Methodical instructions
of practice for students of pharmacy department
LESSON № 16 (practical classes – 6 hours)
Theme:
PREPARATIONS INFLUENCE ON THE BLOOD SYSTEM–1: (Ferri lactas, Ferri sulfas, Ferrum Lek, Fercoven, Hemostimulinum, Cyanocobalaminum, Acidum folicum, Pentoxilum, Natrii nucleas, Methyluracilum, Leukogenum, Molgramostinum (leikomax), Natrii phosphas Р32) – 3 hours
PREPARATIONS INFLUENCE ON THE BLOOD SYSTEM –2: (Vicasolum, Fibrinogenum, Etamzilatum, Hemostatic sponge, Thrombinum, Calcii chloridum, Heparinum, Fraxiparine, Protamini sulfas, Neodicumarinum, Phenilinum, Acidum acetylsalicilicum, Dipyridamolum, Ticlopidin (Ticlid), Pentoxiphillinum) – 4 hours
Aim: to memorize the pharmacokinetic and Pharmacodynamics effects of hematological agents, their clinical usage and complications.
Professional motivation
Anemia is a clinical sign; its use as a diagnostic term requires an understanding of its mechanism or essential nature. Its clinical symptoms depend upon the severity and duration of the anemia. Severe anemia can be associated with weakness vertigo, headache, tinnitus spots before the eyes, lasses of fatigue, drowsiness irritability, and ever bizarre behave. One of the most critical clinical lessons in the management of anemia’s is that therapy should be specific, depending on cause of anemia.
Agents used to prevent or contract pathologic intravascular clotting consist of anticoagulants (notably heparin and vitamin K antagonists), thrombolytic agents. And drugs that impair platelet function.
1. Student’s Independent Study Program
Theme № 1 – 2. Preparations influence on the blood system
1. Classification of preparation influencing on the blood system.
2. Pharmacokinetic and Pharmacodynamics of iron preparations, their usage, side effects Cobalt containing drugs.
3. Agents used for megaloblastic and macrocytic anemias, mechanism of their action.
4. Pharmacologic characteristic leucopoiesis stimulators, their usage; side effects.
5. Agents used for hemoblastosis treatment, mechanism of action. Uses and side effects.
6. Pharmacology and uses of homeostatic.
7. Pharmacodynamics, mechanism of action and uses of heparin, complications, blood coagulation control.
8. Pharmacologic characteristic features of oral anticoagulants, uses, compilation’s/ their antagonists
9. Mechanism of fibrinolitic activity of streptoliasum. Principle of contricalum and acidum aminocaproninicum action during activation of fibrinolisis.
10. Mechanism of action and uses of antiagregants.
2. Example of control task.
A. Patients with normal platelet counts and normal bleeding time may still bleed severely as a result of aspirin ingestion prior to a dental or surgical procedure. The aspirin interference with normal platelet function may last as long as:
1. 4 hours
2. 12 hours
3. 2 days
4. 5 days
5. 7 days
B. Which of the following drugs is oral anticoagulant:
1. Aspirin (asidum acetylsalicylicum)
2. Heparin
3. Fibrinogen
4. Acidum folicum
5. Phenylinum
C. Which of the following substances are most likely to treatment of megaloblastic anemia?
1. folic acid and vitamin B12
2. folic acid and vitamin B6
3. acetylsalicylic acid and vitamin B12
4. acetylsalicylic acid and vitamin B6
5. folic acid and acetylsalicylic acid
D. What anticoagulant prevent coagulation of blood in vivo and in vitro?
1. Neodicumarinum
2. Syncumar
3. Phenylinum
4. Heparin
5. Acidum acetylsalicylicum
E. After the usage of heparin the rectal bleeding in patient is appiried. Which of the following drugs can be used for the reducing of anticoagulant activity?
1. Protamini sulfas
2. Thrombin
3. Atropini sulfas
4. Calcii chloridum
5. Adrenalini hydrochloridum
Real-life situation. For the treatment of venous thrombotic disease continuous infusion of heparin was prescribed. Acute hemorrhage as a complication of heparin administration occurred. What antidote must be prescribed?
3. Correct answers for the control task
A –5; B – 5; C-1; D – 4; E –3
Protamine sulfate
4. References:
1. Pharmacology at your palms: reference book / Drogovoz S.M., Kutsenko T.A. – Kharkiv: NPhaU, 2008. – 80 p.
2. Pharmacology secrets / edited by Patricia K. Anthony. – Hanley Belfus, INC/ – Philadelphia, 2002. – 305 p. www.hanleyandbelfus.com
3. Rang and Dale’s Pharmacology / H.P. Rang, M.M. Dale, J.M. Ritter, R.J. Flower // Churchill Livingstone, 2007. – 829 p. www.studentconsult.com
4. Tripathi K.D. Essentials of medical pharmacology 6 th Edition. – Jaypee Brothers Medical Publishers (P) LTD New Delhi, 2008. – 875 p.
5. Stefanov O., Kucher V. Pharmacology with general prescription. – Kiev, 2004. – 150 p.
6. Multimedia lectures from pharmacology for 3d course students
7. http://intranet.tdmu.edu.ua/ukr/kafedra/index.php?kafid=pharm&lengid=eng
5. Students’ Practical Activities
900-1200 in case of 6-hours practical classes
Theme № 1 – 2. PREPARATIONS INFLUENCE ON THE BLOOD SYSTEM
Write out the prescriptions in the protocol copybook, their pharmacological group and clinical usage for the following drugs: Ferro lactase, Fercovenum, Coamidum, Acidum folicum, Ferrum Lek, Pentaxylum, Methyluracilum, Natrii nucleinas, Mercaptopurinum, Metotrexatum, Vinblastinum, Mielosanum, Chlorbutinum, Vicasolum, Fibrunogenum, Ihrombikum, Calcii chloridum, Heparinum, Neodicumarinum, Phenylinum, Streptoliasum, Acidum aminocapronicum, Dipyridamolum, acidum acetylsalicylicum.
Answer the following questions in the protocols:
1. Why are folic acid and vitamin B12 both for megaloblastic anemias treatment?
2. What are the ways of cyanocobalamini injections?
3. What is the drug anticoagulants the coumarin derivatives?
4. Does have neodicumarine anticoagulantive activity in vitro? heparine?
5. What is the mechanism of streptoliase fibrinolitic acto?
6. What is the mechanism of antiagregants action?
7. Haw you can control the effectiveness of anticoagulants therapy?
8. For treatment of what kinds of bleeding thrombin is used for treatment of?
9. What are the ways of heparine injection?
I Choose the correct answer / statement and write down in your protocol copybook:
1) True statements about the purini analog 6-mercaptopurine include which of the following?
1. it is a structural analog of hypoxanthine
2. it decreases the synthesis of 5-phosphoribosylamine
3. it interferes with the formation of adenylosuccinic acid
4. its metabolism is stimulated by allopurinol
5. it is a structural analog ofpurine
2) All of the following statements about drugs for iron-deficiency anemia re true EXEPT:
1. Oral iron preparations contain ferrous iron
2. Iron dextran contains ferric iron
3. Ferrous sulfate is the drug of choice for iron-deficiency anemia
4. Ferrous sulfate contains more that 90 % elemental iron
5. Diarrhea or constipatiob can occur with oral iron preparations
Real-life situation to be solved: patient with acute myocardial infarction intravineous injection of antocoaguland was prescribed. After a few days capillar bluding appeared. What drug was prescribed?
IV. Get acquainted with thematic medicine collection.
6. Discussion of basic questions
1230 – 1400 in case of 6 – hour’s practical classes
7. Students must know:
1. Classification of preparation influencing on the blood system.
2. Pharmacokinetic and Pharmacodynamics of iron preparations, their usage, side effects Cobalt containing drugs.
3. Agents used for megaloblastic and macrocytic anemia’s, mechanism of their action.
4. Pharmacologic characteristic leukopoesis stimulators, their usage; side effects.
5. Agents used for hemoblastosis treatment, mechanism of action. uses and side effects.
6. Pharmacology and uses of homeostatic.
7. Pharmacodynamics, mechanism of action and uses of heparin, complections, blood coagulation control.
8. Pharmacologic characteristic features of oral anticoagulants, uses, compilation’s/ their antagonists
9. Mechanism of fibrinolitic activity of streptoliasum. Principle of contricalum and acidum aminocaproninicum action during activation of fibrinolisis.
10. Mechanism of action and uses of antiagregants.
8. Students should be able to: choose the drug in correspondent medicinal form for injection, write out the prescription for solution for injection, for drugs in liquid medicinal forms, make a choice of different above-mentioned drugs in real-life situations, know the measures to prevent their adverse effects, write out the prescriptions for these drugs in different pharmaceutical forms.
Methodical instructions were prepared by Nakonechna S.S., Volska A.S.
Discussed and adopted at chair-sitting of Pharmacology department
with Clinical pharmacology
04 January 2013, minute № 7
Readopted at chair-sitting of Pharmacology department
with Clinical pharmacology
___ __________200__, minute № __
