Musculoskeletal Pharm EC

Question 1

LTB4 function

Answer 1

Neutrophil chemotaxis

Question 2

LTC4, LTB4, LTE4 functions

Answer 2

Bronchoconstriction
Vasoconstriction
SM contraction
Increased vascular permeability

Question 3

PGI2 functions

Answer 3

Inhibits platelet aggregation

Vasodilation

Question 4

PGE2, PGF2 functions

Answer 4

Increase uterine tone
Increase vascular tone
Decrease bronchial tone

Question 5

TXA2 functions

Answer 5

Increase platelet aggregation
Increase vascular tone
Increase bronchial tone

Question 6

Aspirin (MOA, Use, Tox)

Answer 6

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)

Question 7

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

Answer 7

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)

Question 8

Celecoxib (MOA, Use, Tox)

Answer 8

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

Question 9

Acetaminophen (MOA, Use, Tox)

Answer 9

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)

Question 10

Alendronate (MOA, Use, Tox)

Answer 10

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

Osteoporosis
Hypercalcemia
Paget’s

Corrosive esophagitis, osteonecrosis of jaw

Question 11

Allopurinol (MOA, Use, Drug-interaction)

Answer 11

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)

Question 12

Febuxostat (MOA, Use, Tox)

Answer 12

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

Chronic Gout

Question 13

Probenecid (MOA, Use, Drug-interaction)

Answer 13

Inhibit reabsorption of uric acid in proximal convoluted tubule

Chronic Gout

Inhibits secretion of penicillin

Question 14

Colchicine (MOA, Use, Tox)

Answer 14

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

Chronic Gout

GI side effects

Question 15

Acute gout drugs

Answer 15

Naproxen, Indomethacin (NSAIDS)

Glucocorticoids

Question 16

Etanercept (MOA, Use, Negative effects)

Answer 16

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

Question 17

Infliximab, Adalimumab (MOA, Use, Negative effects)

Answer 17

Anti-TNF-alpha monoclonal antibody

Crohn’s disease, RA, Ankylosing spondylitis, psoriasis