MSS Drugs

Question 2

Aspirin MOA

Answer 2

irreversibly inhibits COX by covalent acetylation; this decreases synthesis of TXA2 and prostaglandins

Question 3

Decreased synthesis of TXA2 and prostaglandins leads to…

Answer 3

increased bleeding time until new platelets are produced (7 days).

Question 4

Low dose Aspirin (

Answer 4

decreased platelet aggregation

Question 5

Intermediate dose (300-2400) Aspirin use

Answer 5

antipyretic and analgesic

Question 6

High dose (2400-4000) Aspirin use

Answer 6

anti-inflammatory

Question 7

Aspirin toxicity

Answer 7

gastric ulceration and tinnitus

Question 8

Chronic use of Aspirin leads to…

Answer 8

acute renal failure, interstitial nephritis and upper GI bleeding.

Question 9

Aspirin can also stimulate respiratory centers leading to…

Answer 9

hyperventilation and respiratory alkalosis.

Question 10

Indomethacin is..

Answer 10

an NSAID used to close a PDA.

Question 11

NSAIDs cause gastric ulcer bc…

Answer 11

prostaglandins protect the gastric mucosa.

Question 12

NSAIDs cause… renal ischemia bc…

Answer 12

PGs vasodilate the afferent arteriole.

Question 13

Celecoxib is…

Answer 13

a COX-2 inhibitor

Question 14

COX-2 is found in…

Answer 14

inflammatory cells and vascular endothelium. It mediates inflammation and pain.

Question 15

Celecoxib spares…

Answer 15

COX1 which helps maintain the gastric mucosa. And spares platelet fxn because TXA2 production is dependent on COX1.

Question 16

Use of Celecoxib

Answer 16

RA and osteoarthritis; pts with gastritis or ulcers

Question 17

Toxicity of Celecoxib

Answer 17

-increased risk of thrombosis -sulfa allergy

Question 18

Acetaminophen MOA

Answer 18

reversibly inhibits COX, mostly in CNS; inactivated peripherally

Question 19

Use of acetaminophne

Answer 19

antipyretic, analgesic, but not anti-inflammatory; use instead of aspirin to avoid Reye

Question 20

Toxicity of Acetaminophen

Answer 20

hepatic necrosis - a metabolite (NAPQI) depletes glutathione and forms toxci tissue adducts in liver

Question 21

Antidote to Acetaminophen induced Hepatotoxicity is…

Answer 21

N-acetylcysteine - it regenerates glutathione

Question 22

Bisphosphonates (Aledronate) MOA

Answer 22

pyrophosphate analogs; binds hydroxyapatite in bone, inhibiting osteoclast activity

Question 23

Use of Bisphosphonates

Answer 23

-osteoporosis -hypercalcemia -Paget disease of bone

Question 24

Toxcity of Bisphosphonates

Answer 24

-corrosive esophagitis -osteonecrosis of the jaw

Question 25

Allopurinol acts by…

Answer 25

inhibiting xanthine oxidase, which decreases the conversion of xanthine to uric acid.

Question 26

Additional use of Allopurinol

Answer 26

in lymphoma and leukemia to prevent tumor lysis-associated urate nephropathy

Question 27

Chronic gout drugs

Answer 27

-Allopurinol -Febuxostat -Probenecid

Question 28

Febuxostat

Answer 28

inhibits xanthine oxidase

Question 29

Probenecid

Answer 29

inhibits reabsorption of uric acid in the PCT

Question 30

Acute gout drugs

Answer 30

-NSAIDs (naproxen, indomethacin) -Glucocorticoids -Colchicine -TNF-alpha inhibitors (Etanercept, Infliximab, Adalimumab)

Question 31

Colchicine acts by…

Answer 31

binding and stabilizing tubulin to inhibit microtuble polymerization, impairing leukocyte chemotaxis and degrunlation

Question 32

Etanercept is a…

Answer 32

fusion protein (TNF-alpha inhibitor) used in RA, psoriasis, ankylosing spodylits and gout.

Question 33

Infliximab/Adalimumab is an…

Answer 33

anti-TNFalpha monoclonal antibody used for IBD, RA, ankylosing spondylitis, psoriasis and gout