MSK, Skin, and Connective Tissue Drugs Flashcards Preview

Pharmacology > MSK, Skin, and Connective Tissue Drugs > Flashcards

Flashcards in MSK, Skin, and Connective Tissue Drugs Deck (27):
1

mechanism of acetaminophen

reversive inhibition of COX1, COX2

2

clinical use of acetaminophen

- antipyretic, analgesic
- NOT anti-inflamm
- use in children instead of aspirin to prevent Reye syndrome

3

toxicity of acetaminophen

- hepatic necrosis - metabolite NAPQI depletes glutathione and forms toxic tissue byproducts in the liver (treat with N-acetylcysteine) --> alcohol induces the enzyme that breaks down acetaminophen, increasing levels of this toxic metabolite
- PUBs (PGs protect gastric mucosa)
- interstitial nephritis, renal ischemia (PGs dilate afferent arterioles)

4

mechanism of aspirin

irreversible inhibitor of COX1, COX2 via acetylation --> decreased synthesis of TXA2 (for the lifetime of the platelet - 10 days) and PGs --> increased bleeding time

5

clinical use of aspirin

- low dose: antiplatelet
- medium dose: antipyretic, analgesic
- high dose: anti-inflamm

6

toxicity of aspirin

PUBs, tinnitus, renal ischemia, interstitial nephritis, Reye syndrome (liver/brain edema), metabolic acidosis/respiratory alkalosis

7

mechanism of celecoxib

reversible inhibition of COX2

8

clinical use of celecoxib

- RA, osteoarthritis
- colon adenocarcinoma

9

toxicity of celecoxib

- sulfa allergy
- thrombosis (TXA2 is NOT inhibited leading to unchecked aggregation)

10

mechanism of bisphosphonates (-dronate)

- pyrophosphate analogues that inhibit osteoclast function by blocking apical GTPase --> inhibit bone resorption
- bridge first 48 hrs with calcitonin

11

clinical use of bisphosphonates (-dronate)

- osteoporosis
- hypercalcemia
- Paget disease of bone

12

toxicity of bisphosphonates (-dronate)

- corrosive esophagitis
- jaw osteonecrosis

13

mechanism of teriparatide

- recombinant PTH analog that increases osteoblast activity when given intermittently

14

clinical use of teriparatide

osteoporosis - causes bone growth

15

toxicity of teriparatide

- transient hypercalcemia
- risk of osteosarcoma if used > 2 yrs

16

vemarafinib

BRAF TKI used for melanoma with BRAF V600E mutation unnameable to surgical resection

17

allopurinol

- xanthine oxidase inhibitor --> decreased conversion of purines to uric acid
- used in gout to prevent uricemia
- used in lymphoma and leukemia to prevent tumor lysis-associated nephropathy
- increases concentrations of azathioprine and 6-MP since XO normally metabolizes these drugs

18

febuxostat

XO inhibitor

19

pegloticase

recombinant uricase that catalyzes metabolism of of uric acid to allantoin which is more water soluble

20

probenecid

inhibits reabsorption of uric acid in PCT --> uricemia is fixed, but can cause uric acid nephrolithiasis

21

colchicine

binds and stabilizes tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis and degranulation (used for gout)

22

infliximab, adalimumab

anti-TNFa monoclonal antibody

23

etanercept

fusion of IgG and TNF-a receptor (soluble TNFa receptor!)

24

Before starting any TNFa modulator, it is important to do what?

TB test - inhibiting TNFa function can lead to reactivation of TB since TNFa is important in granuloma formation and stabilization

25

naproxen

like ibuprofen (rev COX1 and 2 inh) but longer t1/2

26

indomethacin

used to close PDA (vs. PGE1 and PGE2 used to keep it OPEN)

27

ketorolac

most efficacious NSAID