Anti-Inflammatory Drugs

Question 1

Histamine

Answer 1

Released by Mast cell IgE mediated degranulation, and from basophils. Leads to redness, heat, swelling, and airway constriction acid secretion, urticaria. No chemotaxis.

Question 2

LTB4

Answer 2

Leukotriene which is Chemotactic for neutrophils, reduces pain threshold.

Question 3

LTC4

Answer 3

Causes bronchoconstriction, increased vascular permeability,

Question 4

LTD4

Answer 4

Causes bronchoconstriction, increased vascular permeability

Question 5

LTE4

Answer 5

Causes bronchoconstriction, increased vascular permeability

Question 6

PGD2

Answer 6

Prostaglandin receptor leading to bronchoconstriction. Produced by mast cells.

Question 7

PGE2

Answer 7

Prostaglandin receptor causing FEVER(IL-1 mediated) Vasodilation, increased vascular permeabilty and pain.

Question 8

PGF2

Answer 8

prostaglandin receptor which leads to uterine contraction, and bronchoconstriction.

Question 9

PGI2

Answer 9

Prostaglandin receptor causing Vasodilation, increased vascular permeabilty and pain, and opposes platelet aggregation.

Question 10

TXA2

Answer 10

Thromboxane which leads to bronchoconstriction, platelet aggregation, and vasoconstriction.

Question 11

Bradykinin

Answer 11

Does everything(leads to infllamation, redness, swelling, heat, pain). It is also a strong VASODILATOR resulting in hypotension. not a chemoattractant

Question 12

Kallidin

Answer 12

Kinin which Does everything. It is also a strong VASODILATOR resulting in hypotension. not a chemoattractant

Question 13

Diphenhydramine

Answer 13

1st generation Antihistamine Prevents histamine induced bronchoconstriction, contraction of GI smooth muscle, hives, itch, pain. NOT pumped out of CNS. Low GI side effects. Drying of secretions. Has antimuscarinic properties.

Question 14

Chlorpheniramine

Answer 14

1st generation Antihistamine Prevents histamine induced bronchoconstriction, contraction of GI smooth muscle, hives, itch, pain. Not as sedating as diphenhydramine. Drying of secretions. Has antimuscarinic properties.

Question 15

Cetirizine

Answer 15

2nd Generation Antihistamine. Has minimal anticholinergic properties, Does not cause sedation or drying of secretions. Subject for P-Glycoprotein Efflux pump.

Question 16

Fexofenadine

Answer 16

2nd Generation Antihistamine. Has minimal anticholinergic properties, Does not cause sedation or drying of secretions. Subject for P-Glycoprotein Efflux pump.

Question 17

Loratadine

Answer 17

2nd Generation Antihistamine. Has minimal anticholinergic properties, Does not cause sedation or drying of secretions. Subject for P-Glycoprotein Efflux pump.

Question 18

Zileuton

Answer 18

Inhibits 5- lipoxygenase and prevents synthesis of LTB4, increasing pain threshold, may decrease use of beta agonsists in asthma, AE: CYP450, hepatotoxicity.

Question 19

Zafirlukast

Answer 19

Leukotriene receptor antagonist (LTD receptor), AE: inhibits a cytochrome P450 isoenzyme and may cause significant drug interactions. Used in asthma.

Question 20

Montelukast

Answer 20

Leukotriene receptor antagonist,(LTD4 receptor), Used in Asthma. daily admin w/o meal restrictions.

Question 21

Aspirin

Answer 21

Irreversible COX inhibitor. Has more effects on platelets because they don’t have a nucleus. AE: bleeding and GI problems, tinnitus, asprin hypersensitivity(rhinitis, urticaria, asthma, laryngeal edema) due to shift to lypoxegenase shift. Rye syndrome: encephalopathy and fatty liver following viral infection in kids.

Question 22

Ibuprofen

Answer 22

Nonselective COX inhibitor, fewer GI side effects than aspirin.

Question 23

Naproxen

Answer 23

Aleve, Nonselective COX inhibitor.

Question 24

Ketorlac

Answer 24

More potent NSAID, Nonselective COX inhibitor, used for analgesia, but is also anti-inflammatory.

Question 25

Indomethacin

Answer 25

MOST potent NSAID, Nonselective COX inhibitor, AE: severe frontal headache and blood disorders

Question 26

Sulindac

Answer 26

More potent NSAID, Nonselective COX inhibitor

Question 27

Ketoprofen

Answer 27

More potent NSAID Nonselective COX inhibitor, related to ibuprofen

Question 28

Piroxicam

Answer 28

More potent NSAID once a day admin, can cause dose related serious GI bleeding.

Question 29

Celecoxib

Answer 29

Selective COX II inhibitor.

Question 30

Acetaminophen

Answer 30

Not an NSAID, Is a weak inhibitor of COX, and has minimal anti-inflammatory effect. Analgesic and antipyretic. AE: hepatotoxicity.

Question 31

Cortisol

Answer 31

Anti-inflammatory Steroid,

Question 32

Hydrocortisone

Answer 32

Anti-inflammatory Steroid

Question 33

Prednisone

Answer 33

Anti-inflammatory steroid

Question 34

Methylprednisone

Answer 34

Anti-inflammatory steroid

Question 35

Betamethasone

Answer 35

Anti-inflammatory Steroid, long acting

Question 36

Dexamethasone

Answer 36

Anti-inflammatory Steroid, Long acting.

Question 37

Cyclosporine

Answer 37

Immunosuppresive agent, Binds cyclophilin receptor inhibiting calcineurin activity, blocking dephosphorylation events for T cell activation. Liver met. AE: Drug interactions, renal toxicity up to 75%. Used long term for transplants.

Question 38

Tacrolimus (FK506)

Answer 38

Immunosuppressive, binds FKB506 resulting in inhibition of calcineurin. Blocks the dephosphorylation events for cytokine expression and T cell activ. 100X more potent than cyclosporine. AE: nephrotoxicity.

Question 39

Sirolimus

Answer 39

Antiproliferative drug used for organ transplant rejection. Binds FKBP to inhibit mTOR and stop cell cycle progression of B and T cells. AE: dose dependant increase in cholesterol and Triglycerides, nephrotoxicity, increased lymphomas and infections, CYP3A4.

Question 40

Mycophenolate

Answer 40

Antimetabolic drug, used in organ transplant, metabolite is inhibitor of inosine monophosphate dehydrogenase, preventing guanine synthesis. B and T cells are highly dependant on this pathway for proliferation. AE: hematologic and GI tox. Leukopenia, diarrhea and vomiting.

Question 41

Anti-thymocyte Globulin

Answer 41

Immunosuppressive, Ig binds thymocytes in circulation resulting in lymphopenia and impaired T cell immune response. AE: toxicity due to Ig being recognized as foriegn: i.e. serum sickness, nephritis, occasional anaphylaxis

Question 42

Muromonab-CD3

Answer 42

Immunosuppressive, used for whole organ transplants. Is an antibody whcih binds CD3(t-cell receptor). AE: cytokine release syndrome, give corticosteroids first.

Question 43

Daclizumab

Answer 43

Immunosuppressive. Humanized, Anti-IL-2 receptor for activated T cells, blocking IL2 activated T cell activation events. Used in organ transplantation. AE: few, common antibody side effects

Question 44

Basiliximab

Answer 44

Immunosuppressive. Humanized, Anti-IL-2 receptor for activated T cells, blocking IL2 activated T cell activation events. Used in organ transplantation. AE: few, common antibody side effects

Question 45

Phenylephrine

Answer 45

Alpha1 agonist, leads to vasoconstriction

Question 46

Theophylline

Answer 46

adenosine receptor antagonist, increases cAMP, inhibits leukotriene synthesis

Question 47

omalizumab

Answer 47

Antibody to IgE, increased risk of parasitic infections. expensive.