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Pharm Term 4 > Anti-Inflammatory Drugs > Flashcards

Anti-Inflammatory Drugs Flashcards

1
Q

Ketorlac

A

NSAID for IM and IV

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2
Q

Indomethacin

A

used for patent ductus arteriosus

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3
Q

What is the mechanism of antipyretic NSAID?

A

dec. PGE2 and inh. IL-1 activity

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4
Q

What is the mechanism of analgesic NSAID?

A

PGE2 and INF mechanism

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5
Q

What is general pharmacokinetics of NSAIDs?

A

Weak acids, well absorbed
cyp3A or cyp2C
renal excretion and some biliary excretion that can cause GI damage
Used for acute inflammation and Sx Tx of chronic inflammation

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6
Q

What are general contraindications of NSAIDs?

A

Allergy
Viral fever in kids (Reye’s Syndrome)&raquo_space; fatal, fatty LV, encephalopathy, hypoglycemia. No jaundice
3rd trimester&raquo_space; could close ductus

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7
Q

What are drug interactions with NSAIDs?

A 
Anti-virals + NSAIDs >> nephrotoxicity >> separate use by 7 days
Inhibits Li excretion
Additive with opiods
GI complications
Caffeine is additive
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8
Q

What is Acetominophen?

A

Analgesic and antipyretic
Destroyed in INF’ed tissue
Inh Cox-3 (a Cox-1 variant in the CNS)&raquo_space; works for H/A
Few side effects in GI, KD, CV

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9
Q

What are chronic inflammatory mediators?

A

IL-1, 2, 3, GM-CSF, TNF-alpha, IFN, PDGF

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10
Q

What are the 3 categories of anti-chronic inflammation?

A

Ablation with DMARDs
inh. cytokine and immune cells with GC
Anti-TNF&raquo_space; inh. cytokines

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11
Q

What are Three DMARDs?

A

MTX
Leflunomide
Sulfasalazine

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12
Q

What is MTX?
What are side effects?
Contraindication?
What is this the first line med for?

A

DMARD
inh folate metabolism (non toxic at low dose)
GI distress, oral ulcers, hepatotoxicity
Contraindicated: prego, LV/KD problems, DM, obesity
First line med for RA, better used in Crohn’s disease, but also in UC

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13
Q

What is Leflunomide?
S/E?
Contraindications?

A

Inh pyrimdine synthesis
inh. COX-2 expression
GI distress, oral ulcers, hepatotoxicity
Contraindicated: prego, LV/KD problems, DM, obesity
As effective as MTX for RA but more hepatotoxicity

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14
Q

What is Sulfasalazine?

A

Combo of Mesalamine and Sulfapyridine
Mes&raquo_space; inh. COX and LOX in gastric mucosa
Sul&raquo_space; free O2 scavenger effective in joints
Not absorbed in ST or SI&raquo_space; used for IBD
More toxic than MTX and Leflunomide

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15
Q

What is the anti-inflammatory mechanisms Glucocorticoids?

A

inh. INF, edema, scar tissue, and immune response
Lipocortins, PLA2 and lipo-oxygenase inhibitory proteins
Essentiall prevent INF from causing immune response

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16
Q

What is the immunosuppression mechanisms Glucocorticoids?

A

inh. lymphoid and myeloid lineages

17
Q

What are S/E of glucocorticoids?

A

Cushingoid syndrome and other endocrine

Peptic ulcers, hypomania, acute psychosis, depression, fluid retention

18
Q

What are contraindications of GC?

A

Peptic ulcer, heart dz, HTN, infexs, DM, psychoses,

hepatic dysfux

19
Q

What are three Anti-TNF agents?

A

Infliximab (remicade)
Adalimumab (humira)
Etanercept

20
Q

What are Infliximab (remicade) and Adalimumab (humira)?

What is different about them?

A

Both Anti-TNF-alpha mAb
Both use murine Ab
Humira is more human, so has less side effects

21
Q

What is the significance of Etanercept?

A

Anti-TNF-alpha mAb
more favored for PAIN
Very expensive

22
Q

What are indications for
Infliximab (remicade)
Adalimumab (humira)
Etanercept

A

arthritis (RA, PsA, AS, Juv RA), psoriasis

Infliximab is also indicated for Behcet’s syndrome and Crohn’s

23
Q

What are contraindications of
Infliximab (remicade)
Adalimumab (humira)
Etanercept

A

breast feeding, DM, elderly

may cause infections and cancer due to inh. immunity

24
Q

What are indole and indene acetic acids and indomethacin used for in term 4?

A

RA, OA, PDA

25
Q

What are Heteroacyl acetic acid, diclofenac used for…
Rapid release?
Slow release?
Topical?

A

Rapid release form&raquo_space; Tx for pain and dysmenorrhea
Slow release form&raquo_space; OA, RA, ank spond
Topical&raquo_space; Actinic keratosis

26
Q

What are enolic acids piroxicam used for?
feature?
contraindicated?

A

OA, RA
Long half-life
NOT in KD pts

27
Q

What are alkanones, nabumetone used for?

Contraindicated

A

Prodrug&raquo_space; LV&raquo_space; 6-MNA is active form
Cox-2 selectve
NOT with LV pts

28
Q

When is Celecoxib still used?

A

Cox-2, but CV effects

Adjuvant for FAP&raquo_space; dec. polyps

Pharm Term 4 (3 decks)

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