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Med School Year 2 Flash Cards > Pharmacology > Flashcards

Flashcards in Pharmacology Deck (157)
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1

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

2

What are the corticosteroids used for asthma?

Beclomethasone
Budesonide
Triamcinolone

3

What is the toxicity associated with systemic administration of corticosteroids?

HPA suppression
Immunosuppression - poor wound healing, opportunistic infection
Cushing's syndrome
Hyperglycemia
Hypertension
Peptic ulcers
Myopathy
Behavioral changes
Cataracts
Osteoporosis
Growth retardation

4

What are the therapeutic considerations for a short course of corticosteroids?

Insomnia and hyperactivity

5

When do you use pulse therapy with corticosteroids?

When the person has a serious or life-threatening disease

6

What is the treatment for anaphylactic reaction?

Epinephrine

7

What are topical corticosteroids used for?

Dermatologic conditions

8

What is a COX 2 Inhibitor?

Celecoxib

9

What is a non-NSAIDs antipyretic / analgesic?

Acetaminophen

10

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

11

What are the 5 prostanoids?

1. Prostacyclin
2. Thromboxane A2
3. Prostaglandin D2
4. PGE2
5. PGF2

12

Where is COX1 expressed?

In most tissues - it is constitutively active

13

What is COX2 induced by?

Induced by cytokines and other inflammatory mediators

14

What are the contraindications to Celebrex?

Aspirin allergy and 3rd trimester

15

What was the reason for taking COX 2 inhibitors off the market?

Increased risk for cardiac events

16

What are some of the advantages to NSAIDs over aspirin?

More potent
More efficacious
Less GI problems
Have longer duration of action

17

What are the disadvantages to new NSAIDs compared to aspirin.?

More expensive
More toxic
No CV benefit or anti-cancer usage

18

What level of pain are NSAIDs effective for?

Low-to-moderate intensity

19

What are the GI effects of prostaglandins?

Inhibit gastric acids secretion
Stimulate synthesis of bicarbonate and mucus
Promotes mucosal blood flow

20

What are the GI effects of NSAIDs?

Epi gastric distress
Nausea
Vom
Microhemorrhage
Ulceration
Anemia

21

What does thromboxane A2 do?

Vasoconstrictor
Activates platelet aggregation and release

22

How is aspirin good for prophylaxis of CVD?

It inhibits TXA2 so inhibits vasoconstriction and platelet aggregation

23

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,

24

What are the anti-cancer effects of COX2 inhibitors and aspirin?

Reduces occurrence and mets of cancer by 1/3

25

What is Reyes's syndrome?

Consequence of flu virus of chicken pox and using salicylates in children.
Liver damage and encephalopathy

26

What is indomethacin?

The most efficacious NSAID. But causes high rates of GI bleeding so not used chronically.

Used to tx patent ductus arteriosus

27

What are the side effects of NSAIDs?

Epi gastric distress, naus/vom, microscopic bleeding, ulceration, anemia, prolonged bleeding time, hypersensitivity,

28

What are the sign of salicylism?

Naus/vom, tinnitus, hyperventilation, headache, mental confusion, dizziness

29

What are the signs of overdose of a salicylate?

Fever, dehydration, delirium, hallucination, convulsions, coma, respiratory and metabolic acidosis, death

Children are especially vulnerable!!!

30

What are adverse effects of salicylates during pregnancy?

Low birth weight
Increased perinatal mortality
Anemia
Antepartum and postpartum hemorrhage
Prolonged gestation
Premature closure of ductus arteriosus