Anti Inflammatory Drugs Flashcards Preview

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Flashcards in Anti Inflammatory Drugs Deck (23)
1

What is the action of acetomenophen?

(Tylenol)
Reversibly inhibits Cox in the CNS- analgesic and anti-pyretic (inactive peripherally- not anti-inflammatory)

2

What is the clinical use of acetomenophen?

anti-pyretic, anagesic
NOT anti-inflammatory
Used instead of aspirin for children with viral infection bc of Reyes syndrome

3

What are the toxicities of acetomenophen?

hepatic necrosis (NAPQ1 metabolite depleates glutathione and forms toxic metabolites in the liver; treat with N-acetyl cysteine)

4

What is the method of action of aspirin?

Irreversibly inhibits COX1/2 via acetylation
Decrease synthesis of TxA2 to increase bleeding time

5

What is the clinical uses of aspirin?

Low dose (300 mg/day): anti-platelet
Medium dose (300-2400 mg/day): analgesic, anti-pyretic
High dose (2400-4000 mg/day): anti-inflamatory

6

Toxicity of aspirin?

Gastric ulceration
Tinnitis
Chronic use --> acute renal failure, interstilial nephritis, GI bleeding
Reyes in kids
Respiratory alkalosis early followed by a metabolic acidosis for a mixed picture
Can treat with alkalization

7

What is the mechanism of action of celecoxib?

reversible inhibition of COX2
Inflammatory cells and vasc endothelium to mediate inflammation and pain
(sparring of COX1 spares gastric mucosa and TxA2 function in platelets)

8

When is celecoxib used?

osteoarthritis, rheumatoid arthritis

9

What is the toxicity of celecoxib?

increased risk of thrombosis
sulfa allergy

10

What is the mechanism of action for NSAIDS?

ibuprofen, naproxen, indomethicin
Reversible COX1/2 inhibition

11

What are the clinical uses of NSAIDS?

anti-pyretic, anagesic, anti-inflammatory

12

What are toxicities of NSAIDS?

Interstitial nephritis, gastric ulcers (prostaglandins protect gastric mucosa/COX1), and renal ischemia (prostaglandins dilate afferent arteriole)

13

What are the mechanisms of bisphosphonates?

pyrophasphate analogs, bind to hydroxyappetite in bones and inhibit osteoclast action

14

When are bisphosphonates used?

Osteoporosis, hypercalcemia, Pagets disease of the bone

15

What are toxicities of bisphosphonates?

Corrosive esophagitis (take with water and stay upright for 30 mins)
osteonecrosis of the jaw

16

What is the mechanism of action of teriparatide

recombinant PTH
increase osteoblast activity
given subcutaenously

17

When is teriparatide used?

osteoporosis
Can increase bone growth as opposed to anti-absorptive therapies like bisphophanates

18

What is the toxicity of teriparatide?

transient hyerpcalcemia
May increase risk of osteosarcoma

19

What is a toxicity of TNF-a inhibitors?

reactivation of infection, esp TB
TNF-a is important for granuloma formation and stabilization

20

What is the mechanisms of etanercept?

Fusion protein (receptor for Ig Fc + TNF-a) produced by recombinant DNA that acts as a decoy receptor for TNF-a

21

When do you use etanercept?

Rhematoid arthritis, psoriasis, ankalosing spondylitis

22

What is the mechanisms of action of infliximab or adalimumab?

Monoclonal antibody to TNF-a

23

When would you use infliximab /adalimumab?

IBS, RA, psoriasis, ankalosing spondylitis