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Chapter 12: Hematologic Drugs 1. Blood coagulates to form a blood clot through a complex series of steps involving all of the following EXCEPT ______. a. clotting factors b. platelets c. white blood cells d. thromboplastin Answer: c. white blood cells Correct Feedback: White blood cells are not involved in the process of blood clotting. Blood coagulates to form a blood clot through a complex cascading series of steps involving clotting factors, thromboplastin, and platelets. The clotting factors eventually produce thrombin, then fibrinogen, and finally strands of fibrin. These strands trap red blood cells, and this forms a clot. a. clotting factors Incorrect Feedback: Clotting factors are involved in the steps of blood clotting. b. platelets Incorrect Feedback: Platelets are involved in the steps of blood clotting. d. thromboplastin Incorrect Feedback: Thromboplastin is involved in the steps of blood clotting. 2. Warfarin (Coumadin, Jantoven) differs from heparin in that warfarin is _______. a. measured in milligrams and given intravenously b. measured in milligrams and given orally c. measured in units and given intravenously d. measured in units and given orally Answer: b. measured in milligrams and given orally Correct Feedback: Warfarin (Coumadin, Jantoven) is measured in milligrams (mg) and is given orally. It is heparin that is always measured in units and given subcutaneously or intravenously. a. measured in milligrams and given intravenously Incorrect Feedback: Warfarin is not given intravenously. c. measured in units and given intravenously Incorrect Feedback: Warfarin is not measured in units and it is not given intravenously. d. measured in units and given orally Incorrect Feedback: Warfarin is not measured in units. 3. ________ drugs bind to fibrin strands in the clot, convert plasminogen in the clot to plasmin (fibrinolysin); the plasmin lyses, or breaks the clot apart. a. Anticoagulant b. Platelet aggregation inhibitor c. Thrombin inhibitor d. Thrombolytic Answer: d. Thrombolytic Correct Feedback: Thrombolytic drugs bind to fibrin strands in the clot and then convert plasminogen in the clot to plasmin. Plasmin (also known as fibrinolysin) is an enzyme that lyses fibrin. As the fibrin strands break apart, the clot dissolves. a. Anticoagulant Incorrect Feedback: Anticoagulant drugs do not bind to fibrin strands. b. Platelet aggregation inhibitor Incorrect Feedback: Platelet aggregation inhibitor drugs do not bind to fibrin strands. c. Thrombin inhibitor Incorrect Feedback: Thrombin inhibitor drugs do not bind to fibrin strands. 4. The formation of many clotting factors is dependent on the presence of ______. a. fibrin b. plasminogen c. thrombin d. vitamin K Answer: d. vitamin K Correct Feedback: The formation of many clotting factors is dependent on the presence of vitamin K. a. fibrin Incorrect Feedback: Fibrin is involved in the formation of a blood clot, not in the formation of clotting factors. b. plasminogen Incorrect Feedback: Plasminogen is involved in the formation of a blood clot, not in the formation of the clotting factors. c. thrombin Incorrect Feedback: Thrombin is involved in the formation of a blood clot, not in the formation of clotting factors. 5. Heparin is composed of large molecules that are not easily absorbed, and so only about ________ percent of a dose exerts a therapeutic effect. a. 0 to 10 b. 20 to 30 c. 40 to 50 d. 50 to 60 Answer: b. 20 to 30 Correct Feedback: Heparin is composed of large molecules that are not easily absorbed, and so only about 20 to 30 percent of a dose of heparin exerts a therapeutic effect. a. 0 to 10 Incorrect Feedback: This is not correct. c. 40 to 50 Incorrect Feedback: This is not correct. d. 50 to 60 Incorrect Feedback: This is not correct. 6. Heparin is always measured in ________. a. grains b. milligrams c. milliliters d. units Answer: d. units Correct Feedback: Heparin is always measured in units. a. grains Incorrect Feedback: Heparin is not measured in grains. b. milligrams Incorrect Feedback: Heparin is not measured in milligrams. c. milliliters Incorrect Feedback: Heparin is not measured in milliliters. 7. While she was in the hospital, Renee Waters was receiving subcutaneous heparin administered by a nurse. Now that she is being discharged home, the physician has switched her to what other drug? a. an intravenous anticoagulant drug Incorrect Feedback: Intravenous anticoagulant drugs are not appropriate for a home setting. b. intravenous heparin Feedback: Intravenous heparin is not appropriate for a home setting. c. an oral anticoagulant drug Correct Feedback: Patients receiving subcutaneous heparin administered by a nurse in a hospital are switched to an oral anticoagulant drug before being discharged home. d. oral heparin Incorrect Feedback: Heparin cannot be administered orally, only intravenously or subcutaneously. 8. Some platelet aggregation inhibitor drugs block a receptor (glycoprotein IIb/IIIA) on the platelets to prevent platelets from binding to ________. a. cellulose b. plasminogen (clotting factor II) c. fibrinogen (clotting factor I) d. vitamin K Answer: c. fibrinogen (clotting factor I) Correct Feedback: Some platelet aggregation inhibitor drugs block a receptor (glycoprotein IIb/IIIa) on the platelets to prevent platelets from binding to fibrinogen (clotting factor I). a. cellulose Incorrect Feedback: Platelet aggregation inhibitor drugs do not affect cellulose. b. plasminogen (clotting factor II) Incorrect Feedback: Platelet aggregation inhibitor drugs do not affect plasminogen. d. vitamin K Incorrect Feedback: Platelet aggregation inhibitor drugs do not affect vitamin K. 9. One cause of anemia is due to a decrease in the ________ in the blood. a. amount of vitamin K b. number of clotting factors c. number of red blood cells d. volume of blood Answer: c. number of red blood cells Correct Feedback: Anemia is a decrease in the number of red blood cells produced by the red bone marrow. a. amount of vitamin K Incorrect Feedback: Vitamin K plays a role in blood clotting, not anemia. b. number of clotting factors Incorrect Feedback: Clotting factors play a role in blood clotting, not anemia. d. volume of blood Incorrect Feedback: The volume of blood is not the cause of anemia. 10. Anticoagulant drugs are used to ________ a blood clot. a. dissolve b. enhance c. prevent d. treat Answer: c. prevent Correct Feedback: Anticoagulant drugs are used to prevent a blood clot. a. dissolve Incorrect Feedback: Anticoagulant drugs cannot dissolve a blood clot. b. enhance Incorrect Feedback: Anticoagulant drugs do not enhance a blood clot. d. treat Incorrect Feedback: Anticoagulant drugs cannot treat a blood clot. 11. The first anticoagulant drug was ______. a. folic acid b. heparin c. streptokinase d. warfarin Answer: b. heparin Correct Feedback: The first anticoagulant drug was heparin. a. folic acid Incorrect Feedback: Folic acid was not the first anticoagulant drug. c. streptokinase Incorrect Feedback: Streptokinase is not an anticoagulant drug. d. warfarin Incorrect Feedback: Warfarin was not the first anticoagulant drug. 12. The platelet aggregation inhibitor drug dipyridamole (Persantine) is given along with other anticoagulant drugs to preventing platelets from _______. a. adhering to artificial heart valves b. forming blood clots after a myocardial infarction c. causing anemia d. depleting levels of vitamin K Answer: a. adhering to artificial heart valves Correct Feedback: Dipyridamole is given in conjunction with other anticoagulant drugs to enhance their effectiveness by specifically preventing platelets from adhering to artificial heart valves. b. forming blood clots after a myocardial infarction Incorrect Feedback: Dipyridamole does not keep blood clots from forming after a myocardial infarction. c. causing anemia Incorrect Feedback: Platelets do not cause anemia. d. depleting levels of vitamin K Incorrect Feedback: Platelets do not deplete levels of vitamin K. 13. Cathflo Activase is used to _______. a. break up a clot that has formed in a urinary catheter b. break up a clot that has formed within a central venous catheter c. prevent a clot from forming in a urinary catheter d. prevent a blood clot from forming within in a central venous catheter Answer: b. break up a clot that has formed within a central venous catheter Correct Feedback: Cathflo Activase is used to break up a blood clot that has formed within a central venous catheter. a. break up a clot that has formed in a urinary catheter Incorrect Feedback: Cathflo Activase is not used in urinary catheters. c. prevent a clot from forming in a urinary catheter Incorrect Feedback: Cathflo Activase does not prevent blood clots from forming. d. prevent a blood clot from forming within in a central venous catheter Incorrect Feedback: Cathflo Activase does not prevent blood clots from forming. 14. Thrombolytic enzyme drugs or tissue plasminogen (tPA) drugs are given at the time of a _______ to dissolve a blood clot that has already formed. a. myocardial infarction Incorrect Feedback: This is true, but it is not the only correct statement. b. stroke Incorrect Feedback: This is true, but it is not the only correct statement. c. pulmonary embolism Incorrect Feedback: This is true, but it is not the only correct statement. d. all of the above Answer: d. all of the above Correct Feedback: Thrombolytic enzyme drugs and tissue plasminogen activator (tPA) drugs are given at the time of a myocardial infarction, stroke, or pulmonary embolism to dissolve a blood clot that has already formed in the coronary artery or within arteries to the brain or lung. a. myocardial infarction Incorrect Feedback: This is true, but it is not the only correct statement. b. stroke Incorrect Feedback: This is true, but it is not the only correct statement. c. pulmonary embolism Incorrect Feedback: This is true, but it is not the only correct statement. 15. Anemia can be due to insufficient amounts of all of the following EXCEPT ______. a. folic acid b. iron c. thrombin d. vitamin B12 Answer: c. thrombin Correct Feedback: Thrombin is part of the clotting process, not the production of red blood cells. Anemia is a decrease in the number of red blood cells (erythrocytes) produced by the red bone marrow. This can be due to insufficient amounts of amino acids, folic acid, iron, or vitamin B12, all which are needed to form red blood cells. a. folic acid Incorrect Feedback: Anemia can be due to insufficient amounts of folic acid. b. iron Incorrect Feedback: Anemia can be due to insufficient amounts of iron. d. vitamin B12 Incorrect Feedback: Anemia can be due to insufficient amounts of iron. 16. All of the following statements about protamine sulfate are FALSE? a. Protamine sulfate is a low molecular weight heparin drug. b. Protamine sulfate is used to treat a heparin overdose. c. Protamine sulfate is a heparin antagonist drug. d. Protamine sulfate neutralizes the anticoagulant effect of heparin. Answer: a. Protamine sulfate is a low molecular weight heparin drug. Correct Feedback: Protamine sulfate is a heparin antagonist drug that binds with heparin to neutralize its anticoagulant effect. This drug is used to treat a heparin overdose or reverse the therapeutic effect of heparin administered during surgery. b. Protamine sulfate is used to treat a heparin overdose. Incorrect Feedback: This statement is true. c. Protamine sulfate is a heparin antagonist drug. Incorrect Feedback: This statement is true. d. Protamine sulfate neutralizes the anticoagulant effect of heparin. Incorrect Feedback: This statement is true. 17. All of the following drugs are able to dissolve a blood clot EXCEPT ______. a. darbepoetin alfa (Aranesp) b. alteplase (Activase, Cathflo Activase) c. reteplase (Retavase) d. tenecteplase (TNKase) Answer: a. darbepoetin alfa (Aranesp) Correct Feedback: Darbepoetin alfa is an erythropoietin-like drug created with recombinant DNA technology; like natural erythropoietin (a hormone produced by the kidneys), it stimulates red blood cell production and is used to treat various types of anemia, not dissolve a blood clot. All of the other drugs end in the suffix –ase and are either thrombolytic enzyme drugs or tPA drugs that can dissolve a blood clot. b. alteplase (Activase, Cathflo Activase) Incorrect Feedback: Alteplase (Activase, Cathflo Activase) can dissolve a blood clot. c. reteplase (Retavase) Incorrect Feedback: Reteplase (Retavase) can dissolve a blood clot. d. tenecteplase (TNKase) Incorrect Feedback: Tenecteplase (TNKase) can dissolve a blood clot. 18. _________ is the only one of the original thrombolytic enzyme drugs that is still on the market. a. Bivalirudin (Angiomax) b. Tirofiban (Aggrastat) c. Streptokinase (Streptase) d. Folic acid (Folvite) Answer: c. Streptokinase (Streptase) Correct Feedback: The only original thrombolytic enzyme drugs still on the market is streptokinase. a. Bivalirudin (Angiomax) Incorrect Feedback: Bivalirudin (Angiomax) is not a thrombolytic enzyme drug. b. Tirofiban (Aggrastat) Incorrect Feedback: Tirofiban (Aggrastat) is not a thrombolytic enzyme drug. d. Folic acid (Folvite) Incorrect Feedback: Folic acid (Folvite) is not a thrombolytic enzyme drug. 19. Which of the following statements is FALSE? a. Blood clots formed in arteries are mainly composed of platelet clumps. b. Units of whole blood and blood products (plasma, packed red blood cells, clotting factors) are used to treat anemia and hemophilia. c. Blood clots formed in veins are mainly composed of fibrin and red blood cells. d. A prescription written for the generic drug warfarin could be filled with either of the trade name drugs of Coumadin or Ferro-Sequels. Answer: d. A prescription written for the generic drug warfarin could be filled with either of the trade name drugs of Coumadin or Ferro-Sequels. Correct Feedback: All of the generic drugs that have ferrous or iron in their names are iron supplements that are used to treat iron-deficiency anemia. Coumadin is another trade name for the generic drug warfarin. The pharmacy could have filled the prescription with generic warfarin, Coumadin, or Jantoven. a. Blood clots formed in arteries are mainly composed of platelet clumps. Incorrect Feedback: This is a true statement. b. Units of whole blood and blood products (plasma, packed red blood cells, clotting factors) are used to treat anemia and hemophilia. Incorrect Feedback: This is a true statement. c. Blood clots formed in veins are mainly composed of fibrin and red blood cells. Incorrect Feedback: This is a true statement. 20. All of the following are platelet aggregation inhibitor drugs EXCEPT ______. a. aspirin (Bayer, Ecotrin) b. cyanocobalamin (Cyomin, Nascobal) c. cilostazol (Pletal) d. dipyridamole (Persantine) Answer: b. cyanocobalamin (Cyomin, Nascobal) Correct Feedback: Cyanocobalamin and hydroxycobalamin are vitamin B12 drugs that are used to treat pernicious anemia. a. aspirin (Bayer, Ecotrin) Incorrect Feedback: Aspirin (Bayer, Ecotrin) is a platelet aggregation inhibitor drug. c. cilostazol (Pletal) Incorrect Feedback: Cilostazol (Pletal) is a platelet aggregation inhibitor drug. d. dipyridamole (Persantine) Incorrect Feedback: Dipyridamole (Persantine) is a platelet aggregation inhibitor drug. 21. All of the generic drugs that have _______ or iron in their name are iron supplements that are used to treat iron deficiency anemia. a. aggregation b. inhibitor c. enzyme d. ferrous Answer: d. ferrous Correct Feedback: All of the generic drugs that have ferrous or iron in their names are iron supplements that are used to treat iron deficiency anemia. a. aggregation Incorrect Feedback: The word aggregation is not in the generic name of iron supplement drugs. b. inhibitor Incorrect Feedback: The word inhibitor is not in the generic name of iron supplement drugs. c. enzyme Incorrect Feedback: The word enzyme is not in the generic name of iron supplement drugs. 22. The suffix ________ is common to generic name heparin and low molecular weight heparin drugs. a. –rudin b. –parin c. –cel d. all of the above Answer: b. –parin Correct Feedback: The suffix –parin is common to generic name heparin and low molecular weight heparin drugs. a. –rudin Incorrect Feedback: The suffix –rudin is not common to generic name heparin drugs. c. –cel Incorrect Feedback: The suffix –cel is not common to generic name heparin drugs. d. all of the above Incorrect Feedback: There is only one correct answer. 23. Hemophilia A is ________. a. the most common type of hemophilia b. caused by the hemophilia gene carried by the mother c. caused by the lack of clotting factor VIII d. all of the above Answer: d. all of the above Correct Feedback: Hemophilia A, caused by a lack of clotting factor VIII, is the most common type of hemophilia. The mother is the carrier of the hemophilia gene. a. the most common type of hemophilia Incorrect Feedback: This is true, but it is not the only correct statement. b. caused by the hemophilia gene carried by the mother Incorrect Feedback: This is true, but it is not the only correct statement. c. caused by the lack of clotting factor VIII Incorrect Feedback: This is true, but it is not the only correct statement. 24. Which of the following statements about low molecular weight heparins is FALSE? a. Low molecular weight heparins are prepared from cows’ or pigs’ intestines. b. Some low molecular weight heparins are measured in units and some are measured in milligrams. c. Low molecular weight heparins have a larger molecular size than heparin. d. Low molecular weight heparins were created from the original heparin molecule. Answer: c. Low molecular weight heparins have a larger molecular size than heparin. Correct Feedback: Low molecular weight heparins (LMWH), such as dalteparin, enoxaparin, and tinzaparin, were created by breaking apart the heparin molecule and decreasing the size of the molecule. Dalteparin and tinzaparin are measured in units (like heparin), but enoxaparin is measured in milligrams (mg). Low molecular weight heparins are given subcutaneously. Both heparin and low molecular weight heparins are prepared from cows’ or pigs’ intestines. a. Low molecular weight heparins are prepared from cows’ or pigs’ intestines. Incorrect Feedback: This statement is true. b. Some low molecular weight heparins are measured in units and some are measured in milligrams. Incorrect Feedback: This statement is true. d. Low molecular weight heparins were created from the original heparin molecule. Incorrect Feedback: This statement is true. 25. All of the following anticoagulant drugs can be given orally EXCEPT ________. a. heparin b. Coumadin c. warfarin d. all of the above may be given orally Answer: a. heparin Correct Feedback: Heparin is given subcutaneously or intravenously. b. Coumadin Incorrect Feedback: Warfarin (Coumadin) is given orally. c. warfarin Incorrect Feedback: Warfarin (Coumadin) is given orally. d. all of the above may be given orally Incorrect Feedback: One of the drugs cannot be given orally. 26. Patients on long-term anticoagulant drug therapy need to be sure they do not eat too much of which kinds of foods? a. Leafy green vegetables b. beef liver c. soybeans, soy milk, and tofu d. all of the above Answer: d. all of the above Correct Feedback: Patients taking warfarin (Coumadin, Jantoven) for long-term anticoagulant therapy should monitor their dietary intake of certain types of foods. Leafy green vegetables (broccoli, Brussels sprouts, spinach, bok choy, kale, parsley, turnip greens), beef liver, garbanzo beans (chickpeas), and soy products (soybeans, soy milk, tofu) contain large amounts of vitamin K that can decrease the therapeutic effect of an anticoagulant drug. a. Leafy green vegetables Incorrect Feedback: This is true, but it is not the only correct answer. b. beef liver Incorrect Feedback: This is true, but it is not the only correct answer. c. soybeans, soy milk, and tofu Incorrect Feedback: This is true, but it is not the only correct answer. 27. All of the following are thrombin inhibitor drugs EXCEPT ________. a. fondaparinux (Arixtra) b. bivalirudin (Angiomax) c. desirudin (Ipravask) d. lepirudin (Refludan) Answer: a. fondaparinux (Arixtra) Correct Feedback: Factor Xa inhibitor drugs inhibit the action of factor Xa. These drugs include fondaparinux (Arixtra). The other drugs are thrombin inhibitor drugs as shown by their suffix –rudin which is common to generic thrombin inhibitor drugs. b. bivalirudin (Angiomax) Incorrect Feedback: Bivalirudin (Angiomax) is a thrombin inhibitor drug. c. desirudin (Ipravask) Incorrect Feedback: Desirudin (Ipravask) is a thrombin inhibitor drug. d. lepirudin (Refludan) Incorrect Feedback: Lepirudin (Refludan) is a thrombin inhibitor drug. 28. The trade name of the generic drug alteplase is ________. a. Activase b. Mephyton c. Ticlid d. Coumadin Answer: a. Activase Correct Feedback: Altiplase (Activase) is a tissue plasminogen activator drug. b. Mephyton Incorrect Feedback: The trade name of alteplase is not Mephyton. c. Ticlid Incorrect Feedback: The trade name of alteplase is not Ticlid. d. Coumadin Incorrect Feedback: The trade name of alteplase is not Coumadin. 29. All of the following are low molecular weight heparin drugs EXCEPT ________. a. heparin b. tinzaparin (Innohep) c. dalteparin (Fragmin) d. enoxaparin (Lovenox) Answer: a. heparin Correct Feedback: Low molecular weight heparins (LMWH), such as dalteparin, enoxaparin, and tinzaparin, were created by breaking apart the heparin molecule and decreasing the size of the molecule. b. tinzaparin (Innohep) Incorrect Feedback: Tinzaparin (Innohep) is a low molecular weight heparin. c. dalteparin (Fragmin) Incorrect Feedback: Dalteparin (Fragmin) is a low molecular weight heparin. d. enoxaparin (Lovenox) Incorrect Feedback: Enoxaparin (Lovenox) is a low molecular weight heparin. 30. Topical hemostatic drugs control bleeding because they contain any of the following substances EXCEPT ________. a. thrombin b. enzymes c. gelatin d. cellulose Answer: b. enzymes Correct Feedback: Topical hemostatic drugs contain gelatin, collagen fibers, cellulose, fibrin, or thrombin in a liquid sealant or powder form. a. thrombin Incorrect Feedback: Some topical hemostatic drugs do contain thrombin. c. gelatin Incorrect Feedback: Some topical hemostatic drugs do contain gelatin. d. cellulose Incorrect Feedback: Some topical hemostatic drugs do contain cellulose. 31. Anemia can be caused by all of the following EXCEPT ________. a. a lack of vitamin K b. radiation or chemotherapy drugs that damage the bone marrow c. trauma or hemophilia d. increased destruction of red blood cells Answer: a. a lack of vitamin K Correct Feedback: The formation of many clotting factors is dependent on the presence of vitamin K. A lack of vitamin K causes a clotting disorder, not anemia. Anemia can be caused by disease, cancer, radiation, or chemotherapy drugs that damage the red bone marrow where red blood cells are produced. Anemia can also result from excessive blood loss due to trauma or hemophilia. Anemia can also be caused by increased destruction of fragile red blood cells, as in sickle cell anemia. b. radiation or chemotherapy drugs that damage the bone marrow Incorrect Feedback: Radiation or chemotherapy drugs that damage the bone marrow can cause anemia. c. trauma or hemophilia Incorrect Feedback: Anemia can be caused by trauma or hemophilia. d. increased destruction of red blood cells Incorrect Feedback: Anemia can be caused by increased destruction of red blood cells. 32. Which of the following is an example of the drug effect of antagonism? a. changing from intravenous heparin in the hospital to an oral anticoagulant drug upon discharge home b. giving a vitamin K drug to a newborn after birth to prevent hemorrhagic disease c. taking an anticoagulant drug with a meal of leafy green vegetables d. all of the above Answer: c. taking an anticoagulant drug with a meal of leafy green vegetables Correct Feedback: Leafy green vegetables (broccoli, Brussels sprouts, spinach, bok choy, kale, parsley, turnip greens), beef liver, garbanzo beans (chickpeas), and soy products (soybeans, soy milk, tofu) contain large amounts of vitamin K that can decrease the therapeutic effect of an anticoagulant drug. This is known as antagonism. a. changing from intravenous heparin in the hospital to an oral anticoagulant drug upon discharge home Incorrect Feedback: This is not an example of antagonism. b. giving a vitamin K drug to a newborn after birth to prevent hemorrhagic disease Incorrect Feedback: This is not an example of antagonism. d. all of the above Incorrect Feedback: Only one of the answers is an example of antagonism. 33. A platelet aggregation inhibitor drug would be given in all of the following situations EXCEPT ______. a. to prevent hemorrhagic disease after birth b. to prevent a blood clot after a myocardial infarction or stroke c. during angioplasty or cardiac valve surgery d. to prevent a blood clot in patients with acute coronary syndrome Answer: a. to prevent hemorrhagic disease after birth Correct Feedback: A vitamin K drug is given prophylactically to all newborns to prevent hemorrhagic disease of the newborn. Some platelet aggregation inhibitor drugs are used to prevent a blood clot in patients who are undergoing angioplasty, stent placement, or cardiac valve surgery. Others are used to prevent a blood clot in patients who have had a myocardial infarction or stroke, or to treat patients with acute coronary syndrome. b. to prevent a blood clot after a myocardial infarction or stroke Incorrect Feedback: Platelet aggregation inhibitor drugs are used to prevent a blood clot after a myocardial infarction or stroke. c. during angioplasty or cardiac valve surgery Incorrect Feedback: Platelet aggregation inhibitor drugs are used during angioplasty or cardiac valve surgery. d. to prevent a blood clot in patients with acute coronary syndrome Incorrect Feedback: Platelet aggregation inhibitor drugs are used in patients with acute coronary syndrome. 34. In the drugs ferrous fumarate (Ferro-Sequels, Hemocyte) and ferrous gluconate (Fergon), the word ferrous tells you that these drugs contain ______. a. folic acid b. iron c. thrombin d. erythropoietin Answer: b. iron Correct Feedback: All of the generic drugs that have ferrous or iron in their names are iron supplements that are used to treat iron deficiency anemia. a. folic acid Incorrect Feedback: These drugs do not contain folic acid. c. thrombin Incorrect Feedback: These drugs do not contain thrombin. d. erythropoietin Incorrect Feedback: These drugs do not contain erythropoietin. 35. The liver produces clotting factors I through X. Answer: False Feedback: The liver produces clotting factors I through XIII. 36. Heparin inhibits clotting factor XIII in the liver, which stops the series of steps needed to form a blood clot. Answer: False Feedback: Heparin inhibits clotting factor X in the blood, which stops the series of steps needed to form a blood clot. 37. Heparin can only be given subcutaneously or intravenously. Answer: True Feedback: Heparin is given subcutaneously or intravenously. 38. Platelet aggregation inhibitor drugs prevent platelets from adhering to the site of injury or from clumping together to begin the formation of a clot. Answer: True Feedback: Platelet aggregation inhibitor drugs keep platelets from adhering to the site of injury and clumping together. 39. Platelet aggregation inhibitor drugs are classified under the larger category of anticoagulant drugs. Answer: True Feedback: Anticoagulant drugs include heparin and low molecular weight heparins, warfarin, platelet aggregation inhibitor drugs, thrombin inhibitor drugs, and factor Xa inhibitor drugs. 40. Thrombin inhibitor drugs bind to receptors on both circulating thrombin and thrombin already incorporated in a blood clot. Answer: True Feedback: Thrombin inhibitor drugs inhibit the action of thrombin. They bind to receptor sites on both circulating thrombin and thrombin already incorporated in a blood clot. 41. Factor Xa inhibitor drugs have no effect on thrombin or platelets. Answer: True Feedback: Factor Xa inhibitor drugs inhibit the action of factor Xa, a subset of clotting factor X, in the blood. They have no effect on thrombin or platelets. 42. Anticoagulant drugs can prevent blood clots from forming, prevent blood clots from enlarging, and are effective in dissolving blood clots once they have formed. Answer: False Feedback: Anticoagulant drugs are used to prevent a blood clot. Anticoagulant drugs can only prevent blood clots from forming (or enlarging once they are formed), but are not effective in dissolving blood clots. 43. Topical hemostatic drugs are applied topically during surgery or dental procedures to control bleeding. Answer: True Feedback: Topical hemostatic drugs are applied topically during surgery or dental procedures to control bleeding. 44. Hemophilia is an inherited genetic abnormality that causes a deficiency of a specific clotting factor. Answer: True Feedback: Hemophilia is an inherited genetic abnormality that causes a deficiency of a specific clotting factor. 45. The drug Coagulin-B is the actual cellular gene that directs the liver to produce clotting factor IX. Answer: True Feedback: The drug Coagulin-B is the actual cellular gene that directs the liver to produce clotting factor IX. 46. The anticoagulant drug warfarin blocks vitamin C to keep the liver from producing clotting factors. Answer: False Feedback: The anticoagulant drug warfarin blocks vitamin K and keeps the liver from producing clotting factors that are dependent on the presence of vitamin K. 47. Thrombolytic enzyme drugs revolutionized the treatment of myocardial infarction and stroke because they were the first drugs that could actually dissolve a clot. Answer: True Feedback: Thrombolytic enzyme drugs were the first drugs that could actually dissolve a clot. Their appearance revolutionized the treatment of myocardial infarction and stroke. 48. Darbepoetin alfa, epoetin alfa, and epoetin beta are erythropoietin-like drugs created with recombinant DNA technology. Answer: True Feedback: Darbepoetin alfa, epoetin alfa, and epoetin beta are erythropoietin-like drugs created with recombinant DNA technology. 49. The anticoagulant drug warfarin (Coumadin) can dissolve clots that have already formed. Answer: False Feedback: Anticoagulant drugs can only prevent blood clots from forming (or enlarging once they are formed), but are not effective in dissolving blood clots. 50. A saline or heparin lock is a special device that allows intravenous access for administering intravenous drugs without the need to have intravenous fluids running continuously. Answer: True Feedback: A saline or heparin lock is a special device that allows intravenous access for administering intravenous drugs without the need to have intravenous fluids running continuously. 51. Factor Xa inhibitor drugs are used to prevent blood clots in patients undergoing joint replacement surgery or abdominal surgery. Answer: True Feedback: Factor Xa inhibitor drugs are used to prevent or treat deep venous thrombosis or pulmonary embolism in patients undergoing joint replacement surgery or abdominal surgery. 52. Anticoagulant drugs are given during hemodialysis to treat patients with chronic kidney failure. Answer: True Feedback: Anticoagulant drugs are also used to provide anticoagulation during hemodialysis for patients with chronic renal failure. 53. Platelets stick to damaged tissue to form clumps, and this process is known as platelet __________. Answer: aggregation Feedback: Platelets stick to the damaged and injured tissue to form clumps, a process known as platelet aggregation. 54. The suffix __________ (which means enzyme) is common to both the generic and trade names of thrombolytic drugs. Answer: –ase Feedback: The suffix –ase (which means enzyme) is common to both the generic and trade names of thrombolytic drugs. 55. Thrombolytic enzyme drugs and tPA drugs are used to __________ (break apart) a blood clot once it has formed. Answer: lyse Feedback: Thrombolytic enzyme drugs and tPA drugs are used to lyse (break apart) a blood clot once it has formed. 56. The chemical symbol for iron is ______. Answer: Fe Feedback: The chemical symbol for iron is Fe. 57. Define these abbreviations. DVT ________ LMWH _________ tPA _________ Answer: deep venous thrombosis, low molecular weight heparin, tissue plasminogen activator. 58. 1. clopidogrel (Plavix) A. erythropoietin-like drug for anemia 2. absorbable gelatin (Gelfoam) inhibitor B. combination drug platelet aggregation 3. Aggrenox C. factor Xa inhibitor drug 4. bivalirudin (Angiomax) D. drug used to treat hemophilia 5. Coumadin E. low molecular weight heparin drug 6. enoxaparin (Lovenox) F. platelet aggregation inhibitor drug 7. epoetin alfa (Epogen, Procrit) G. thrombin inhibitor drug 8. fondaparinux (Arixtra) H. tissue plasminogen activator drug 9. reteplase (Retavase) I. topical hemostatic drug 10. tranexamic acid (Cyclokapron) J. warfarin Answer: F Answer: I Answer: B Answer: G Answer: J Answer: E Answer: A Answer: C Answer: H Answer: D Feedback: These drugs and their categories are found throughout the chapter. 59. Describe one of the five different ways that anticoagulant drugs work to prevent a blood clot from forming. Answer: Anticoagulant drugs inhibit the action of clotting factors in the blood, or they inhibit the formation of those clotting factors in the liver that require the presence of vitamin K. Other anticoagulant drugs prevent platelets from adhering to the site of injury or prevent platelets from clumping together to begin the formation of a clot. Some other anticoagulant drugs decrease the viscosity (thickness) of the blood and increase red blood cell flexibility to promote the flow of blood. 60. After an injury occurs, the injured tissue starts the clotting process. Any one of the steps involved can be the source of a hematologic drug. Briefly describe the clotting process. Answer: When an injury occurs, the injured tissue releases tissue thromboplastin, and clotting factors in the blood are activated. Platelets stick to the damaged tissue to form clumps, a process known as platelet aggregation. The clotting factors eventually produce thrombin, then fibrinogen, and finally strands of fibrin. These strands trap red blood cells, and this forms a blood clot. Test Bank for Understanding Pharmacology for Health Professionals Susan M. Turley 9780135145708, 9780133911268
