Anti-inflammatories, Biologics, Corticosteroids, Gout, & Osteoporosis Flashcards
Peptide blocker of N-type voltage gated calcium channels administered intrathecally for refractory pain
Ziconotide
PEGylated version of recombinant mammalian uricase used to treat chronic gout in those refractory to conventional therapy
Pegloticase
NSAID ingredient of topical gel that is perhaps the most effective topical pain remedy for osteoarthritis
Diclofenac
Can occur in the jaw of people using bisphosphonates (or denosumab); can be triggered by dental work
Osteonecrosis
Osteoporosis monoclonal antibody therapy that binds RANKL (receptor activator of nuclear factor kappaB ligand) to decrease formation and function of osteoclasts
Denosumab
Patients with pain due to rheumatoid arthritis are often administered NSAIDs or glucocorticoids despite their lack of effect on disease progression while waiting for a drug from this class to begin exertings its effects
DMARD
Classic NSAID with COX1 selectivity, remains a drug of choice for treating acute gouty arthritis
Indomethacin
The interaction between cyclooxygenase and aspirin is _________, which is not the case as with the other NSAIDs
Irreversible
Patient population at greater risk for serious adverse effects of NSAIDs
Elderly
Uricosuric agent acting similar to probenicid, both require GFR >60 ml/min
Sulfinpyrazone
Disrupts pyrimidine synthesis, a second-choice traditional DMARD due to more common serious adverse effects
Leflunomide
Exerts its pain-relieving effects by binding to the alpha-2-delta subunit of N-type voltage-gated calcium channels
Gabapentin
Anti-TNF biologic DMARD, this humanized monoclonal antibody is administered subcutaneously every 2 weeks; also used for psoriatic arthritis, ankylosing spondylitis, and Crohns disease
Adalimumab
Antagonist at NMDA-type glutamate receptors that relieves pain; also used to reduce amount of morphine needed by humans; adverse effects include agitation and hallucinations
Ketamine
Fusion protein made from Fc portion of IgG and two TNF receptors, a biologic DMARD administered 1-2x/week by subcutaneous injection; also used for psoriasis
Etanercept
______ syndrome is associated with swelling of the liver and brain due to use of aspirin by children with viral illness
Reye
_________ of methotrexate is associated with its low-dose ability to treat RA and the persistence of beneficial effects for some time after drug discontinuation
Polyglutamation
Drugs such as lidocaine and pramoxine that can help treat neuropathic pruritis or pruritis due to CKD
Local anesthetics
Cyclooxygenase that is induced in response to pathologic stimuli; unfortunately, its selective blockade was found to increase risk for vascular thrombosis as balance between local TXA2 and PGI2 was altered to favor platelet aggregation and vasoconstriction
COX-2
Refers to the use of methotrexate, hydroxychloroquine, and sulfasalazine together to treat RA
Triple therapy
Relieves inflammation from gout if administered within 12-24 hrs of symptom onset by blocking the tubulin polymerization (microtubule formation) needed by leukocytes of migration and phagocytosis; can cause GI distress when used for prophylaxis
Colchicine
Cleaved from cell membrane phospholipids by PLA2 in response to ‘stimuli’, converted to eicosanoids such as prostaglandins and thromboxanes
Arachidonic acid
Synthesized by platelets; causes vasoconstriction and promotes platelet aggregation
TXA2
Classic alpha2-adrenergic agonist administered PO to reduce blood pressure, also administered intrathecally as adjunct therapy for severe cancer pain not treated effectively by opioids alone
Clonidine
Can be triggered by aspirin, presumably because local leukotriene effects predominate over prostaglandin effects
Asthma
Enzyme that converts uric acid to allantoin, mutated/nonfunctional in humans
Uricase
Biologic DMARD of limited efficacy, recombinant version of endogenous human IL-1 receptor antagonist
Anakinra
Calcium-receptor sensitizer, acts to lower PTH secretion in chronic kidney disease
Cinacalcet
Most effective and fastest acting of the traditional DMARDs, monitor for myelosuppression but generally well tolerated at low doses, often added to biologic DMARDs
Methotrexate