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Flashcards in Drugs to Treat Inflammation Deck (25):
1

How is aspirin protective against cardiovascular disease?

Because it tips the balance towards prostacyclin production because prostacyclin producing endothelians can make more COX while thromboxane producing platelets can't

2

How do NSAIDs cause bronchoconstriction in 10% of asthmatics?

Inhibition of the production of prostanoids means more arachonic acid is shuttled into leukotriene production which leads to bronchoconstriction

2

Which of the typical effects of NSAIDs does paracetamol lack?

Anti-inflammatory

4

In what physiological state are prostaglandins produced at the greatest level?

During inflammation

4

How do NSAIDs increase bleeding time?

They downregulate thromboxane A2 production which has pro-coagulative effects

5

How do NSAIDs adversely effect the kidney?

Blocking the tonic vasodilation provided by prostacyclin

6

What is the mechanism of the analgesic effect of NSAIDs?

Prostaglandins sensitise nociceptors therefore inhibiting their production reduces pain

8

COX enzymes catalyse the production of what?

Prostaglandins

Prostacyclin

Thromboxane

9

How does aspirin inhibit COX?

Acetylates it

10

What is the effect of lipoxins?

Resolution of inflammation

11

What is unique of the effect of aspirin on COX?

The inhibition of COX is irreversible

11

When does hepatotoxicity occur with paracetamol use?

When the liver capacity to detoxify the paracetamol is exceeded - usually at dose 20x normal

12

How are lipoxins made due to aspirin?

Aspirin Acetylated COX2 produces them

13

What are the general effects of NSAIDs?

Anti-inflammatory

Anti-pyretic

Analgesia

Anti-aggregative

14

What effect does stimulating canabinoid receptors have on tissue?

Anti-inflammatory as well as

Appetite stimulation

Analgesia

Sedation

Psychoactivity

15

What are the 3 mechanisms of action of glucocorticoids at a cellular level?

Direct Transactivation

Direct Transrepression

Tethered transrepression

16

What is mechanism for GIT damage caused by NSAIDs?

Reduce PGE2 > withdraws its protective effects 

- increase mucus production

- Increase blood flow

- Decrease H+ secretion

- Promotes angiogenesis

17

Which COX enzyme is more widely expressed?

COX-1

19

How do NSAIDs cause an increase in blood pressure?

Decreases the natriuresis effect of PGE2

20

Why can't aspirin be used for gout?

Because it shares a renal transporter with uric acid therefore they compete for secretion

21

What are the limitations to using prostaglandins as treatment?

Generally they are unstable and expensive

22

What types of drugs are given the name NSAID?

Non-selective inhibitors of COX-1 and COX-2

23

Why is aspirin contradicted in children?

It is hepatotoxic in a number of children

24

Which NSAID is preferred for fever?

Paracetamol

25

How is tumour necrosis factor alpha being targeted in therapies?

Block it to block its inflammatory effects

eg in rheumatoid arthritis