Anti-inflammatory and immunosuppressant drugs Flashcards
What classes of Anti-inflammatory drugs are there
- Steroidal anti-inflammatory drugs
- Non-steroidal anti-inflammatory drugs (NSAIDs)
- Traditional or “non-selective” NSAIDS
- COX-2 inhibitors
Give an example of steroidal anti-inflammatory drugs
Corticosteroids - prednisolone
Give an example of NSAIDs
Acetyl salicylic acid - aspirin
Give an example of Traditional or “non-selective” NSAIDs
- Ibuprofen
- Naproxen
- Diclofenac
Give an example of COX-2 inhibitors
- Celecoxib
What is the general mechanism of NSAIDs
They inhibit the production of Prostaglandins from arachidonic acid by COX enzymes
What effects does aspirin have
Analgesic, anti-inflammatory and anti-thrombotic effects
Where is aspirin metabolised and excreted
Metabolised in Liver
Excreted in Kidneys
In which patients should you avoid using aspirin
In patients with severe liver disease and on dialysis
What does aspirin act on
Permanently affects platelet cohesiveness for the entire life span of the platelets
Affects primary homeostasis ~ prolonged bleeding time
What is aspirin’s effect on platelet count, PT/INR and APTT
Nothing
What general effects do traditional/non-selective NSAIDs have
Analgesic, anti-inflammatory and antipyretic actions
What do traditional/non-selective NSAIDs inhibit
COX-1 and COX-2
What does the inhibition of COX-1 and COX-2 result in
- Inhibition of COX-1 = accounts for NSAIDs side effects and toxicity
- Inhibition of COX-2 = accounts for anti-inflammatory actions
What are the side effects of traditional/non-selective NSAIDs
- Gastric irritability
- Platelet dysfunction ~ temporarily affect platelet cohsiveness
- Acute renal failure ~ short term, low dose use does not cause this effect
- Leukotriene overproduction ~ bronchoconstriction ~ avoid in asthmatic patients
What general effects do selective NSAIDs or COX-2 inhibitors have
- Analgesic
- Anti-inflammatory
- Anti-pyretic
Give examples of selective NSAIDs or COX-2 inhibitors
Celecoxib
Etoricoxib
What do selective NSAIDs or COX-2 inhibitors affect
Promotes platelet aggregation - avoid use in patients with significant history of atherosclerosis
Where are selective NSAIDs or COX-2 inhibitors metabolised and excreted
Metabolised in the liver
Excreted in the kidneys
Name some types of anti-inflammatory/immunosuppressive drugs
Antimitotic agents
Calcineurin inhibitors
Biological response modifiers
Name some kinds of anti-inflammatory drugs
Corticosteroids
Name some kinds of anti-mitotic agents
- Azathioprine
- Cyclophoshphamide
- Chlorambucil
Name some types of calcineurin inhibitors
- Ciclosporin
- Tacrolimus
Name some types of biological response modifiers
- Adalimumab
- Infliximab
- Etanercept