Pharmacology - Hematology and Oncology

Motion sickness/hyperemesis gravidarum- Antimuscarinics (M1), e.g. scopolamine- Antihistamines (H1), e.g. diphenhydramine, meclizine, promethazine Chemotherapy-induced emesis:- Dopamine receptor antagonists, e.g. prochlorperazine, metoclopramide- Serotonin (5-HT3) receptor antagonists, e.g. ondansetron, granisetron→ Side effects: Headaches, constipation or diarrhea, QT interval prolongation (torsades de pointes), increase in liver enzymes, serotonin syndrome- Neurokinin 1 (NK1) receptor antagonists, e.g. aprepitant, fosaprepitant The vomiting reflex can be activated by hormonal or neuronal stimuli. The area postrema in the fourth ventricle has a chemoreceptor trigger zone that can respond to many neurotransmitters, drugs, or toxins. The nucleus tractus solitarius in the medulla receives information from the area postrema, GI tract via the vagus nerve, vestibular system, and the CNS. Neurons from the NTS coordinate the vomiting process.

Low-molecular-weight heparin Acts predominantly on factor Xa. - Has better bioavailability and 2-4x longer half life than unfractionated heparin. - Can be administered subcutaneously and without laboratory monitoring. 

Low-molecular-weight heparin Acts predominantly on factor Xa. - Has better bioavailability and 2-4x longer half life than unfractionated heparin. - Can be administered subcutaneously and without laboratory monitoring. 

Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.

Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.

Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.

Thrombolytic Directly or indirectly aids conversion of plasminogen to plasmin, which cleaves thrombin and fibrin clots.

ADP receptor inhibitor

Pyrimidine synthesis inhibitor Inhibits the enzyme orotate reductase, which catalyzes the oxidation of dihydroorotic acid (an essential step in pyrimidine synthesis). Side effects:- Hepatotoxicity- Cytopenias

TNF & IL-1 suppressor Indications:- Treatment and prophylaxis of malaria due to P. malariae, P. ovale, or susceptible strains of P. falciparum (not P. vivax)- Rheumatoid arthritis (basic therapy)- Systemic and discoid lupus erythematosus (without organ involvement) Side effects:- Retinopathy

Adalimumab, Certolizumab, Etanercept, Golimumab, Infliximab Side effets:- Infection- Demyelination- Congestive heart failure- Malignancy