Flashcards in Chapter 42: Eicosanoids Deck (38)
Which NSAID works in an irreversible manner to block COX 1 and COX 2?
What NSAID would you AVOID using in children with chickenpox or flu symptoms? Why?
Aspirin - risk of Reye's disease
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
Should you use aspirin for asthmatics?
Not really...aspirin induced airway hyperreactivity is a potential problem
What NSAID would you use to CLOSE a patent ductus arteriosus?
Adverse side effects of NSAIDs?
Stevens Johnson syndrome (life threatening skin condition, really nasty)
NSAID that has a longer half life, it 20 times more potent, and has less GI issues than aspirin
NSAID used for analgeisa for post surgical pts
Do not use for more than 3-5 days
What NSAID has the greatest selectivity for COX2 ? (NSAID, not another type..)
NSAIDs that aren't really used at all
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
Which NSAID has a long enough half life that once-daily dosing is used?
"cam" - take a picture and it lasts all day
Typical uses for NSAIDs?
Which NSAID would you use to prevent strokes and MIs? why?
aspirin - antiplatelet effects
COX 3 inhibitor - supposedly
thus does NOT have anti inflammatory effects
What is the serious adverse effect of acetaminophen use?
hepatotoxicity - leading cause of liver failure is acetaminophen OD
Which is tolerated better by patients: ibuprofen or indomethacin?
Kids at risk for Reye's disease with aspirin use can be treated with what instead?
MOA: COX 2 inhibitor
No anti platelet effect
Less GI disturbance
TX: arthritis and POLYPOSIS
watch out for MI or stroke...YIIIIIIKESSSSSS
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!
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
IL-1 antagonist to stop inflammatory response
e.coli derived -ewwwwww
What drug maintains a patent ductus arteriosis?
Alprostadil - PDE1 analogue
(prostaglandin EEE keeeeeps the PDA open)
(PROSTA - it's IN the name idiot)
MOA: PGE1 analogue
TX: Protective effect against gastric ulcers in long term NSAID use
protectively coats the stomach like miso soup
MOA: PGF2a analogue
TX: abortion in 2nd semester
carb-loving prostitutes probably need an abortion
What prostanoids would you use to treat ocular hypertension or open-angle glaucoma? Eye craps.
(Prost sounds like provost...provosts wear glasses....eye crap)
Thromboxane antagonists - what are 3 and why not use 'em?
no advantages over aspirin and they are way more expensive $$$$$$$
MOA: inhibits 5-lipooxygenase
leukotriene receptor antagonists
TX: Not ACute asthma and rhinitis
Both are excreted in breast milk!
What is the function of PGD2?
Sleep control fxns
pgD2 --> R2D2 --> darthvader heavy breathing --> asthma
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
What is the function of PGF2a?
Vascular tone/ smooth mm contraction
pgF - Fuck - Abortion
Thromboxane, TXA2, is produced by ____
Prostacyclin, PGI2, is produced by _____
vascular endothelial cells
Which functions as a vasodilator, venodilator, and inhibitor of platelet aggregation, PGI2 or TXA2?
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
What are the primary functions of lipoxins?
Stop neutrophil chemotaxis, adhesion, and migration through endothelium
Help resolve inflammation - bc they remove neutrophils blah blah
Which NSAID can be used to treat familial adenomatous polyposis? Hint: selective COX-2 inhibitor