Flashcards in Exam 3 immune modulators/antifinflammatory agents for AI Deck (24):
MOA of what drug is: reduce inflammation, pain and fever
Aspirin and NSAIDS (cornerstones of tx)
MOA of what drug is: interferes with prostaglandin synthesis
sulfasalazine (Azulfidine) (Used for tx of RA when NSAIDS are inadequate)
MOA of what drug is: Inhibits pyrimidine synthesis, resulting in anti-proliferatice and anti-inflammatory effects
MOA of what 3 drugs is an TNF alpha blocker - binds to TNF molecules and blocks interaction with cell surface receptors
MOA of what drug is an interleukin 1-receptor antagonist (blocker)
5 categories that make up DMARDS (disease modifying anti-rheumatic drugs)
1. Immune modulators
2. Anticytokine therapies
5. Gold (unknown mechanism, many possibilities)
When are DMARDS used?
On pts who do not respond to cox2 inhibitors - slows course of disease (RA/OA) may induce remission and prevent further destruction of joints/tissue
Which drug depresses circulating IgM rheumatodi factor, and depresses Tcell activity?
2 classes of immunosuppressants used to treat AI diseases
Which drug inhibits the production and release of interleukin II and inhibits interleukin II induced activation of resting T lymphocytes?
cyclosporine (Sandimmune, Gengraf, Neoral, Restasis)
Which drug Increase in concentration in neutrophils and decrease in lymphocytes, monocytes, eosinophils, and basophils. It also inhibits phospholipase A, IL-2 migration, and decrease production of both prostaglandins and leukotrienes from arachidonic acid
4 Aspirin side effects
1, GI ulceration and bleeding
2. Kidney retention of sodium and water - may cause hyperkalemia and edema
3. Tinnitus (sign of toxicity)
4. respiratory acidosis (toxicity)
4 side effects of sulfasalazine (Azulfidine)
3. GI distress
5 side effects of celebrex (cox2 inhibitor)
2. decreases effectiveness of BP meds
4. Bleeding - asses when using warfarin
5. cross sensitivity with NSAIDS allergy
6. contraindicated with sulfonamide allergy
What drug can cause prolonged bleeding and oral aphthous ulcerations/aphthous stomatitis?
aspirin and NSAIDS
What drug can cause mucosal ulcerations?
methotrexate (Rheumatrex, Trexall)
What 2 drugs can cause blue black intraoral pigmentation?
1. chloroquine (Aralen)
2. hydroxychloroquine (Plaquenil)
4 oral side effects of penicillamine
2. delayed healing
3. prolonged bleeding
4. oral ulceration
What drug causes dermatitis with mucosal ulcerations, infection, delayed healing, prolonged bleeding, glossitis, aphthous stomatitis, blue black intraoral pigmentation
What immunosuppressive drug can cause gingival hyperplasia
Important dental practice considerations for patients taking immune modulators
1. Vital signs taken - ____ ___ may be due to chronic pain or medication-induced _____ _____ from antihypertensives.
2. Obtain recent ___ ___ - checks if predisposed to other infections, multiple ____ = affects liver and kidneys (organ dysfunction)
3. Most do not require _____ ___- consult physician if cardiac/kidney involvement, will need a pre-med if pt has AI plus a ____ ____ ____.
4. Stress caused by anxiety, anticipation of pain, infections or surgical procedures significantly raises ____ and ____ of ____.
prosthetic joint replacement
4 stress reduction procedures
1. Increased communication
2. anti-anxiety meds and nitrous oxide
3. behavioral interventions
4. good pain control
More important dental practice considerations for patients taking immune modulators.
1. Have emergency ___/____
2. Create ____ envirnoment
3. Xerostomia - susceptibility to _____
4. oral ____
5. Difficulty eating, speaking, _____
6. ____ challenges
7. Depression: ___ of ___ ___
lack of self care