Chapter 42: Eicosanoids Flashcards Preview

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Flashcards in Chapter 42: Eicosanoids Deck (38)
1

Which NSAID works in an irreversible manner to block COX 1 and COX 2?

aspirin

2

What NSAID would you AVOID using in children with chickenpox or flu symptoms? Why?

Aspirin - risk of Reye's disease

3

A daily, low dose of which NSAID is used for its antithrombogenic properties?

Aspirin --> shifts the PGI/TXA balance toward prostacyclin and away from thromboxane formation

4

Should you use aspirin for asthmatics?

Not really...aspirin induced airway hyperreactivity is a potential problem

5

What NSAID would you use to CLOSE a patent ductus arteriosus?

Indomethacin

6

Adverse side effects of NSAIDs?

GI issues
Stevens Johnson syndrome (life threatening skin condition, really nasty)

7

Naproxen

NSAID that has a longer half life, it 20 times more potent, and has less GI issues than aspirin

winner!

8

Ketorolac

NSAID used for analgeisa for post surgical pts

Do not use for more than 3-5 days

9

What NSAID has the greatest selectivity for COX2 ? (NSAID, not another type..)

Nabumetone

10

Fenamates

NSAIDs that aren't really used at all
why not?
they are more toxic and worse at antiinflammatory crap than aspiriin

why use inmates (fenamates) when you can use aspirin? AND..inmates bleed a lot...
fenamates can be used to treat primary dysmennorrhea

11

Which NSAID has a long enough half life that once-daily dosing is used?

Piroxicam

"cam" - take a picture and it lasts all day

12

Typical uses for NSAIDs?

Period crap
Mild/moderate pain
fever
Osteoarthritis
gout

13

Which NSAID would you use to prevent strokes and MIs? why?

aspirin - antiplatelet effects

14

Acetaminophen MOA?

COX 3 inhibitor - supposedly

thus does NOT have anti inflammatory effects

15

What is the serious adverse effect of acetaminophen use?

hepatotoxicity - leading cause of liver failure is acetaminophen OD

16

Which is tolerated better by patients: ibuprofen or indomethacin?

ibuprofen

17

Kids at risk for Reye's disease with aspirin use can be treated with what instead?

acetaminophen

18

Celecoxib

MOA: COX 2 inhibitor
No anti platelet effect
Less GI disturbance
TX: arthritis and POLYPOSIS

watch out for MI or stroke...YIIIIIIKESSSSSS

19

So when would you actually use a "coxib"?

Patient needs chronic anti inflamm therapy but also is at risk for gastropathy

then can use celecoxib with an NSAID!

20

Etanercept
- mab(s)

TNF alpha inhibitor to stop inflamm response
TX of rheumatoid arthritis (halt joint destruction, etc.)

BUT - high increased risk of infection was found , so pts must be continuously tested for Tb

21

Anakinra

IL-1 antagonist to stop inflammatory response
e.coli derived -ewwwwww

22

What drug maintains a patent ductus arteriosis?

Alprostadil - PDE1 analogue
(prostaglandin EEE keeeeeps the PDA open)
(PROSTA - it's IN the name idiot)

23

Misoprostol

MOA: PGE1 analogue
TX: Protective effect against gastric ulcers in long term NSAID use

protectively coats the stomach like miso soup

24

Carboprost

MOA: PGF2a analogue
TX: abortion in 2nd semester
postpartium hemorrhage

carb-loving prostitutes probably need an abortion

25

What prostanoids would you use to treat ocular hypertension or open-angle glaucoma? Eye craps.

Latanoprost
Bimatoprost
Travoprost
(Prost sounds like provost...provosts wear glasses....eye crap)

26

Thromboxane antagonists - what are 3 and why not use 'em?

Dazoxiben
Pirmagrel
Rodigrel

no advantages over aspirin and they are way more expensive $$$$$$$

27

Zileuton

MOA: inhibits 5-lipooxygenase
TX: asthma

28

MonteLUKAST
ZafirLUKAST

leukotriene receptor antagonists
TX: Not ACute asthma and rhinitis
Both are excreted in breast milk!

29

What is the function of PGD2?

Bronchoconstriction (asthma)
Sleep control fxns
Alzheimer's?

pgD2 --> R2D2 --> darthvader heavy breathing --> asthma

30

What is the function of PGE2?

PGE2 is the housekeeping prostaglandin; vasodilation, bronchoconstriction, fever, mucus production, cytoprotective to the gastric mucosa by modulating acid secretion, mucus, and blood flow

31

What is the function of PGF2a?

Vascular tone/ smooth mm contraction
Bronchoconstriction
Abortion

pgF - Fuck - Abortion

32

Thromboxane, TXA2, is produced by ____

platelets

33

Prostacyclin, PGI2, is produced by _____

vascular endothelial cells

34

Which functions as a vasodilator, venodilator, and inhibitor of platelet aggregation, PGI2 or TXA2?

PGI2 duh

35

Explain why certain populations that consume more EPA and DHA have a decreased incidence of heart disease, stroke, and thromboembolisms?

EPA and DHA (commonly found in cold water fish) lead to more formation of TXA3 over TXA2. TXA3 is less effective at stimulating platelet aggregation and vasoconstriction than TXA2

36

What are the primary functions of lipoxins?

Stop neutrophil chemotaxis, adhesion, and migration through endothelium

Help resolve inflammation - bc they remove neutrophils blah blah

37

Which NSAID can be used to treat familial adenomatous polyposis? Hint: selective COX-2 inhibitor

Celecoxib

38

Misoprostol is aborticaient with what drug?

mifepristone