Flashcards in Pharmacology Deck (157)
What is the effect of corticosteroids?
Inhibit the production and release of many different cytokines that normally would stimulate the proliferation and function of B and T lymphocytes
Block the phospholipase 2
What are the corticosteroids used for asthma?
What is the toxicity associated with systemic administration of corticosteroids?
Immunosuppression - poor wound healing, opportunistic infection
What are the therapeutic considerations for a short course of corticosteroids?
Insomnia and hyperactivity
When do you use pulse therapy with corticosteroids?
When the person has a serious or life-threatening disease
What is the treatment for anaphylactic reaction?
What are topical corticosteroids used for?
What is a COX 2 Inhibitor?
What is a non-NSAIDs antipyretic / analgesic?
What is the MOA of NSAIDs?
Non-selectively Blocks the action of COX 1 and 2 so it ultimately stops the production of prostaglandins which are involved in inflammation
What are the 5 prostanoids?
2. Thromboxane A2
3. Prostaglandin D2
Where is COX1 expressed?
In most tissues - it is constitutively active
What is COX2 induced by?
Induced by cytokines and other inflammatory mediators
What are the contraindications to Celebrex?
Aspirin allergy and 3rd trimester
What was the reason for taking COX 2 inhibitors off the market?
Increased risk for cardiac events
What are some of the advantages to NSAIDs over aspirin?
Less GI problems
Have longer duration of action
What are the disadvantages to new NSAIDs compared to aspirin.?
No CV benefit or anti-cancer usage
What level of pain are NSAIDs effective for?
What are the GI effects of prostaglandins?
Inhibit gastric acids secretion
Stimulate synthesis of bicarbonate and mucus
Promotes mucosal blood flow
What are the GI effects of NSAIDs?
Epi gastric distress
What does thromboxane A2 do?
Activates platelet aggregation and release
How is aspirin good for prophylaxis of CVD?
It inhibits TXA2 so inhibits vasoconstriction and platelet aggregation
How can NSAIDs cause renal failure?
In the setting of diseases with high levels of circulation vasoconstrictors, it can cause acute renal failure by decreasing renal blood flow because it is inhibiting prostacyclin which normally opposes vasoconstrictor action on the efferent arterioles in the kidney
Diseases to be careful with using NSAIDs: liver failure, CHF,
What are the anti-cancer effects of COX2 inhibitors and aspirin?
Reduces occurrence and mets of cancer by 1/3
What is Reyes's syndrome?
Consequence of flu virus of chicken pox and using salicylates in children.
Liver damage and encephalopathy
What is indomethacin?
The most efficacious NSAID. But causes high rates of GI bleeding so not used chronically.
Used to tx patent ductus arteriosus
What are the side effects of NSAIDs?
Epi gastric distress, naus/vom, microscopic bleeding, ulceration, anemia, prolonged bleeding time, hypersensitivity,
What are the sign of salicylism?
Naus/vom, tinnitus, hyperventilation, headache, mental confusion, dizziness
What are the signs of overdose of a salicylate?
Fever, dehydration, delirium, hallucination, convulsions, coma, respiratory and metabolic acidosis, death
Children are especially vulnerable!!!