Musculoskeletal Pharm EC Flashcards Preview

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Flashcards in Musculoskeletal Pharm EC Deck (17):
1

LTB4 function

Neutrophil chemotaxis

2

LTC4, LTB4, LTE4 functions

Bronchoconstriction
Vasoconstriction
SM contraction
Increased vascular permeability

3

PGI2 functions

Inhibits platelet aggregation
Vasodilation

4

PGE2, PGF2 functions

Increase uterine tone
Increase vascular tone
Decrease bronchial tone

5

TXA2 functions

Increase platelet aggregation
Increase vascular tone
Increase bronchial tone

6

Aspirin (MOA, Use, Tox)

Irreversibly inhibit COX1&2 by acetylation
Increased bleeding time with no change in PT or PTT

Low dose=inhibit platelet aggregation
Medium dose=antipyretic/analgesic
High dose=anti-inflammatory

Gastric ulceration, tinnitus, acute renal failure, interstitial nephritis, upper GI bleed.
Risk of Reye's syndrome in children with viral infection.
Stimulates respiratory centers (hyperventilation/respiratory alkalosis)

7

Ibuprofen, Naproxen, Indomethacin, Ketorolac, Diclofenac (MOA, Use, Tox)

NSAIDS
Reversibly inhibit COX 1&2

Antipyretic, analgesic, anti-inflammatory.
Indomethacin used to close PDA

Interstitial nephritis, Gastric ulcer (PG's protect gastric mucosa), Renal ischemia (PGs vasodilate afferent arteriole)

8

Celecoxib (MOA, Use, Tox)

COX 2 inhibitor (spares COX1 which helps maintain gastric mucosa and spares platelet function as TXA2 is dependent on COX 1)

RA and osteoarthritis, patients with gastritis or ulcers

Increased risk of thrombosis
Sulfa allergy

9

Acetaminophen (MOA, Use, Tox)

Reversibly inhibits cyclooxygenase, MOSTLY IN CNS (inactivated peripherally)

Antipyretic, analgesic, NOT ANTI-INFLAMMATORY
Used instead of aspirin to avoid Reye's syndrome in children with viral infection

Overdose produces hepatic necrosis
(acetaminophen metabolite depletes glutathione and forms toxic tissue adducts in liver)

*Antidote=N-acetylcysteine (regenerates glutathione)

10

Alendronate (MOA, Use, Tox)

Bisphosphonate
Pyrophosphate analog (bind hydroxyapatite in bone, inhibiting osteoclasts)

Osteoporosis
Hypercalcemia
Paget's

Corrosive esophagitis, osteonecrosis of jaw

11

Allopurinol (MOA, Use, Drug-interaction)

Inhibits Xanthine oxidase (decrease conversion of xanthine to uric acid)

Chronic Gout, lymphoma/leukemia (prevent tumor lysis)

Increases Azathioprine and 6-MP (met. by XO)

12

Febuxostat (MOA, Use, Tox)

Inhibits Xanthine oxidase (decrease conversion of xanthine to uric acid)

Chronic Gout

13

Probenecid (MOA, Use, Drug-interaction)

Inhibit reabsorption of uric acid in proximal convoluted tubule

Chronic Gout

*Inhibits secretion of penicillin*

14

Colchicine (MOA, Use, Tox)

Stabilize tubulin to inhibit polymerization (impairing leukocyte chemotaxis and degranulation)

Chronic Gout

GI side effects

15

Acute gout drugs

Naproxen, Indomethacin (NSAIDS)
Glucocorticoids

16

Etanercept (MOA, Use, Negative effects)

TNF-alpha inhibitor
Fusion protein (receptor for TNF-a +IgG Fc)
*produced by recombinant DNA*

RA, psoriasis, ankylosing spondylitis (HLA-B27 diseases)

Predispose to infection including reactivation of TB

17

Infliximab, Adalimumab (MOA, Use, Negative effects)

Anti-TNF-alpha monoclonal antibody

Crohn's disease, RA, Ankylosing spondylitis, psoriasis