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anti-inflammatory Flashcards

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1
Q

what receptors does aspirin (ASA) work on?

A

cox1 and cox2

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2
Q

what kind of drug is aspirin (ASA)?

A

salicylate

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3
Q

how is aspirin (ASA) absorbed? (route)

A

rapid and complete with PO - also rectal

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4
Q

how is aspirin (ASA) excreted?

A

through the kidneys

- the rate of excretion increases as pH increases

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5
Q

when does the rate of EXCRETION for aspirin (ASA) increase?

A

increased pH = increased aspirin (ASA) excretion

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6
Q

what are the therapeutic uses of aspirin (ASA)?

A
  • anti-inflammatory - cox2 arthritis treatment
  • analgesic - short lived pain relief
  • antipyretic - fever
  • antiplatelet - 8-day irreversible effect on COX1
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7
Q

what is salicylism?

A

too much salicylates - aspirin toxicity

  • renal failure - dehydration, overwork, and competition
  • tinnitus - CN8
  • respiratory alkalosis - aspirin (ASA) is a respiration stimulant that will increase respiration rate
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8
Q

what group of people should not take aspirin (ASA)?

A

kids - can cause Reyes’s syndrome (brain and liver swelling)

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9
Q

what are the adverse effects of aspirin (ASA)?

A
  • GI bleeding and distress
  • renal
  • salicylism
  • reyes’s syndrome
  • hypersensitivity
  • drug interaction
  • overdose/toxicity
  • DECREASED URINE OUTPUT
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10
Q

what drug does aspirin (ASA) interact badly with?

A

Motrin - they bind to the same receptors in the P450 system which makes aspirin (ASA) less effective

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11
Q

what does cox1 interact with?

A

GI tracts, increases blood flow to kidenys, and platelet stickiness

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12
Q

what does cox2 interact with?

A

pain and inflammation

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13
Q

when does inflammation occur?

A

increased prostaglandins = increased inflammation

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14
Q

is aspirin (ASA) reversible?

A

no

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15
Q

what are the names of 1st generation NSAIDs?

A
  • ibuprofen (advil, motrin)
  • naproxen (naprosyn, aleve)
  • indomethacin (indocin)
  • ketorolac (toradol)
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16
Q

what receptors does ibuprofen (Advil, Motrin) work on?

A

cox1 and cox2

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17
Q

how long does ibuprofen (Advil, Motrin) last?

A

6-8 hours

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18
Q

is ibuprofen (Advil, Motrin) tolerated?

A

generally tolerated well

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19
Q

what does ibuprofen (Advil, Motrin) help with?

A

inflammation

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20
Q

what are the positives for ibuprofen (Advil, Motrin)?

A

less gastric bleeding and platelet inhibition than aspirin

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21
Q

what is the negative of ibuprofen (Advil, Motrin)?

A

decreased blood flow to kidneys

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22
Q

what receptors does indomethacin (Indocin) work on?

A

primarily cox1

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23
Q

what is indomethacin (Indocin) used for?

A
  • arthritis
  • bursitis
  • tendonitis
  • gout
  • premature infants with patent ductus arteriosus
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24
Q

what is one abnormal use of indomethacin (Indocin)?

A

premature infants with patent ductus arteriosus

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25
what route is indomethacin (Indocin) given?
PO and IV
26
what side effects are seen with indomethacin (Indocin)?
- more severe GI issues and headache - increased risk for toxicity so not routinely used for pain and fever - black box warning for increased risk of CVA and MI
27
what is ketorolac (Toradol) used for?
- pain relief equivalent to opioids | - for acute pain not for chronic pain
28
what group of people does ketorolac (Toradol) work well for?
people with a history of drug abuse due to its effective pain relief but it is not an opioid
29
what is the route for ketorolac (Toradol)?
PO, IV, and IM
30
how would ketorolac (Toradol) be taken?
every 5 days ( 5 days before surgery and 5 days after)
31
what needs to be monitored with ketorolac (Toradol)?
kidney function
32
what risk is there with ketorolac (Toradol)?
increased risk for stroke and bleeding
33
what receptors does ketorolac (Toradol) work on?
primarily cox1
34
what drug is a 2nd generation NSAID?
celecoxib (Celebrex)
35
what receptor does celecoxib (Celebrex) work on?
only inhibits cox2
36
what is celecoxib (Celebrex) used for?
- osteoarthritis - rheumatoid arthritis (juvenile) - acute pain
37
what adverse effects are seen with celecoxib (Celebrex)?
- GI distress - renal impairment - black box warning for increased risk for CVA and MI
38
who shouldn't celecoxib (Celebrex) be used in?
people with sulfa allergies
39
what drug interaction does celecoxib (Celebrex) have?
increases effectiveness of warfarin (coumadin) | - would need to decrease the dose
40
what is acetaminophen (Tylenol) used for?
- analgesic - pain | - antipyretic - fever
41
what happens a lot with acetaminophen (Tylenol)?
overdose | - antidote is acetylcysteine
42
what is the antidote to acetaminophen (Tylenol)?
acetylcysteine
43
is acetaminophen (Tylenol) an anti-inflammatory?
no
44
what drugs are used for gout?
- colchicine - allopurinol - probenecid
45
what is the action of colchicine?
decreases inflammatory reaction to urate crystals
46
what is colchicine used for?
gout - treat acute attacks - prevent long-term attacks
47
what are the adverse effects of colchicine?
- nausea, vomiting, diarrhea - hepatotoxicity - bone marrow suppression
48
what is the action of allopurinol?
decreased blood levels of uric acid by inhibiting enzymes needed for production will then decrease inflammation
49
what is allopurinol used for?
- acute and chronic tophaceous gout | - kidney stones
50
what are the adverse effects of allopurinol?
steven johnson syndrome - deadly rash
51
what is the downfall of allopurinol?
takes months to see results
52
what is the action of probenecid?
uric acid excretion increases | - decreases hyperurecemia
53
what is the downfall of probenecid?
can initially increase acute attacks
54
is probenecid used alone?
often used as an adjunct therapy
55
what are the signs and symptoms of rheumatoid arthritis?
- fever - weightloss - weakness - thin skin - red sclera - vascultitus - worse in AM - ulcers - nodules - warm to touch
56
what drugs are used to treat rheumatoid arthritis?
- NSAIDs - DMARDs - TNF blockers - glucocorticosteroids
57
what do DMARDs stand for?
disease-modifying antirheumatic drugs
58
what is the purpose of DMARDs?
reduction of joint destruction and slow disease progression - catch early and slow progression - delayed onset of benefits
59
what drugs are DMARDS?
- methotrexate (rheumatrex) - hydroxychloroquine (plaquenil) - TNF blockers ~ etanercept (enbrel) ~ infliximab (remicade) ~ adalimumab
60
what kind of drug is methotrexate (Rheumatrex)?
DMARDs
61
what is the action of methotrexate (Rheumatrex)?
stop folic acid metabolism especially in areas where cells reproduction is rapid (fetuses and bloodstream)
62
what else could methotrexate (Rheumatrex) be used for?
abortion
63
what is the most common and most rapid DMARD?
methotrexate (Rheumatrex)
64
what education is needed with methotrexate (Rheumatrex)?
- takes 3-6 weeks to see the effectiveness | - would need a negative TB and pregnancy test before starting
65
what are the side effects of methotrexate (Rheumatrex)?
- hepatic fibrosis - fetal death - bone marrow suppression - GI ulceration - clotting - risk for infection
66
what kind of drug is hydroxychloroquine (Plaquenil)?
DMARD
67
what is the action of hydroxychloroquine (Plaquenil)?
suppress cellular reproduction | - doesn't slow the progression of RA but helps with long term outcome
68
what else is hydroxychloroquine (Plaquenil) used for?
antimalaria
69
what can be taken with hydroxychloroquine (Plaquenil)?
NSAIDs or steroids
70
what education is needed with hydroxychloroquine (Plaquenil)?
an eye exam would be needed every 6-12 months due to possible retinopathy - hye=eye
71
what kind of drugs are TNF blockers?
- etanercept (enbrel) - infliximab (remicade) - adalimumab (humira)
72
what kind of drug are TNF blockers?
DMARDs
73
what is the action of TNF blockers?
suppress inflammation by neutralizing (decreasing) TNF - tumor necrosis factor
74
what are TNF blockers used for?
RA, psoriasis, chron's disease
75
what are the adverse effects of TNF blockers?
- decreased white blood cells (immunosuppression) - fever - increased risk for infection
76
what teaching is needed with TNF blockers?
- would need a negative TB test | - no live vaccines like chickenpox or shingles
77
what are glucocorticoids?
powerful anti-inflammatory agent | - can relieve symptoms and may slow down disease progression
78
what are glucocorticoids used for?
- RA - lupus - COPD - psoriasis - allergies
79
what is the route for glucocorticoids?
PO or intra-articularly for a specific joint
80
should glucocorticoids be used short-term or long-term?
short term
81
what do glucocorticoids increase the risk of?
infection
82
what are the 7 s's of glucocorticoids?
- swollen - sepsis - sugar decrease - skinny bones (fractures) - sight (cataracts) - slow taper - stress
83
do glucocorticoids have a fast or slow onset?
fast
84
what drugs are used for osteoporosis?
- calcium - vitamin D (diet and sun) - calcitonin (miacalcin, osteocalcin, salomine) - selective estrogen receptor modulators (SERMs)
85
what is the action of calcitonin (miacalcin, osteocalcin, salomine)?
inhibits osteoclast activity - treats osteoporosis but doesn't prevent
86
what is the route for calcitonin (miacalcin, osteocalcin, salomine)?
nasal spray - 1 spray per day, alternate nostrils
87
what is the ending for bisphosphates?
dronate - alendronate (fosamax) - risedronate (actonel) - ibandronate (boniva)
88
what is the action of bisphosphates (-dronate)?
prevent and treat osteoporosis - works by inhibiting bone resorption by osteoclasts
89
what is the teaching needed with bisphosphates (-dronate)?
- must be given on empty stomach with a full glass of water and sit up for 30 minutes after to help with esophagus irritation - tell dentist due to jaw osteonecrosis
90
what is the name of the drug that is selective estrogen receptor modulators?
raloxifene (Evista)

Pharm Exam 2 (5 decks)

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