Anti-inflammatories, Biologics, Corticosteroids, Gout, & Osteoporosis Flashcards

1
Q

Peptide blocker of N-type voltage gated calcium channels administered intrathecally for refractory pain

A

Ziconotide

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2
Q

PEGylated version of recombinant mammalian uricase used to treat chronic gout in those refractory to conventional therapy

A

Pegloticase

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3
Q

NSAID ingredient of topical gel that is perhaps the most effective topical pain remedy for osteoarthritis

A

Diclofenac

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4
Q

Can occur in the jaw of people using bisphosphonates (or denosumab); can be triggered by dental work

A

Osteonecrosis

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5
Q

Osteoporosis monoclonal antibody therapy that binds RANKL (receptor activator of nuclear factor kappaB ligand) to decrease formation and function of osteoclasts

A

Denosumab

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6
Q

Patients with pain due to rheumatoid arthritis are often administered NSAIDs or glucocorticoids despite their lack of effect on disease progression while waiting for a drug from this class to begin exertings its effects

A

DMARD

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7
Q

Classic NSAID with COX1 selectivity, remains a drug of choice for treating acute gouty arthritis

A

Indomethacin

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8
Q

The interaction between cyclooxygenase and aspirin is _________, which is not the case as with the other NSAIDs

A

Irreversible

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9
Q

Patient population at greater risk for serious adverse effects of NSAIDs

A

Elderly

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10
Q

Uricosuric agent acting similar to probenicid, both require GFR >60 ml/min

A

Sulfinpyrazone

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11
Q

Disrupts pyrimidine synthesis, a second-choice traditional DMARD due to more common serious adverse effects

A

Leflunomide

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12
Q

Exerts its pain-relieving effects by binding to the alpha-2-delta subunit of N-type voltage-gated calcium channels

A

Gabapentin

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13
Q

Anti-TNF biologic DMARD, this humanized monoclonal antibody is administered subcutaneously every 2 weeks; also used for psoriatic arthritis, ankylosing spondylitis, and Crohns disease

A

Adalimumab

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14
Q

Antagonist at NMDA-type glutamate receptors that relieves pain; also used to reduce amount of morphine needed by humans; adverse effects include agitation and hallucinations

A

Ketamine

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15
Q

Fusion protein made from Fc portion of IgG and two TNF receptors, a biologic DMARD administered 1-2x/week by subcutaneous injection; also used for psoriasis

A

Etanercept

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16
Q

______ syndrome is associated with swelling of the liver and brain due to use of aspirin by children with viral illness

A

Reye

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17
Q

_________ of methotrexate is associated with its low-dose ability to treat RA and the persistence of beneficial effects for some time after drug discontinuation

A

Polyglutamation

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18
Q

Drugs such as lidocaine and pramoxine that can help treat neuropathic pruritis or pruritis due to CKD

A

Local anesthetics

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19
Q

Cyclooxygenase that is induced in response to pathologic stimuli; unfortunately, its selective blockade was found to increase risk for vascular thrombosis as balance between local TXA2 and PGI2 was altered to favor platelet aggregation and vasoconstriction

A

COX-2

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20
Q

Refers to the use of methotrexate, hydroxychloroquine, and sulfasalazine together to treat RA

A

Triple therapy

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21
Q

Relieves inflammation from gout if administered within 12-24 hrs of symptom onset by blocking the tubulin polymerization (microtubule formation) needed by leukocytes of migration and phagocytosis; can cause GI distress when used for prophylaxis

A

Colchicine

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22
Q

Cleaved from cell membrane phospholipids by PLA2 in response to ‘stimuli’, converted to eicosanoids such as prostaglandins and thromboxanes

A

Arachidonic acid

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23
Q

Synthesized by platelets; causes vasoconstriction and promotes platelet aggregation

A

TXA2

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24
Q

Classic alpha2-adrenergic agonist administered PO to reduce blood pressure, also administered intrathecally as adjunct therapy for severe cancer pain not treated effectively by opioids alone

A

Clonidine

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25
Q

Can be triggered by aspirin, presumably because local leukotriene effects predominate over prostaglandin effects

A

Asthma

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26
Q

Enzyme that converts uric acid to allantoin, mutated/nonfunctional in humans

A

Uricase

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27
Q

Biologic DMARD of limited efficacy, recombinant version of endogenous human IL-1 receptor antagonist

A

Anakinra

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28
Q

Calcium-receptor sensitizer, acts to lower PTH secretion in chronic kidney disease

A

Cinacalcet

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29
Q

Most effective and fastest acting of the traditional DMARDs, monitor for myelosuppression but generally well tolerated at low doses, often added to biologic DMARDs

A

Methotrexate

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30
Q

Formed by endothelial cells that causes local vasodilation and inhibits platelet aggregation

A

PGI2

31
Q

Antiepileptic drug also used to treat neuropathic pain of diabetes, shingles, and fibromyalgia

A

Pregabalin

32
Q

Dexamethasone, betamethasone, and triamcinolone are among the _________ prednisolones, which have much greater potency and/or half life than natural hydrocortisone

A

Fluorinated

33
Q

Allopurinol is among the widely used drugs that can cause this potential syndrome of epidermal necrolysis

A

Stevens Johnson

34
Q

Class of drugs widely used for tx of pain and inflammation, but significant CV/Resp/Renal/GI contraindications and can cause HSR skin reactions

A

NSAIDs

35
Q

Cells that are particularly vulnerable to the effects of ASA as they cannot synthesize replacement cyclooxygenase

A

Platelets

36
Q

Class of antidepressant drugs having the most evidence of benefit for treating neuropathic pain; AEs include dry mouth, constipation, tachycardia, palpitations, nausea, and sedation

A

TCAs

37
Q

Nonpegylated recombinant uricase administered for prevention of acute uric acid nephropathy due to tumor lysis syndrome

A

Rasburicase

38
Q

Capsaicin and camphor stimulation of ________ gives a sensation of “heat” that can be a useful counterirritant to reduce pain

A

TRPV1

39
Q

“Cold” receptor stimulated by menthol in IcyHot

A

TRPM8

40
Q

Prostaglandin that has widespread effects throughout the body including increasing vascular permeability, mucosal protection in the gut, fever in CNS, pain sensation in the periphery, and salt/water homeostasis in the kidney

A

PGE2

41
Q

Cyclooxygenase that is constitutive in all tissues; has physiologic role and contributes to pathologic responses

A

COX-1

42
Q

Blocking the effects of ______ inflammatory mediator is a common target in tx of RA and various other autoimmune diseases

A

TNF

43
Q

Chimeric (human and mouse) monoclonal antibody directed against TNF that can be administered IV every 6 weeks as a biologic DMARD

A

Inflixumab

44
Q

COX-2 inhibitor that can be administered to tx pain and inflammation of RA if benefits > risks (e.g., if pt has ulcers, bleeding risk); only member of its class still marketed in US

A

Celecoxib

45
Q

JAK3 antagonist used as a biologic DMARD, novel in that it is orally active

A

Tofacitinib

46
Q

Expensive non-purine xanthine oxidase inhibitor useful for reducing urate levels in those with allopurinol intolerance

A

Febuxostat

47
Q

Blocks urate reabsorption by URAT1 transporter in proximal tubule to increase fractional excretion of filtered urate in urine

A

Probenicid

48
Q

Alpha-2-adrenergic agonist administered IV for pain and sedation

A

Dexmedetomidine

49
Q

Agent used as a traditional DMARD alone or in combo and also to tx IBD, GI side effects are a common reason for discontinuing

A

Sulfasalazine

50
Q

Glucocorticoid, prednisolone prodrug, short-term use is useful in therapy for RA until DMARD effects are seen

A

Prednisone

51
Q

Non-aspirin NSAID with long half-life that can be useful for treating inflammation and/or pain of arthritis, a recommended drug of choice when benefis still outweigh concurrent cardiovascular risks

A

Naproxen

52
Q

Along with chondroitin, widely used in hope of treating osteoarthritis but little evidence of benefit beyond placebo effect

A

Glucosamine

53
Q

Damage to the ______ is a serious side effect of hydroxychloroquine, but little risk from low doses now used to treat RA

A

Retina

54
Q

Antidote for acetaminophen poisoning, substitutes for depleted glutathione in liver cells

A

N-acetylcysteine

55
Q

Targets CD20 antigen of B cells to cause a B cell “do-over”, used to treat NHL and CLL and can be effective in some antibody-dependent autoimmune diseases

A

Rituximab

56
Q

Absolute contraindication for tx of RA with methotrexate, reason to choose hydroxychloroquine instead

A

Pregnancy

57
Q

Bisphosphonate administered by IV injection once per year; also associated with highest incidence of osteonecrosis of the jaw

A

Zolendronic acid

58
Q

NSAID notable for often being administered IV or IM

A

Ketorolac

59
Q

Suppresses fever and pain but not inflammation, presumably in part by inhibiting prostaglandin synthesis in the CNS

A

Acetaminophen

60
Q

Drugs that lower serum urate levels by increasing its fractional excretion by the kidneys

A

Uricosurics

61
Q

Refers to the pt with hyperuricemia due to excess synthesis, excess diet intake, and/or excess cell turnover (e.g., tumor lysis syndrome)

A

Overproducer

62
Q

Antimalarial also used as a traditional DMARD; used alone or in combo, alters antigen presentation by disrupting lysosomal pH

A

Hydroxychloroquine

63
Q

1-34 PTH, only agent that forms bone but must be administered in PULSED manner…otherwise leads to bone resorption

A

Teriparatide

64
Q

Methotrexate, hydroxychloroquine, and sulfasalazine are examples of this type of DMARD

A

Traditional

65
Q

A weak mu agonist that also blocks 5-HT and NE reuptake, used by many to tx moderate to severe pain

A

Tramadol

66
Q

Biologic DMARD that is a humanized antihuman IL-6 receptor antibody, among its effects is to decrease acute-phase response of liver

A

Tocilizumab

67
Q

Drug class associated with atypical bone fractures (e.g., simple fracture of compact bone like femur)

A

Bisphosphonates

68
Q

Calcitonin from this species has a longer half-life and greater potency than human calcitonin, can be administered intranasally or parenterally to treat established osteoporosis

A

Salmon

69
Q

_______ accumulates outside the cell as a consequence of AICAR accumulation inside cells due to action of polyglutamated methotrexate; binds to purinergic GPCR on cell surface to exert anti-inflammatory response

A

Adenosine

70
Q

Competitive xanthine oxidase inhibitor that lowers serum urate levels, preferred/standard-of-care therapy for tx of recurrent gout if low GFR or past urate stone or to reduce effects of urate overproduction (e.g., due to tumor lysis)

A

Allopurinol

71
Q

SERM with agonist effects on bone but not breast or uterus used to treat osteoporosis

A

Raloxifene

72
Q

Prototypical example in drug class of first choice for treating osteoporosis, its incorporation into bone inhibits the number and activity of osteoclasts

A

Alendronate

73
Q

Irreversible COX inhibitor used to relieve inflammation and pain of RA, dose not alter disease progression

A

Aspirin

74
Q

Biologic DMARD, fusion protein blocks T cell CD80/86 co-stimulatory signal needed for activation

A

Abatacept