Pharm

Question 1

Cox 1 actions

Answer 1

renal function
bronchodilation/constriction
acute prostaglandin production
gastric cytoprotection
platelet aggregation

Question 2

cox 2 actions

Answer 2

renal function
bronchodilation/constriction
sustained prostaglandin production

Question 3

COX1 and COX2 shared functions

Answer 3

renal function

bronchodilation/constriction

Question 4

COX1 only functions

Answer 4

gastric cytoprotection

platelet aggregation

Question 5

PGE1

Answer 5

vasodilation

maintenance of patent ductus arteriosus

Question 6

PGE2

Answer 6

vasodilation
diuresis- Na and K loss in urine
patent ductus arteriosus
gastric cytoprotection
pain sensitization
fever
uterine and GI smooth muscle contraction
relaxation of respiratory smooth muscle

Question 7

PGF2

Answer 7

vasoconstriction
increased aqueous humor drainage
uterine, GI, and respiratory smooth muscle contraction

Question 8

changes in vessel diameter

Answer 8

vasodilation- PGE1, PGE2, PGI2

vasoconstriction- PGF2, TXA2

Question 9

uterine changes

Answer 9

contraction- PGE2, PGF2

relaxation- PGI2

Question 10

GI contraction

Answer 10

PGE2

PGF2

Question 11

respiratory changes

Answer 11

contraction- PGF2, TXA2, leukotrienes C, D, E

relaxation- PGE2, PGI2

Question 12

PGI2

Answer 12

vasodilation- diuresis, NA and K loss in urine
gastric cytoprotection
pain sensitization
fever
relaxation of uterine and respiratory smooth muscle
prevents spontaneous platelet aggregation- inhibits TXA2

Question 13

gastric cytoprotection

Answer 13

PGE2

PGI2

Question 14

pain sensitization

Answer 14

PGE2
PGI2
leukotrienes (LTB4)

Question 15

fever

Answer 15

PGE2

PGI2

Question 16

TXA2

Answer 16

vasoconstriction
contraction of respiratory smooth muscle
platelet aggregation

Question 17

platelet aggregation

Answer 17

inhibit- PGI2

promote- TXA2

Question 18

LTC4, LTD4, LTE4

Answer 18

bronchoconstriction

increased vascular permeability

Question 19

LTB4

Answer 19

chemoattraction

pain sensitization

Question 20

EP1

Answer 20

fever

Question 21

EP2

Answer 21

vascular smooth muscle relaxation

Question 22

EP3

Answer 22

vascular smooth muscle relaxation
decreased gastric acid secretion
increased gastric mucus secretion
uterine contraction
fever

Question 23

EP4

Answer 23

vascular smooth muscle relaxation

pain sensitization

Question 24

budesonide

Answer 24

short half life
used in asthma inhalers
easily penetrates airway mucosa

Question 25

dexamethasone

Answer 25

very potent long half life oral, parenteral, topical multipurpose

Question 26

fluticasone

Answer 26

asthma inhalers and nasal sprays medium potency short half life

Question 27

hydrocortisone (cortisol)

Answer 27

low potency OTC for skin also used PO and parenteral used for adrenal insufficiency replacement medium half life

Question 28

mometasone

Answer 28

medium potency asthma and skin not metabolized in skin, so can cause local side effects systemically absorbed *not as commonly used as budesonide or fluticasone

Question 29

prednisone

Answer 29

long half life prodrug metabolized by liver PO only used for inflammatory conditions

Question 30

prednisolone/methylprednisolone

Answer 30

active metabolite of prednisone used in hepatic disease patients PO, inject, eye drops no bioactivation required

Question 31

triamcinolone

Answer 31

oral, injection, topical potency depends on formulation causes skin issues like mometasone

Question 32

ibuprofen

Answer 32

COX1 pain, fever, OA, RA, dysmenorrhea topical for MSK and dental pediatric- fever

Question 33

naproxen

Answer 33

COX1 similar to ibuprofen LONG half life used 2x daily for arthritis

Question 34

piroxicam

Answer 34

COX1 OA, RA long half life- once daily noncox mediated anti-inflammatory effects high doses more likely to cause peptic ulcers than other NSAIDs

Question 35

indomathacin

Answer 35

COX1 extensive toxicities with severe sideffects used to reverse acute disorders- pericarditis, patent ductus closure, acute gout attack few, night time doses

Question 36

sulindac

Answer 36

``` COX1 RA, OA, gout polyp regression in familial adenomatous polyposis prodrug less GI irritation high CNS effects enterohepatic recycling ```

Question 37

ketoralac

Answer 37

``` COX1 analgesic- better than morphine used with opioids and reduces required opioid dose not anti-inflammatory high risk renal toxicity do not use more than 5 days renal impairment- contraindication ```

Question 38

nabumetone

Answer 38

``` COX1 and COX2 OA, RA, pain non acid NSAID metabolized to weak acid to be activated >24 hour half life pseudoporphyria and photoinsensitivity ```

Question 39

etodolac

Answer 39

COX2 OA, RA less GI ulceration

Question 40

diclofenac

Answer 40

OA, RA less likely to cause GI ulcerations topical gel for localized arthritis more likely to elevate liver enzymes

Question 41

celecoxib

Answer 41

cox 2 selective OA, RA promote regression of polyps lower GI ulceration, but can delay healing of existing ulcers increased risk of Cardiovascular adverse efects

Question 42

meloxicam

Answer 42

cox 2 selective OA, RA low doses have fewer GI sed effects activity is dose dependent