Pharmacology - Anti Inflammatory Drugs Flashcards
(42 cards)
What are the 4 class of anti-inflammatory drugs?
1) Corticosteroids
2) Topical Agents
3) NSAIDs
4) Monoclonal Antibodies
Cortisol is responsible for the redistribution of what?
Neutrophils (moves to plasma and then can’t get out), lymphocytes, monocytes, eosinophils, and basophils
What does cortisol cause a decrease in the release from macrophages?
Decreases release of TNFa, IL1, metalloproteinase, and plasminogen factor
What does cortisol cause a decrease in synthesis of?
- A decrease in synthesis of prostaglandins, leukotrienes, thromboxane, and histamines from mast cells.
What Cox does cortisol decrease the expression of?
- It decreases the expression of COX2
What are 4 synthetic corticosteroids?
1) Prednisone
2) Triamcinolone
3) Dextametasone
4) Fludrocortisone
How are synthetic corticosteroids different from natural corticosteroids?
- Higher affinity for mineral corticoids and glucocorticoid receptors
- Protein binding affinity, rate of elimination, and metabolic products.
Basically it prolongs it
What corticosteroid has the highest salt-retaining activity and is essentially equivalent to aldosterone?
- Fludrocortisone
What drugs have the highest anti inflammatory activity?
- Betamethasone, Desamethasone, and Fludrocortisone.
What are the clinical indication for use of corticosteroids?
- Arthritis (Osteoarthritis, Rheumatoid arthritis, and Psoriatic arthritis)
- Bursitis and tenosynovitis
- Asthma
- Temporal arteritis (Giant cell arteritis)
- Dermatitis
- Inflammatory bowel disease (chrohn’s and UC)
What are the adverse effects of corticosteroids?
What are some contraindication?
- Na+ retention and hypertension.
- Hypokalemia
- Osteoporosis
- Infections
- Hyperglycemia, glycosuria, and peptic ulcers
- Contraindications: peptic ulcers, hypertension, osteoporosis, and heart failure
Why is use of glucocosteroids assist in infection spread?
- due to immune system supression.
Why do NSAIDs cause kidney failure?
- Because of lower levels of prostacyclin in the afferent arterioles.
What 3 classes to NSAIDs fall into?
- Anti-inflammatory, anti-pyretic, and analgesics
What are some adverse affects with long term NSAID use.
-Increase in bleeding time, dyspepsia, subepithelial damage and hemorrhage, GASTRIC MUCOSAL EROSION, FRANK ULCERATION, and GASTRIC MUCOSAL NECROSIS
What is NSAIDs effects on the blood vessels?
- decrease the blood vessels’ sensitivity to bradykinin and histamine
What are the 3 traditional classifications of NSAIDs
- Aspirin and other traditional NSAIDs
- Acetaminophen
- COX2 - selective
In the Mode of action for Aspirin, what is irreversible inhibited and what does that lead to?
- COX1 and COX2 are irreversible inhibited leading to inhibition of prostaglandins, thromboxanes, and prostacyclins.
In the mode of action of aspirin what effect is there on energy production?
decrease in NADPH oxidase which is responsible for neutrophil oxidative burst (aka energy to engulf stuff)
Aspirin inhibition of this leads to increased aspirin-triggered lipoxins?
-COX2
What are aspirins clinical uses?
- decreases incidence of transient ischemic attacks
- unstable angina and coronary artery thrombosis
- ANALGESIC: synergistic with opioids and has been used in combination with morphine, etc. against cancer pain.
What are some adverse effects of Aspirin use?
- AIRWAY HYPERACTIVITY in asthmatic patients. Susceptible patients may also be reactive to indomethacin, naproxen, mefenamate, and phenylbutazone.
- REYE syndrome: may affect certain children under a certain age.
What NSAIDs are members of the propionic acid derivatives?
-IBUPROFEN, naproxen, ketoprofen, flurbiprofen
What are some clinical uses for propionic acid derivatives?
- Ibuprofen for arthritis
- a. spondylitis, gout, primary dysmenorrhea
