Anti-inflammatory Drugs Flashcards
the 3 phases of inflammation of ______, subacute, and _____.
acute
chronic
the _____ phase lasts 1-3 days, and has 5 clinical signs: heat, redness, swelling, pain, impaired function
acute
the subacute phase lasts ___ - ___ days to about 1 month and corresponds to a cleaning phase. If it is not resolved, it becomes ______
3-4 days
chronic
prostaglandins in the hypothalamus stimulate the production of ________, which reset the temperature set to a higher point, and bone marrow to release more _______
cytokines
WBCs
step 3: biochemical messages are released to cause _______ and blood vessel ________, which allow WBCs to reach the site
vasodilation
blood vessel permeability
activation of local _______ in the tissues is step 2, which start to fight the infection until the _____ comes
macrophages
WBCS
in step 4, dendritic cells (phagocytic) present more information and samples from the invading organisms, so they specifically signal the _____
WBCs (T Helper cells)
in step 5, the main fighting force arrives. If a virus, _______ cells are recruited
cytotoxic CD8 cells
in step 5, ______ are recruited if it is bacterial
neutrophils
______ are specialized phagocytes that engulf the ____ - ____ bacterial
neutrophils
antibody-coated
things turn back to normal in step 6. Dead cells are ______, fibroblasts _____ the damaged site, involved cells return to _______
phagocytized
repair
circulation
_________ are the principle cells of chronic inflammation
macrophages
vascular changes, edema, and neutrophilic response are ____ inflammation, whereas good tissue destruction, scarring, and _______ are _____ inflammation
acute
angiogenesis
chronic
________ inflammation is a distintive pattern of chronic inflammation characterized by aggregates of activated _______ with scattered lymphocytes
granulomatous
macrophages
granulomas are attempting to ____-___ and isolate ____ ____ and debris
wall-off
foregin material
mycobacterium TB, T. pallidum, fungal infections may all cause ________ inflammation, which form in persistent T-cell responses, immune-mediated diseases, and foreign bodies (sutures/splinters)
granulomatous
inflammatory injury may occur if the reaction is ____ (severe infection), prolonged, or _______ (autoimmune)
strong
inappropriate
pyrogens (and LPS) stimulate _______ in the vascular cells of the hypothalamus to produce ______
prostaglandins
fever
C-reactive portein, _____, and _____ ____ are the 3 best known acute phase proteins. These are stimulated by cytokines
fibrinogen
serum amyloid A protein
acute-phase proteins bind to microbial cell walls, to act as ________
opsonins
fibrinogen binds to ________ and causes them to form stacks (_______) that sediment more rapidly. This is why the ______ is a test for systemic inflammatory response
erythrocytes
roleaux
ESR
prolonged infection stimulates the production of _____, which increase the bone marrow output of leukocytes, to compensate for the consumption of them in the inflammatory reaction
colony stimulating factors
the body release ___ - ___ mg of cortisol daily. Half life is ___ to ___ minutes
10-20 mg
60 to 90 minutes
glucocorticoids cause increase in gluconeogenesis, lipolysis, _____, ____ ____, and a decrease in inflammation and immune
proteolysis, insulin resistance
glucocorticoid injections caue changes in _____, resulting in mood changes (insomnia, euphoria, depression)
CNS changes
giving 5 mg of prednisone, is equivalent of giving _____ mg of cortisol (hydrocortisone). Range is 5-60mg.
20 mg
Prednisone (Deltasone) is primarily given in the ____ form
oral
if the condition came on fast and aggressive, treat with ____ initial doses, and taper ____
high initial
taper quickly
under treatment of prednisone will be more _______ than overtreatment
dangerous
prednisone inhibits ______
phospholipase
prednisone is activated by enzymes in the _____ to turn into _____ (used if there is liver toxicity/failure)
liver
prednisolone
2 weeks or longer on prednisone, you must ____
taper
GI disturbances are common (abdominal dissension, diarrhea) with _________
corticosteroid use
An ADR may cause _____ changes, rare risk of suicide
mood
if treatment extends over weeks to months, the patient should be given _______ therapy during additional stress or trauma
supplementary
it make take ___ to ___ for the HPA axis to function acceptably. Cortisol levels may not return to normal for another ___ to ___ months following taper
2-12 months
6 to 9 months
withdrawal of prednisone will be fever, malaise, ______, and _____
arthralgia
myalgia
_______ of TB should be used in patients with latent TB if they are on prednisone
chemoprophylaxis
Prenisone 10mg #10
take 1 tab PO q12 hours x 5 days
example
other inflammatory drugs include tetracyclines, _________ (inhibit cytokines and inflammatory pathways) , and metronidazole
macrolides (azithromycin) - protein synthesis inhibitors
