Pharmacology: Drugs for Inflamation Flashcards
What is inflamation useful for?
A defensive res[onse to tissue damage designed ot eradicate the the causative agent and iniate the repair process
Acute vs Chronic inflamation
Clinical features of inflamation
- Heat
- Redness
- Swelling
- Pain
Basic categorrisation of anti-inflamatory drugs
Big Families:
- Anti-inflamatories
- Immunosuppressants
Sub Families:
- NSAIDs
- Corticosteroids - belongs to both anti-inflamatory and immunosuppressants
- Other immunosuppressants
Picture just for visual detail but defos don’t need to know it
What does Cox-1 and Cox-2 stand for?
cyclo-oxygenase
How are prostaglandins synthesised?
It is a lipid synthesised from arachindonic-acid by the cyclo-oxygenase enzyme
What do the two main types of prostaglandins do? Which one is turned on the whole time and which one is only synthesised during injury?
The left one is synthesised during injury
The right one is always active
Which Cox’s are responsible for synthesising which prostaglandins?
Which NSAIDs act to inhibit which Cox enzymes and what is the knockon effects
What are the dangers of inhibiting Cox 1?
- Will prevent clotting (can be good, can be bad)
- Will damage the gastric mucosa
- Will constrict blood flow to the kidneys causing kidney injury
What are the dangers of inhibiting Cox 2?
Can cause thrombosis
Ibuprofin Dosage
200-400mg 3 times daily
Naproxin dosage
0.5-1g 2x daily
Which family of corticosteroids have an anti-inflamatory response?
Glucocorticoids
What is the Glucocorticoid mechanism?
The have the right lipo/hydro phylic/phobic balance in order to cross the lipid membrane
Once crossed they bind to receptors and then translocate to the nucleus where mRNAs are produced which in turn sythesise the proteins which are responsible for the steroid response
The secondary mechanism is the inhibition of pro-inflamatory transcription factors
The response of glucocorticoid steroids
The response is vast however the importent ones here are anti-inflammatory effects and immunosupressent effects
What is the mechanism for the imunosuppresent steroid response
Just like NSAIDs the immonsupressent effects also come from inhibiting enzymes responsible for prostaglandin synthesis
Corticosteroids adverse effects
Loads, this is why use is cautionary
Corticosteroid withdrawal
If there is extended treatment withdrawal must be slow as the hypothalmic-pituitery-adrenal axis has been supressed resulting in a risk of acute adrenal insufficiency
This can be fatal
