Anti-Inflammatories

Question 1

Cortisol MOA

Answer 1

Redistribution of neutrophils, lymphocytes monocytes, eosinophil and basophils.

 macrophage release of TNFα, IL1, metalloproteinase and plasminogen factor

 synthesis of prostaglandins, leukotrienes, thromboxane and histamines from mast cells

COX2 expression

Question 2

drug with the highest anti-inflammatory activity

Answer 2

Dexmethasone

Question 3

Contraindications of anti-inflammatory use

Answer 3

Peptic ulcers, hypertension, osteoporosis and heart failure

Question 4

Adverse effects of anti-inflammatory drugs

Answer 4

Na+ retention and hypertension
Hypokalemia
Osteoporosis
Infections
Hyperglycemia, glycosuria, and peptic ulcers

Question 5

MOA of NSAIDs: Inhibit _____ and _____ , long-term use → many deleterious effects: ___bleeding time, dyspepsia, ________damage and hemorrhage, gastric mucosal erosion, frank ulceration and gastric mucosal necrosis.

Answer 5

COX1, COX2, increased, subepithelial

Question 6

NSAIDs: ____ blood vessels’ sensitivity to bradykinin and histamine, ___ GFR and may lead to kidney failure

Answer 6

Decreased, decreased

Question 7

Aspirine MOA, what other three drugs do this

Answer 7

Decreased NADPH oxidase which affects neutrophils oxidative burst, (indomethacin, piroxicam & ibuprofen)

Question 8

Adverse effects of aspirine

Answer 8

airway hyperactivity, Reye syndrome

Question 9

long T½ is 20 times more potent than aspirin, directly inhibits leukocyte function and cause less severe adverse effects that aspirin, and is a derivative of _____

Answer 9

Naproxen, Propionic acid, (same as ibuprofen)

Question 10

Used for anti-inflammation as well as closure of ducts arteriosus

Answer 10

Indomethacin

Question 11

decreases intracellular concentration of arachidonic acid, used widely in renal stone-associated pain, derivative of_____

Answer 11

diclofenac, acetic acid

Question 12

, strong analgesic properties, used in post surgical patients, derivative of____

Answer 12

ketorolac, acetic acid

Question 13

Fenamate derivatives used for primary dysmenorhea, and arthritis

Answer 13

Mefenemate, meclofenamate

Question 14

A pro-drug

More selective for COX2, less GI disturbances

Answer 14

Nabumetone

Question 15

As efficacious as aspirin, naproxen and ibuprofen against arthritis and is better tolerated

Answer 15

Piroxicam

Question 16

devoid of anti inflammatory activity but has a lower toxicity profile, maybe suitable for______, side effects include

Answer 16

Acetaminophen, children, kidney and liver toxicities

Question 17

More expensive than aspirin or traditional NSAIDs

Similar efficacy in treating osteoarthritis, rheumatoid arthritis, 1 dysmenorrhea but cause less GI side effects than other NSAIDs

Also approved for familial adenomatous polyposis
Higher risk of cardiovascular toxicity (heart attack and stroke) than other NSAIDs

Answer 17

celecoxib

Question 18

Adalimumab, Etanercept and Infliximab
suppress IL-1, IL-6
risk of lymphoma with use

Answer 18

Anti-TNF-alpha

Question 19

blocks T-cell activation with subsequent decrease in TNF. It is approved for use in patient with severe resistant rheumatoid arthritis.

Answer 19

abatacept

Question 20

is a recombinant human anti-CD11a mononclonal antibody approved for adults with sever psoriasis

Answer 20

efalizumab

Question 21

blocks interaction between IgE and the high affinity Fc receptor. Approved for resistant allergic asthma in adults and adolescents

Answer 21

omilzumab

Question 22

PLA is stimulated by

Answer 22

TNFalpa and gamma interferon, macrophages, colony stimulating factor, granulocytes