Flashcards in Anti Inflammatory Drugs Deck (23)
What is the action of acetomenophen?
Reversibly inhibits Cox in the CNS- analgesic and anti-pyretic (inactive peripherally- not anti-inflammatory)
What is the clinical use of acetomenophen?
Used instead of aspirin for children with viral infection bc of Reyes syndrome
What are the toxicities of acetomenophen?
hepatic necrosis (NAPQ1 metabolite depleates glutathione and forms toxic metabolites in the liver; treat with N-acetyl cysteine)
What is the method of action of aspirin?
Irreversibly inhibits COX1/2 via acetylation
Decrease synthesis of TxA2 to increase bleeding time
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
Toxicity of aspirin?
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
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)
When is celecoxib used?
osteoarthritis, rheumatoid arthritis
What is the toxicity of celecoxib?
increased risk of thrombosis
What is the mechanism of action for NSAIDS?
ibuprofen, naproxen, indomethicin
Reversible COX1/2 inhibition
What are the clinical uses of NSAIDS?
anti-pyretic, anagesic, anti-inflammatory
What are toxicities of NSAIDS?
Interstitial nephritis, gastric ulcers (prostaglandins protect gastric mucosa/COX1), and renal ischemia (prostaglandins dilate afferent arteriole)
What are the mechanisms of bisphosphonates?
pyrophasphate analogs, bind to hydroxyappetite in bones and inhibit osteoclast action
When are bisphosphonates used?
Osteoporosis, hypercalcemia, Pagets disease of the bone
What are toxicities of bisphosphonates?
Corrosive esophagitis (take with water and stay upright for 30 mins)
osteonecrosis of the jaw
What is the mechanism of action of teriparatide
increase osteoblast activity
When is teriparatide used?
Can increase bone growth as opposed to anti-absorptive therapies like bisphophanates
What is the toxicity of teriparatide?
May increase risk of osteosarcoma
What is a toxicity of TNF-a inhibitors?
reactivation of infection, esp TB
TNF-a is important for granuloma formation and stabilization
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
When do you use etanercept?
Rhematoid arthritis, psoriasis, ankalosing spondylitis
What is the mechanisms of action of infliximab or adalimumab?
Monoclonal antibody to TNF-a