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COM: MSK II - Midterm > Pharm > Flashcards

Pharm Flashcards

1
Q

NSAID ingredient of topical gel that is perhaps the most effective pain remedy for osteoarthritis

A

diclofenac

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2
Q

biologic DMARD of limited efficacy, recombinant version of endogenous human IL-1 receptor antagonist

A

Anakinra

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3
Q

JAK3 antagonist used as a biologic DMARS, novel in that it is orally active

A

Tofacitinib

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4
Q

Peptide blocker of N-type voltage gated calcium channels administered intrathecally for refractory pain

A

ziconotide

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5
Q

classic NSAID with COX1 selectivity, remains a drug of choice for treating acute gouty arthritis

A

Indomethacin

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6
Q

Drugs that relieve pain without causing loss of consciousness

A

Analgesics

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7
Q

Noteworthy because it suppresses fever and pain but not inflammation, presumably in part by inhibiting prostaglandin synthesis in the CNS

A

Aceetaminophen

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8
Q

COX-2 inhibitor that can be administered to treat pain and inflammation of RA if the benefits outlay the risk; only member of its class still marketed in the US

A

Celecoxib

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9
Q

Accumulates outside of the cell as a consequence of AICAR accumulation inside cells due to the action of polyglutamated methotrexate; binds to purinergic GPCR on cell surface to exert anti-inflammatory response

A

Adenosine

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10
Q

Pts with pain due to RA are often administered NSAIDs or glucocorticoids despite their lack of effect on disease progression while waiting for a drug from this class to begin exerting its effects

A

DMARD

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11
Q

Abbreviation for a prostaglandin that has widespread effects throughout the body including inc vascular permeability, mucosal protection in the gut, fever in the CNS, pain sensation in the periphery, and salt & water homeostasis in the kidney

A

PGE-2

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12
Q

What class of drugs do lidocaine and pramoxine that can help treat things such as neuropathic pruritus or pruritus due to CKD belong to?

A

Local anesthetics

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13
Q

Prototypical bisphosphonate, drug class of first choice for treating osteoporosis, its incorporation into bone inhibits the number and activity of osteoclasts

A

Alendronate

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14
Q

Osteoporosis monoclonal Ab therapy that binds RANKL (receptor activator of NF-kB ligand) to decrease formation and function of osteoclasts

A

Denosumab

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15
Q

Potentially lethal consequence of acetaminophen overdosage

A

Hepatic necrosis

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16
Q

disrupts pyrimidine synthesis, a second choice traditional DMARD due to more common serious adverse effects

A

Leflunomide

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17
Q

Classic alpha2-adrenergic agonist administered PO to reduce blood pressure, also administered intrathecally as adjunct therapy for severe cancer pain not treated effectively by opioids alone

A

Clonidine

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18
Q

This is cleaved from cell membrane phospholipids by phospholipase A2 in response to ‘stimuli’, converted to eicosanoids such as prostaglandins and thromboxjnes

A

Arachidonic acid

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19
Q

What pt population is at greater risk for serious adverse effects of NSAIDS?

A

Elderly

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20
Q

Antidote for acetaminophen poisoning, substitutes for depleted glutathione in liver cells

A

Acetylcysteine

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21
Q

Local anesthetics such as lidocaine interfere with this component of pain sensation

A

Transmission

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22
Q

The dorsal horn of the SC is where descending inhibitory fibers and various drugs such as ketamine and SNRI’s influence this component of pain sensation

A

Modulation

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23
Q

Biologic DMARS, fusion protein blocks T cell CD80/86 co-stimulatory signal needed for activation

A

Abatacept

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24
Q

This structure can be closed prematurely by NSAIDS

A

Ductus arteriosus

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25
Q

COX that is induced in response to pathologic stimuli; unfortunately its selective blockade was found to inc the risk for vascular thrombosis as balance between local TxA2 and PGI2 was altered to favor platelet aggregation and vasoconstriction

A

COX-2

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26
Q

Dexamethasone, betamethasone, and triamcinolone are among the ____________ prednisolone, which have much greater potency and/or 1/2 life than natural hydrocortisone

A

Fluorinated

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27
Q

Fusion protein made from Fc portion of IgG and 2 TNF receptors, a biologic DMARD administered 1-2x/wk by subcutaneous injection; also used for psoriasis

A

etanercept

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28
Q

a weak mu agonist that also blocks 5-HT and NE re-uptake, used by many to treat moderate to severe pain

A

tramadol

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29
Q

Damage to this is a serious side effect of hydroxycloroquine, but little risk from low doses now used to treat RA

A

retina

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30
Q

Expensive non-purine xanthine oxidase inhibitor used for reducing rate levels in those with allopurinol intolerance

A

Febuxostat

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31
Q

abbreviation for the class of antidepressant drugs having the most evidence of benefit for treating neuropathic pain; SE’s include dry mouth, constipation, tachycardia, palpitations, nausea and sedation

A

TCA

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32
Q

Drugs that lower serum urate levels by increasing its fractional excretion by the kidneys

A

Uricosuric

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33
Q

SERM with agonist effects on bone but not breast or uterus used to treat osteoporosis

A

Raloxifene

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34
Q

Bisphosphonate administered by IV injection once per year; also assoc with highest incidence of osteonecrosis of the jaw

A

Zolendronic acid

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35
Q

Antagonist at NMDA-type glutamate receptors that relieves pain, widely used veterinary anesthetic also used to reduce amount of morphine needed by humans; SE’s are agitation and hallucination

A

Ketamine

36
Q

Blocks urate reabsorption by URAT1 transporter in PCT to inc fractional excretion of filtered urate in the urine

A

Probenecid

37
Q

happens during the initial phase of aspirin poisoning

A

Respiratory alkalosis

38
Q

Blocking the effects of this inflammatory mediator is a common target when treating RA and various other autoimmune diseases

A

TNF

39
Q

Calcitonin from this species has a longer 1/2 life and greater potency than human calcitonin, can be administered intranasally or parenterally to treat established osteoporosis

A

Salmon

40
Q

What is the preferred/standard of care therapy for treatment of recurrent gout if low GFR or past urate stone or to reduce effects of urate overproduction from things such as tumor lysis syndrome?

A

allopurinol

41
Q

Type of nociceptive pain that tends to be poorly localized, deep, dull and cramping

A

Visceral

42
Q

abruptly doing this with exogenous glucocorticoids can be deadly

A

Stopping

43
Q

Mammalian enzyme that converts uric acid to allantoin, mutated/nonfuncitonal in humans

A

Uricase

44
Q

Antiepileptic drug also used to treat neuropathic pain of diabetes, shingles and fibromyalgia

A

pregabalin

45
Q

Abbreviation for the prostaglandin formed by endothelial cells that causes local vasodilation and inhibits platelet aggregation

A

PGI2

46
Q

Its presence greatly increases risk of developing gastric ulcer in response to NSAID therapy

A

H. Pylori

47
Q

This can be triggered by aspirin, presumably because local leukotriene effects predominate over prostaglandin effects

A

Asthma

48
Q

biologic DMARd that is humanized antihuman IL-6 receptor Ab, among its effects is to dec acute phase response of the liver

A

Tocilizumab

49
Q

1-34 PTH, only agent that forms bone but must be administered in a pulsed manner otherwise leads to bone resorption

A

Teriparatide

50
Q

nature of the interaction between COX and aspirin, but not other NSAIDs

A

irreversible

51
Q

Calcium receptor sensitizer, acts to lower PTH secretion in chronic kidney disease

A

Cinacalcet

52
Q

Most effective and fastest acting of the traditional DMARDS, monitor for myelosuppression but generally well tolerated at low doses, often added to biologic DMARDs

A

methotrexate

53
Q

Allopurinol is among the widely used drugs that can cause this potential syndrome of epidermal necrolysis

A

steven johnson syndrome

54
Q

absolute contraindication for tx of RA with methotrexate, reason to choose hydroxychloroquine instead

A

Pregnancy

55
Q

NSAID notable for often being administered IM or IV

A

Ketorolac

56
Q

agent used as a traditional DMARD alone or in combo and also to tx IBD, GI side effects are a common reason for discontinuing

A

sulfasalazine

57
Q

uricosuric agent acting similar to probenecid, both require GFR > 60

A

Sulfinpyrazone

58
Q

Exerts its pain relieving effects by binding to the alpha2-Delta subunit of N-type voltage-gated Ca channels (contrary to what its name might suggest)

A

Gabapentin

59
Q

Happens to methotrexate, appears to be responsible for its low dose ability to treat RA and reason its beneficial effects persist for some time after drug discontinuation

A

polygutamation

60
Q

opioids, alpha2-agonists and general anesthetics are among the pharmacological agents that interfere with this component of pain

A

perception

61
Q

alpha2-adrenergic agonist administered IV for pain and sedation

A

Dexmedetomidine

62
Q

Antimalarial that is also a traditional DMARD used alone or in combo, alters Ag presentation by disrupting lysosomal pH

A

hydroxychloroquine

63
Q

non-aspirin NSAID with long 1/2 life that can be useful for treating inflammation and/or pain of arthritis, a recommended drug of choice when benefits still outweigh concurrent CV risks

A

naproxen

64
Q

never do this with biologic DMARDs

A

combine

65
Q

drug class associated with atypical fractures (ex. simple fracture of compact bone such as the shaft of the femur)

A

bisphosphonates

66
Q

seen during second potentially lethal phase of salicylate poisoning

A

Metabolic acidosis

67
Q

COX that is constitutive in all tissues, has physiological role and contributes to pathological responses

A

COX-1

68
Q

Abbreviation for the thromboxane synthesized by platelets that causes vasoconstriction and promotes platelet aggregation

A

TXA-2

69
Q

Chimeric (human and mouse) monoclonal Ab directed against TNF that can be administered IV every 6wks as a biologic DMARD

A

infliximab

70
Q

methotrexate, hydroxychloroquine, and sulfasalazine are examples of this type of DMARD

A

traditional

71
Q

Relieves inflammation from gout if administered with 12-24hrs of sx onset by blocking the tubular polymerization (microtubule formation) needed by leukocytes of migration and phagocytosis; can cause GI distress when used for prophylaxis

A

colchicine

72
Q

AutoAbs present in a majority of RA pts target arginine residues in proteins that have been converted to this

A

Citrulline

73
Q

Targets CD20 Ag of B cells to cause a B cell ‘do-over’ used to treat non-hodgkin lymphoma and CLL, and can be effective in some Ab-dependent autoimmune diseases

A

rituximab

74
Q

along with chondroitin, widely used in hopes of treating osteoarthritis but little evidence of benefit beyond placebo effect

A

Glucosamine

75
Q

can occur in the jaw of people using bisphosphonates, can be triggered by dental work

A

Osteonecrosis

76
Q

These cells are particularly vulnerable to the effects of aspirin as they cannot synthesize replacement COX

A

platelets

77
Q

PEGylated version of recombinant mammalian uricase used to treat chronic gout in those refractory to conventional therapy

A

Pegloticase

78
Q

Dietary supplements for adolescents, postmenopausal women and elderly to treat mild hypocalcemia by facilitating bone growth or limited bone loss

A

Calcium salts

79
Q

non-PEGylated recombinant uricase administered for prevention of acute uric acid nephropathy due to tumor lysis syndrome

A

Rasburicase

80
Q

What is the common triple therapy used to treat RA?

A

Methotrexate
hydroxychloroquine
Sulfasalazine

**all used together

81
Q

Pain due to nerve damage rather than stimulation of nociceptors

A

Neuropathic

82
Q

anti-TNF biologic DMARD, this is humanized monoclonal Ab administered subcutaneously every 2 weeks; also used for psoriatic arthritis, ankylosing spondylitis, Crohn’s disease

A

Adalimumab

83
Q

irreversible COX inhibitor used to relieve inflammation and pain of RA, does not alter disease progression

A

Aspirin

84
Q

Capsaicin and camphor stimulation of these receptors gives a sensation of “heat” that can be useful counterirritant to reduce pain

A

TRPV-1

85
Q

“Cold” receptor stimulated by menthol in IcyHot

A

TRPM-8

COM: MSK II - Midterm (3 decks)

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