite; toxicity is augmented
by renal disease and inhibitors of Xanthine oxidase;
will suppress marrow function; used in kidney
transplants
AZT
Cyclophosphamide -- alkylating agent; used in bone
marrow transplantation
Cytarabine
Dactinomycin
Methotrexate -- used in prophylatic treatment of GVH disease
Vincristine
Macrolide antibiotics
Cyclosporin A -- blocks the differentiation & activation rejection;
of T-cells; used to suppress organ
metabolism is blocked by erythromycin
or ketoconazole
Tacrolimus (FK-506) -- used when cyclosporin is too toxic
or ineffective
Anti-T-cell antibody (OKT3) -- used in kidney transplants
Antithymocyte globulin -- used to treat idiopathic aplastic anemia
Antilymphocyte globulin -- activates complement-
Rh
0 mediated destruction of lymphocytes; used in organ transplantation and GVH disease
(D) immune globulin -- Used in prophylactic treatment of Rh hemolytic disease (Erythroblastosis fetalis)
Thymosin -- produced by thymus; induces the maturation
of T-cells; thymosin levels decrease w/ age
Levamisole -- enhances cellular immunity; potential uses
include Hodgkin’s disease and rheumatoid
arthritis
Inosiplex -- enhances T-cell and monocyte cytotoxicity;
may be useful in treatment of AIDS
Interleukins -- work in different ways to stimulate and
suppress leukocyte proliferation and function
Interferons (  ,  ,  ) -- display antiviral properties; IFN has been approved for the treatment of hepatitis and hematologic neoplasms