Anti-Inflammatory Drugs Flashcards
histamine
vasodilation/redness
swelling (vascular permeability)
bronchoconstriction (type 1)
hypotension
histidine — [L-histadine decarboxylase —- > histamine
LTB4
pain
chemotactic for neutrophils*
LTC4, LTD4, LTE4
peptido leukotrienes
swelling (vascular permeability)
eosinophil chemotactic
bronchoconstriction (type 1)*
PGD2
bronchoconstriction (type 1)
PGE2
vasodilation/redness
pain
fever* (IL-1 –> PGE2 –> hypothalamus –> fever)
PGI2 (prostacyclin)
vasodilation/redness
pain
TXA2 (thromboxane)
causes platelet aggregation
vasoconstriction
bradykinin
strong vasodilator – hypotension
+lots more
kallidin
strong vasodilator – hypotension
+lots more
Diphenhydramine
Sedating Antihistamine
H1 inverse agonist, but also blocks muscarinic, alpha adrenergic, and serotonin receptors
sedation, drying of secretions (anticholinergic), GI disturbances
Chlorpheniramine
Sedating Antihistamine
H1 inverse agonist, but also blocks muscarinic, alpha adrenergic, and serotonin receptors
sedation, drying of secretions (anticholinergic), GI disturbances
Cetirizine (OTC)
non-sedating antihistamine (H1 inverse agonist)
doesn’t penetrate CNS
P-glycoprotein substrate
Fexofenadine
non-sedating antihistamine (H1 inverse agonist)
doesn’t penetrate CNS
P-glycoprotein substrate
Loratadine (OTC)
non-sedating antihistamine (H1 inverse agonist)
doesn’t penetrate CNS
P-glycoprotein substrate
zileuton
lipoxygenase inhibitor
inhibits 5-lipoxygenase –> prevents synthesis of LTB4 (reduced pain and neutrophil chemotaxis)
hepatic tox d/t P450 inhibition (interactions?)
zafirlukast
leukotriene receptor antagonist (LTD4 agonist = decreased bronchioconstiction)
inhibits CYP450 (drug interactions?)
montelukast
leukotriene receptor antagonist (LTD4 agonist = decreased bronchioconstiction)
prescribed more b/c of once PO admin and no restrictions to meals
acetylsalicylate
aspirin (OTC) – NSAID
irreversibly acetylates COX 1 and COX2 serine residues
ibuprofen
NSAID w/ fewer side effects than aspirin
naproxen
NSAID
ketorolac
NSAID
indomethacin
NSAID – most potent*
sulindac
NSAID
ketoprofen
NSAID
piroxicam
NSAID – serious GI bleeding*
celecoxib
COX 2 inhibitor – 10 to 20x more selective for COX2
acetaminophen
analgesic, antipyretic, but NOT anti-inflammatory
inhibits COX in the CNS
serious hepatic injury
H2 receptor stimulation will cause…
gastric acid secretion
actions of kallidin and bradykinin via B2 receptor…
Kallidin and bradykinin are more active than des-arg forms
hypotension, edema, pain, Na+ excretion
actions of kallidin and bradykinin via B1 receptor…
des arg forms most active (thanks to kininase I)
chronic inflammation
vasodilation, pain