Autocoids

Question 1

Eicosanoids are synthesized in response to which kind of stimuli

Answer 1

IgE reactions
inflmmmatory mediators
trauma
toxins
heat

Question 2

Eicosanoids act via which method of signal tranduction

Answer 2

G-protein coupled receptors

Question 3

Membrane phospholipds are broken down to arachidonic acids by which enzyme

Answer 3

phosphoplipase A2

Question 4

What is the function of phosphoplipase A2

Answer 4

Breaks down membrane phospholipids into arachidonic acid

Question 5

Which 2 enzymes break down arachidonic acid?

Answer 5

Cyclooxygenase

Lipoxygenase

Question 6

The reaction of Cyclooxygenase and Lipoxygenase produces which 2 molecules

Answer 6

Endoperoxides and Hydroperoxides

Question 7

Cyclooxygenase and Lipoxygenase act on which molecule

Answer 7

Arachidonic acid

Question 8

Which inflammatory mediators are derived from Endoperoxides

Answer 8

Prostaglandins and thromboxane A2

Question 9

Prostaglandins and thromboxane A2 is derived from which molecule directly

Answer 9

Endoperoxide

Question 10

Which inflammatory mediators are derived from Hydroperoxides

Answer 10

Leukotrienes

Question 11

Leukotrienes are derived from which molecule directly

Answer 11

Hydroperoxide

Question 12

Which group of drugs inhibit phospholipase A2

Answer 12

glucocorticoids

Question 13

Which group of drugs inhibit cyclooxygenase

Answer 13

NSAIDs

Question 14

Which drugs is a selective inhibitor of COX 2

Answer 14

Celecoxib

Question 15

Which drug is an inhibitor of lipoxygenase

Answer 15

Zileuton

Question 16

Which drugs inhibits leukotrienes

Answer 16

Zafirlukast

Question 17

What is the mechanism by which the drug Zafirlukast inhibits leukotrienes

Answer 17

It antagonizes the receptor for leukotrienes

Question 18

Zileuton and Zafirlukast inhibits the production of leukotriene in the treatment of which condition

Answer 18

Asthma

Question 19

What is the action of leuktrienes A4, C4 and D5

Answer 19

bronchoconstriction

vasodilation

Question 20

Which product from endoperoxides are needed for platelet aggregation

Answer 20

Thromboaxane A2

Question 21

A product of endoperoxides responsible for pain, swelling, fever and renal vasodilation

Answer 21

PGE2

Question 22

Which prostaglandins are necessary for maintenance of GI mucosa

Answer 22

PGE2 and PGI2

Question 23

Which cyclooxygenase is constitutively expressed

Answer 23

COX1

Question 24

Which COX is necessary for protecting GI mucosa and platelet aggregation

Answer 24

COX1

Question 25

Which COX is necessary for making the inflammatory prostaglandins

Answer 25

COX2

Question 26

Which COX is necessary for platelet stabilization

Answer 26

COX2

Question 27

COX2 aid in platelet stabilization by allowing the production of which arachidonic acid derivative

Answer 27

Prostaglandin I2 (prostacyclin)

Question 28

Another name for prostacyclin

Answer 28

Prostaglandin I2

Question 29

Misoprostol is the synthetic version of which arachidonic acid derivative

Answer 29

PGE1

Question 30

Which drug is an identical form of the naturally occurring PGE1

Answer 30

Alprostadil

Question 31

What is the contraindication of using Alprostadil during pregancy

Answer 31

Can cause uterine contraction

Question 32

What is misoprostol used for? What is the mechanism of its action

Answer 32

Treat NSAID induced gastric ulcers - it is a synthetic version of PGE1, which maintains the gastric mucosa

Question 33

What are 2 uses of alprostadil? What is the mechanism of its action

Answer 33

Maintains patency of ductus arteriosus - it is identical to PGE1 which dilates vascular smooth muscle Aids erectile dysfunction -vasodilation

Question 34

Which drug is a version of PGE2 and what is it used for

Answer 34

DInoprestone - cervical ripening and abortifacient

Question 35

Carboprost is a version of which prostaglandin? | - what is its use

Answer 35

PGF2 alpha | - abortifacient

Question 36

Latanoprost is a version of which prostaglandin? | - what is its use

Answer 36

PGF2 alpha | -glaucoma by reducing intraocular pressure

Question 37

Which drug, that is a synthetic version of PGI2 is used to treat pulmonary hypertension

Answer 37

Epoprostenol

Question 38

Which 2 derivatives of endoperoxide have opposing effects on platelets

Answer 38

Thromboxane A2 | PGI 2

Question 39

Thromboxane A2 works via which signal transduction pathway

Answer 39

Gq

Question 40

PGI 2 works via which signal transduction pathway

Answer 40

Gs

Question 41

Platelet stabilization is done by which prostaglandin

Answer 41

PGI 2

Question 42

Cyclooxygenases are irreversibly inhibited by which drug

Answer 42

Aspirin

Question 43

High does of aspirin has what effect on uric acid elimination

Answer 43

decreases tubular reabsorption which leads to uricosuria

Question 44

How is the occurrence of gout possible while taking low doses of aspirin

Answer 44

low doses of aspirin decreases renal tubular secretion of uric acid, leading to hyperurecemia

Question 45

What kind of respiratory acid/bases condition is seen in high vs. toxic doses of aspirin why?

Answer 45

High does: respiratory alkalosis because it increases resp rate which lower pCO2 Toxic doses: respiratory acidosis because it inhibits the resp. center leading to high pCO2

Question 46

What is the underlying mechanism of gastritis seen in NSAID use

Answer 46

Inhibition of PGE2 which is needed to maintain the gastric mucosa

Question 47

What physical symptoms are seen in salicylism

Answer 47

tinnitus vertigo decreased hearing

Question 48

Why is bleeding time increased why on NSAIDs

Answer 48

Inhibition of COX1, leads to inhibition of thromboxane A2 production which is needed for platelet aggregation

Question 49

What is the triad seen in aspirin hypersensitivity

Answer 49

asthma nasal polyps rhinitis

Question 50

What clinical symptoms is seen when aspirin is taken with alcohol

Answer 50

GI bleeding

Question 51

How does aspirin affect the use of warfarin

Answer 51

Warfarin's effect is increased (possible toxicity)

Question 52

How does aspirin affect the use of uricosurics

Answer 52

decreases its effect

Question 53

Three treatments for aspirin toxicity

Answer 53

Gastric lavage activated charcoal Alkalizing the urine (eg. sodium bicarb)

Question 54

What is the use of the drug ketorolac

Answer 54

analgesic

Question 55

What is the use of the drug indomethacin | -what is the mechanism of action

Answer 55

Closure of ductus arteriosus by inhibiting COX, so PGE2 cannot be made

Question 56

Why would increased serum creatine be seen in someone using an NSAID

Answer 56

NSAID inhibit the production of prostaglandins which vasodilate the afferent arteriole of the kidney

Question 57

What kind of drug is celecoxib

Answer 57

Selective COX 2 inhibitor

Question 58

Why would less antiplatelet action and less GI toxicity be seen in someone using celecoxib

Answer 58

Celecoxib is a COX2 inhibitor. COX1 is necessary for making PGE2 and TXA2 which re needed for GI mucosa and platelet aggregation respectively.

Question 59

Why is there an increased risk for MIs and stroke while on celecoxib

Answer 59

celecoxib is a COX2 inhibitor which is need to make PGI2 (prostacyclin) which stabilizes platelets

Question 60

This drug acts on CNS cyclooxygenases only

Answer 60

Acetaminophen

Question 61

How can chronic alcohol increase liver toxicity while on acetaminophen

Answer 61

Chronic use of ethanol enhances liver toxicity via induction of P450, which results in formation of a reactive metabolite (N-acetylbenzoquinoneimine), usually inactivated by glutathione (GSH). In overdose situations, the finite stores of GSH are depleted causing the metabolite to react even more with hepatocytes

Question 62

Which NSAID has the highest antithrombotic effect

Answer 62

aspirin