Flashcards in msk, skin, ct - last one eeekkkk!! Deck (61):
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function fo LTC4 D4 and E4
increases bronchial tone
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function fo LTB4
PMN chemo
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function fo PGI2
decrease platelet aggregation
decrease vascular tone
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function of PGE1
decreas vascular tone
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function of PGE2
increases uterine tone
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function fo PGF2
increases uterine tone
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function of thromboxane A2
increases platelet aggregation
increases vascular tone
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moa acetaminophen
reversibly inhibits cox, mostly in cns
inactivated peripherally
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cx use of acetaminophen
antipyretic
analgesic
not anti inflammatory
children with viral infection to avoid reyes syndrome
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toxo of acetaminophen
o/s = hepatic necrosis and NAPQI uses up all the glutathion and causes toxic tissue byproducts in the liver
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antidote fo acetaminophene o/d
NAC - regenerates glutathione
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moa aspirin
irreversibly linhibits cyclooxyngease one and two via acetylation - decrease txa2 and pgs
increase bleeding time (no change to pt and ptt)
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low dose of aspirin?
<300 = platelet inhibit aggregation
causes secretion fo uric acid
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intermediate dose of aspirin?
300-2400 = antipyretic and analgesic
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high does aspirin?
2400-4000 = antiinflammatory
reabsorption of uric acid weakly
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toxo of aspirin
tinnitus
gi ulceration
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chornic used of aspirin?
acute renal failure, interstitial nephtiritis, gi bleeding
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children with aspiring
not in viral infections unless you want to stupor/coma/hepatic encephalopathy them up
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acid base balance with aspring
first - respiratory alkalaosis
progresses - mixed metabolic acidodid resp alkalaossi
used the formulat to see if compensated....somethting liek 1.5 HCO3 + /-??? LOOK UP BAH darn.
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moa celecoxib
reversibly inhibits COS2
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where is cox 2 found
inflammatory cells
vascular endothelium
mediates inflammation and pian
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what does cox1 do?
helps maintain gastric mucosa
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benefit of celecoxib
no corrosive effet like other nsaids on the gi liking
spared paltelet function as txa2 is dependent on COX1
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clinical use fo celecoxib
RA and OA
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treat RA and OA
celecoxib
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toxo of celecoxib
sulfa
thrombotic event risk increase
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list the nsaids
ibuprofen
naproxen
diclofenace
indomethacin
ketorolac
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moa of nsaids
reversibly inhibit cox 1 and 2. block pg synthesis
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use of msaids
antipyretic, analgesic, antiinflammatory
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what is indomethacin used for
closign a pda
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a/se of nsaids please
interstitial nephritis
gastric ulcer
renal iscehmia - pgs vasodilate afferent arteriole
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what are bisphosphonates
DRONTES
alendronate
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moa of dronates
bisphosphonates
pyrophosphate analougs that bind hydroxyapatite in bone and inhibit osteoclast activity
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use of dronates
osteoporposis
hypercalcemia
paget disease of bone
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treat hypercalcemia
dronate/bisphosphonates
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treat pagets disease
dronates
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what is teriparatide
recombinant PTH analog given subcutaneously daily
icnreased osteoblastic activity
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use of teriparatide
osteoproosis - causes increased boen growth vrs antiresorptive threaphy cough cough bisphosphonates
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toxo of teriparatide
transient hypercalcemia
increased risk of osteosarcomas (seen in rodents)
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drug associated potentially with icnreased risk of osteosarcoma?
teriparatide
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list the drugs used for chronic gout as preventative tx
allopurinol
febuxostat
pegloticase
probenecid
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moa fo allopurinol
inhibites xanthine oxisase after being converted to alloxanthing
decrease conversion fo xanthine to uric acid
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cxl use of allopurinol outside of preventative in chronci gout
luekemia and lymphoma to prevent tumor lysis associated urate neprhotpahty
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what drugs shoudl be of concern when treating simultaenously with allopurinol
azothioprine and 6 MP = will be icnreased bc both are normally metabolized by xanthine oxidase
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what is febuxostat
inhibits xanthine oxidase
preventative gout
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what is pegloticase
recombinant uricase that catalyzes metabolism or uric acid to allantoin - more water soluble
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what is probenecid
inhibits reabsorption of uric acid in proximal covoluted tublue - also inhibtis secretino of penicillin
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a/se of probenecid
can ppt uric acid calculi
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tx for acute gout pelase list all
nsaids, glucocorticoids and colchicine
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which nsaids are use for acute gout
naproxen
indomethacin
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how are glucocorticoids used for acute gout
oral or intra-articular
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what is colchicine?
binds and stablized tubulin to inhibit mt polymerization impairing PMN chemotaxis and degranulation
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a/se of colchicine
gi side effects
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use of colchicine
acute and prophylactic gout
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what drugs should be avoided in gout treatmetn?
salicylates - all but the highest doses depress uric acid clearance so even high doese have only minor uricosuric acitivy
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what are a/se of TNFa inhibitos
predispose to infection includign reactivation of latent TB
57
why do you have to worry abotu TB with TNFa inhibitors
bc TNFa promotes granuloma formation and stabilization
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what is etaneracept
TNFa IgG1 Fc fusion protein made by recombinat DNA
aka decoy receptor for TNFa
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what do you use etaneracept for
RA, ankylosing, psoriais
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what are infliximab and adalimumab?
anti TNFA monoclona abts
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