Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

KG - pharmacology 3 > KG - Pharm 3, Exam 1, NSAIDS & DMARDS > Flashcards

KG - Pharm 3, Exam 1, NSAIDS & DMARDS Flashcards

1
Q

clinical signs inflammation?

A
  • erythema, edema, tenderness, pain

- (rubor, calor, tumor, dolor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

three phases inflammation

A
  1. acute inflammation
  2. immune response
  3. chronic inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

ASA: moa

A
  • NONSELECTIVE

- IRREVERSIBLE INHIBITOR COX-1 & COX-2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ASA: pharmacokinetics

A
  • organic ACID
  • fast, ORAL absorption
  • HIGH CONCENTRATION IN STOMACH LUMEN (acidic)
  • distribution throughout body - cross placental and BBB
  • binds to plasma proteins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ASA: drug interactions

A

ASA competes w/ the following drugs for binding:
- T3, PEN G, thiopental, bilirubin, phenytoin, naproxen

(causes drug interaction)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ASA: metabolism

A
  • low doses = first order kinetics
  • high doses = zero order kinetics (above 600 mg)
  • RENAL EXCRETION (alkalization of urine promotes excretion)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ASA: pharmacodynamics

A
  • antiinflammatory
  • analgesic
  • antipyretic
  • antiplatelet (irreversible inhibition of platelet COX enzymes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ASA: uses

A
  • mild/mod pain
  • antipyresis
  • anti-inflammatory
  • MI/thrombosis prophylaxis
  • long term use decr colon CA
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

ASA: adverse effects

A
  1. respiratory alkalosis

2. THEN, metabolic and respiratory acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ASA: platelet effects

A
  • inhibits platelet aggregation, so incr bleeding time

- effects last 8-10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ASA: avoided in pts w/ ___

A
  • hypoprothrombinemia
  • vit K def
  • hemophilia
  • severe hepatic damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

if a pt that takes ASA is going to have surgery, what should he/she do?

A

stop taking ASA AT LEAST ONE WEEK PRIOR to surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

if a pt that takes ASA is pregnant, what should she do?

A
  • avoid ASA prior to labor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

ASA (low dose) & uric acid excretion

A
  • decreases uric acid excretion
  • elevates plasma urate concentration

(1-2 g ASA/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

ASA (high dose) & uric acid excretion

A
  • enhances uric acid secretion (uricosuria)
  • lowers plasma urate concentration

(over 5 g/day)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

ASA: side effects, cardiovascular

A

minimal in reg doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

ASA: side effects, lungs

A

ASPIRIN ASTHMA

- increased leukotriene synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ASA: side effects, GI

A
  • GI upset, gastritis, ulcer, bleeding

- to help, use buffering, food, misoprostol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ASA: side effects, kidneys

A
  • renal damage, acute renal failure, interstitial nephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

ASA & pregnancy

A
  • NO TERATOGENIC effect

- stop aspirin before labor to prevent bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

salicylic acid & irritant effects (NOT ASA)

A
  • destroys epithelial cells, irritant to mucosa
  • used for removal of warts, corns, fungal infections, eczematous dermatitis
  • methyl salicylates = irritating to skin and mucosa (oil of wintergreen)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

ASA: avoid in patients w/ ___

A
  • gastric ulcers
  • hepatic damage
  • hypoprothrombinemia
  • vit K def
  • hemophilia
  • hypersensitivity to ASA/salicylates
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

when should ASA dose be decreased?

A
  • long term therapy w/ oral anticoagulants & hypoglycemic agents (diabetes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

how much for acute salicylate poisoning?

A
  • fatal = 20 g aspirin

- for methyl salicylate = 4-5 ml in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Reye’s Syndrome?

A
  • reason why don’t give ASA to kids

- cerebral edema in children w/ viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

DOC for Reye’s Syndrome?

A

acetaminophen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Celecoxib: moa

A
  • SELECTIVE, REVERSIBLE COX-2 INHIBITOR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

celecoxib: side effects

A
  • less gastropathy (but still warning for GI bleed)

- INCREASED RISK CARDIOVASCULAR DISEASE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

celecoxib: pharmacokinetics

A
  • admin ORALLY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

celecoxib: contraindications

A
  • GI disease
  • asthma
  • breast feeding
  • pregnancy
  • renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

nonspecific reversible inhibitors of COX-1 & COX-2: info

A
  • like ASA, but REVERSIBLE
  • worst (but potent) = indomethacin
  • first choice drug = ibuprofen (best side effect profile)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, GI

A
  • pain
  • bleeding
  • ulcer
  • pancreatitis
  • diarrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, CNS

A
  • HA
  • dizziness
  • confusion
  • depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, lung

A
  • bronchoconstriction
35
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, bone marrow

A
  • agranulocytosis

- aplastic anemia

36
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, kidney

A
  • acute renal failure
  • interstitial nephritis
  • nephrotic syndrome
37
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, liver

A
  • enzyme elevation

- hepatitis

38
Q

nonspecific reversible inhibitors of COX-1 & COX-2: toxicities, allergy

A
  • hypersensitivity rxns
39
Q

indomethacin: info

A
  • reduce PMN migration
  • inhibit phospholipase A
  • potent AI AR agent - high incidence side effects
  • USED FOR PATENT DUCTUS ARTERIOSUS (for when full transposition of great vessels)
40
Q

Diclofenac: info

A
  • potent COX inhibitor
  • decr AA bioavailability
  • oral absorption, liver metabolism
  • mostly GI side effects
  • COMBINE w/ MISOPROSTOL to decrease GI side effects
41
Q

ketorolac: info

A
  • ANALGESIC FOR POSTSURGICAL PAIN
  • oral, IV, IM admin
  • after 5 days use, GI side effects
  • may be combined w/ opiates
42
Q

Ibuprofen: info

A
  • FIRST CHOICE DRUG
  • lowest incidence side effects
  • combo w/ ASA decreases effect on platelet aggregation
  • renal excretion

TOXICITY LOW
- mostly GI

43
Q

Naproxen: info

A
  • similar to aspirin, ibuprofen
  • peak levels after 1-2 hrs, LONG HALF LIFE = 13 hrs
  • excretion = URINE
  • NOT for pregnant women
  • bound to plasma proteins (careful w/ Warfarin, hypoglycemic agents)

TOXICITY:

  • mostly GI
  • gastric bleeding less severe than ASA
44
Q

Piroxicam: info

A
  • inhibits PMN migration, lymphocyte function
  • decreases oxygen radical production
  • long half life
  • LOTS OF GI side effects
45
Q

Nabumetone: info

A
  • prodrug

- long half life

46
Q

Phenylbutazone: info

A
  • POTENT, SERIOUS SIDE EFFECTS

- NOT MARKETED IN US

47
Q

best and cheapest NSAID if person can tolerate it?

A

ASA

48
Q

why is ACETAMINOPHEN preferred to ASA?

A
  • tolerated better

- lacks side effects ASA has (no platelet effects, no ulcerogenics, no acid-base imbalance)

49
Q

Acetaminophen overdose?

A
  • can cause FATAL HEPATIC NECROSIS

- takes 15-20 g to kill pt

50
Q

Acetaminophen: pharmacokinetics

A
  • oral absorption
  • liver metabolism
  • renal excretion
  • DOSE DEPENDENT FREE RADICAL PRODUCTION (eliminated by GSH)
51
Q

acetaminophen: pharmacodynamics

A
  • antipyretic
  • analgesic
  • NO antiinflammatory
  • NO platelet effects
52
Q

DOC fever in children?

A

acetaminophen

53
Q

acetaminophen: uses

A
  • mild, mod pain
  • fever (esp kids)
  • adjuncts to anti-inflammatory therapy
  • doesn’t influence irate excretion
54
Q

acetaminophen: adverse effects

A
  • skin rash
  • cross sensitivity w/ salicylates
  • neutropenia w/ pancytopenia, leukopenia
  • DOSE-DEPEN FATAL HEPATIC NECROSIS
55
Q

acetaminophen: dose-dependent fatal hepatic necrosis

A
  • 10-15 g can be hepatotoxic, 25 g can be fatal
  • elevated serum transaminase, lactic acid dehydrogenase are signs of liver damage
  • hepatotoxicity –> encephalopathy, coma, death
  • the hydroxylated intermediate metabolite = resp for liver damage
  • toxicity serious when metabolites > available reduced glutathione in body
  • CHRONIC ALCOHOL CONSUMPTION INCREASES TOXICITY
56
Q

acetaminophen toxicity: tx?

A
  • antidote = N-acetylcysteine (Mucomyst) 10-12 hrs after intoxication
  • gastric emptying
  • forced diuresis
  • hemodialysis
57
Q

gold salts: info

A
  • inhibit phagocytosis
  • uncouple oxidative phosphorylation & inhibit cellular respiration
  • stabilize lysosomal membranes and inhibit actions of lysosomal enzymes
  • prevent PG synthesis
  • SUPPRESS CELLULAR IMMUNITY
58
Q

gold salts: toxicity

A
  • BONE MARROW DAMAGE
  • dermatitis
  • ENTEROCOLITIS
  • jaundice
  • peripheral neuropathy
59
Q

penicillamine: info

A
  • chelating drug in RA (and Wilson’s)
60
Q

penacillamine: toxicity

A
  • high incidence adverse runs
  • pruritus, rash, alteration in taste
  • thrombocytopenia, leukopenia, agranulocytosis, aplastic anemia
  • proteinuria, hypoalbuminuria, nephrotic syndrome
  • lupus-like dz, pemphigus, Goodpasture’s, MG
  • PTs over 65 HAVE HIGHEST RISK
61
Q

hydroxychloroquine: info

A
  • has antihistaminic, anticholinesterase, and anti protease properties
  • inhibits PG synthesis
  • inhibits biosynthesis of mucopolysaccharide
  • inhibits response to phagocytosis
  • stabilizes lysosomes
  • reacts w/ nucleic acids and tissue proteins
62
Q

hydroxychloroquine: toxicity

A
  • pruritus
  • hemolysis (G6PD def)
  • ototoxicity
  • retinopathy
  • peripheral neuropathy
63
Q

sulfasalazine: info

A
  • used to treat RA
  • less toxic than penacillamine
  • salicylate + sulfa properties
64
Q

sulfasalazine: toxicity

A
  • GI
  • rash
  • hepatitis/blood dyscrasias = rare
  • -> monitor hepatitis & bone barrow suppression first 2-3 wks during first few months tx then less afterward
65
Q

Infliximab: info

A
  • CHIMERIC monoclonal antibody targeted against TNF alpha
  • for Crohn’s & RA
  • combined w/ methotrexate
  • admin = IV
66
Q

Infliximab: adverse rxn

A
  • HA

- infusion rxns

67
Q

infliximab: contraindications

A
  • pregnancy
  • breast feeding
  • children
  • infections
68
Q

Rituximab: info

A
  • CHIMERIC monoclonal antibody
  • binds to CD20, a B-LYMPHOCYTE DIFFERENTIATION ANTIGEN on lymphocytes
  • CD20 antigen expressed on > 90% NHL b cells –> used to treat NHL
  • admin = IV
69
Q

adalimumab: info

A
  • recombinant human monoclonal antibody
  • 100% HUMAN PEPTIDE SEQUENCES
  • specific for TNF alpha
  • approved for mono therapy of RA
  • admin = SUB q
  • half life 8-10 days
70
Q

adalimumab: adverse effects

A
  • rash
  • flu-like symptoms
  • fatigue
  • HA
  • pruritus
  • N/V
71
Q

etanercept: info

A
  • DIMERIC FUSION PROTEIN produced by RECOMBINANT DNA technology
  • consists of extracellular binding portion of human TNF RECEPTOR
  • admin = SUB Q
72
Q

etanercept: adverse effects

A
  • injection site rxn
  • infection
  • increased incidence antibody formation
73
Q

etanercept: contraindication

A
  • bone marrow suppression
  • breast-feeding
  • children
  • DM
  • infection
  • sepsis
  • vaccination
  • varicella
74
Q

Abatacept: info

A
  • HUMAN FUSION PROTEIN as costimulatory or second signal blocker of T cell activation
  • competes w/ CD28 for CD 80/86 binding
  • disturbs progressive joint destruction in RA
  • may affect host defenses against infection and malignancy
  • admin = IV
  • half life = 13 days
75
Q

leflunomide: info

A
  • inhibits DHODH - enzyme in de novo pyrimidine synthesis
  • 2nd moa = inhibition of cytokine GF receptor associated tyrosine kinase activity
  • INHIBITS INDUCTION OF COX-2
  • admin = oral
76
Q

leflunomide: adverse effects

A
  • GI
  • anorexia
  • oral ulceration
  • elevated hepatic enzmyes
77
Q

leflunomide: contraindications

A
  • pregnancy
  • breast feeding
  • hepatic/renal failure
78
Q

mycophenolate mofetil: info

A
  • PRODRUG FOR immunosuppresive agent MPA
  • INHIBITS LYMPHOCYTE PURINE SYNTHESIS
  • admin = oral or IV
79
Q

mycophenolate mofetil: adverse effects

A
  • D/G, GI bleed
80
Q

mycophenolate mofetil: contraindications

A
  • active GI dz
  • diarrhea
  • pregnancy
  • breast feeding
  • infections
81
Q

anakinra: info

A
  • recombinant, non glysosylated form of HUMAN INTERLEUKIN-1 RECEPTOR ANTAGONIST
  • for RA
  • renal elimination
82
Q

anakinra: contraindication

A
  • breast feeding
  • children
  • hypersensitivity rxn
  • renal dz
83
Q

tofacitinib: info

A
  • INHIBITS JAK 1 & JAK 3 (JAK 2)
  • for adults w/ mod to severe RA, w/ intolerance or inadequate response to methotrexate
  • serious infections and malignancies may precipitate
  • half life = 3 hrs

KG - pharmacology 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions