Flashcards in recitation 6.21 Deck (103)
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1
Ziconotide
indicated for intrathecal admin for severe chronic pain
2
Ziconotide MOA
N-type calcium channel blocker in primary nociceptors in the dorsal horn
3
Ziconotide Warnings
neuropyschosis
4
Ziconotide ADR
dizziness, ataxia, somnolence, nausea
5
intrathecal baclofen
severe spasticity
6
Intrathecal Baclofen ADR
hypotonia, somnolence, dizziness,
7
Topical analgesics
methyl salicylate, Trolamaine salicylate
8
Counter irritants
menthol, camphor, capsaicin
9
Counter irritants ADR
creates irritation/inflammation locally to relieve inflammation in underlying or adjacent tissues and local anesthetic action
10
Menthol indications
orally for GI complaints and topically for pain, inflammation
11
Menthol ADR
oral: heartburn, NV. Topical: dermatitis, irritation
12
Camphor
topical anti-tussive, analgesic
13
Camphor toxicity
NV, burning of mouth, and throat. can lead to seizure and respiratory depression
14
Capsaicin MOA
TRPV 1 channel agonist. enhances TRPV1 stimulation and relieves pain when these receptors are desensitized.
15
Capsaicin indications
post herpetic neuralgia
16
Capsaicin ADR
oral- GI discomfort, sweating, flushing, anitcoag
Topical- burning, stinging, erythema
17
Iontophoresis
ion current to deliver charged drugs through the skin
18
Gout
allopurinol, colchicine, febuxostat, probenacid, Rasburicase, pegloticase
19
Allopurinol MOA
Xanthine oxidase inhibitor and purine analog. Reduces production of uric acid
20
Allopurinol indications
Chronic treatment of rimary or secondary gout, tumor lysis syndrome in chemo patients, hyperuricemia with recurrent calcium oxalate stones
21
Allopurinol Drug interactions
Azothioprine, warfarin, increases theophylline
22
Allopurinol ADR
rash, ND, increased LFT, acute gout attack
23
Probenacid
chronic treatment for hyperuricemia associated with gout and boosts PSN levels
24
Probenacid MOA
blocks renal tubular reabsorption of urate
25
Probenacid ADR
HA, nausea, worsening gout flares, dizziness, uric acid, kidney stones, blood dyscrasias
26
Febuxostat
chronic treatment for gout
27
Febuxostat MOA
Xanthine oxidase inhibitor
28
Febuxostat ADR
higher CV events and hepatic failure
29
Lesinurad
use with an XOI when target uric acid levels are not acheived
30
Lesinurad MOA
blocks uric acid resborption
31
Lesinurad interactions
metabolized at CYP2C9- amlodipine, soldenafil
32
Lesinurad ADR
increased SCr, renal failure, kidney stones, HA, flu, GERD
33
Colchicine
prophylaxis and treatment of gout flare and familial mediterranean fever
34
Colchicine MOA
inhibits microtubule formation in bone cells and prevents neutrophil activation
35
Colchicine warnings
blood dyscrasias, neuromuscular toxicity, rhabdo, contraindicated with strong 3A4 inhibitors
36
Colchicine ADR
DIARRHEA, throat pain
37
Pegloticase
refractory chronic gout
38
Pegloticase MOA
PEGylated uricase enzyme catalyzies oxidation of uric acid to allantoin
39
Pegloticase ADR
gout flare, infusion reaction, nausea, ecchymosis, nasopharyngitis, constipation, chest pain, vomiting, CHF exacerbation
40
Rasburicase
hyperuricemia due to tumor lysis syndrome
41
Rasburicase MOA
urate-oxidase, catalyzes oxidation of uric acid to allantoin
42
Rasburicase ADR
anaphylaxis, hemolysis, methemoglobinemia
43
Systemic Corticosteroids
prednisone, methylprednisone, prednisolone
44
Systemic corticosteroid MOA
inhibit cytokine production, adhesion, protein activation, inflammatory cell migration, and activation (anti-inflammatory)
45
Systemic Corticosteroids short term ADR
hyperglycemia, increased appetite, fluid retention, wt gain, mood alteration, HTN, peptic ulcer
46
Systemic Corticosteroids Long term ADR
adrenal axis suppression
47
Systemic corticosteroid indications
Rheumatoid arthritis
48
DMARDS (disease modifying rheumatic drugs)
Methotrexate, leflunomide, hydroxychloroquine, Sulfasalazine, Minocycline
49
DMARDs biologics
humira, enbrel, Remicade, Cimzia, Simponia, orencia, Rituxan, Actemra, Stelara
50
Methotrexate MOA
folate analog, relieves inflammation, swelling and pain
51
Methotrexate
rheumatoid arthritis. psoriasis, some cancers
52
Methotrexate contraindications
pregnancy and lactation, liver disease, alcoholism, blood dyscrasias
53
Methotrexate ADR
NV, hair loss, rash, abnormal liver enzymes, fatigue, mouth sores, diarrhea, low blood counts
54
Leflunomide MOA
pyrimidine synthesis inhibitor
55
Leflunomide
reduces signs and symptoms, inhibit structural damage in RA
56
Leflunomide contraindications
pregnancy
57
Leflunomide warnings
hepatotoxicity
58
Leflunomide ADR
Diarrgea, N, stomach pain, indigestion, rash, hair loss, cough, SOB, lung injury
59
Hydroxychloroquine
antimalarial, RA, discoid and systemic lupus
60
Hydroxychloroquine contraindications
retinal or visual field changes, long term use in kids
61
Hydroxychloroquine ADR
bulls eye maculopathy, nausea, diarrhea, skin and hair changes
62
sulfasalazine
ulcerative colitis, RA, ankylosing spondilitis. psoriatic arthritis
63
Sulfasalazine MOA
anti-inflammatory and immunomodulatory
64
Sulfasalazine ADR
Nausea, abd discomfort, photosensitivity
65
Minocycline
mild RA
66
Minocycline ADR
dizziness, rash, photosensitivity
67
Anti-TNF drugs MOA
genetically engineered proteins that block proinflammatory cytokines
68
Anti-TNF indications
used when DMARDs fail in RA, psoriatic arthritis, peds crohns and UC, anylosing spondylitis and psoriasis
69
Anti-TNF contraindications
infection, HF, MS, cancer
70
Anti-TNF ADR
infection, injection site reactions (local rash, burning, itching), infusion reaction (headache and abdominal pain)
71
Anti-TNF
Humira, Enbrel, remicade, cimzia, Simponi
72
Abatacept (Orencia)
second line for RA, juvenile arthritis after MTX and biologics
73
Orencia MOA
selective T cell costimulation modulator. prevents T cell activation
74
Orencia contraindications
Concomitant use with other biologics
75
Orencia ADR
HA, URI, nasopharyngitis, nausea
76
Ritixumab (Rituxan) MOA
chemo drug- targets and removes abnormal B cells decreasing autoimmune response
77
Rituxan
Non-hogdkins lymphoma, Chronic lymphocytic Leukemia, Second line RA, wegeners granulomatosis, Microscopic polyangitis
78
Rituxan Warnings
tumor lysis syndrome, SJS, TEN, Hep b reactivation, cardiac arrhythmias, renal toxicity, bowel obstruction
79
Rituxan ADR
infusion reaction, hypotension
80
Tocilizumab (Actemra)
RA, JA
81
Actemra MOA
IL-6 receptor agonist- binds and inhibits signaling
82
Actemra warnings
serious infections, GI perforation, neutropenia, live vaccines
83
Actemra ADR
HA, HTN, increased cholesterol, increased ALT, URI
84
Stelara
psoriasis, psoriatic Arthritis
85
Stelara MOA
selectively targets IL-12 and IL-23
86
Stelara ADR
nasopharyngitis, URI, HA, fatigue, arthralgia, nausea
87
Calcium
Osteoporosis
88
Difference in Ca carbonate and Ca citrate
Citrate absorbs better, Carbonate must take with food.
89
Biphosphonates
Alendronate, Risedronate, Ibandronate, Zoledronic acid
90
Biphosphonates MOA
block osteoclasts activity
91
Biphosphonates warning
GI side effects, infusion reactions, osteonecrosis of the jaw, arrhythmias, bone quality, Uveitus/scleritis, esophagitis, not for women of child bearing age
92
Alendronate ADR
dyspepsia, abd pain, acid reflux, constipation, diarrhea, musculoskeletal pain, nausea
93
Zolendronate indications
osteoporosis (Reclast), hypercalcemia of malignancy, multiple myeloma (Zometa)
94
Raloxifene (Evista)
increases BMD without breast Cancer or endometrial hyperplasia
95
Raloxifene ADR
increased risk of DVT
96
Teriparatide (Forteo)
synthetic PTH that builds bone by stimulating osteoblast activity
97
Teriparatide warnings
osteosarcoma
98
Teriparatide contraindications
Pagets disease, preg/nursing, peds, prior radiation therapy, bone mets, skeletal malignancies, hypercalcemia
99
Teriparatide ADR
hypercalcemia, HA, myalgia, arthralgia
100
Denosumab MOA
monoclonal antibody that blocks RANK ligand which stimulates osteoclasts
101
Denosumab indications
postmenopausal women with osteoporosis (Prolia) unresectable giant cell tumor, increase bone mass in high risk for fracture (Xgeva)
102
Denosumab ADR
cellulitis, eczema, flatulence, fatigue, asthenia, hypophosphatemia, nausea, dyspnea, arthralgia, HA
103
