Anti-platelet/Anti-inflammatory Flashcards
Ibuprofen/Advil, Motrin
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs? (2)
Contraindications?
Class?
NSAID
Mechanism?
reversible COX1/2 inhibitor
Net effect?
decrease prostaglandin synthesis of PGE2 (decrease pain sensation, decrease production of gastric mucus), PGI2 (increase gastric secretion), TXA2 (decrease platelet aggregation)
Clinical Uses?
anti-pyretic, analgesic, anti-inflammatory
Side effects?
GI bleeding, interstitial nephritis, tinnitus, hepatitis, allergic reactions
Similar drugs?
Naproxene, indomethacin
Contraindications?
Ibuprofen does NOT have a significant anti-platelet effect since it is a reversible COX1/2 inhibitor, so the platelets can eventually replensih TXA2 levels (compared to aspirin, which irreversibly inhibits COX1/2)
Acetaminophen/Tylenol
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Anti-inflammatory agent
Mechanism?
reversible COX1/2 inhibitor in CNS
Net effect?
decrease prostaglandin synthesis in CNS
Clinical Uses?
anti-pyretic, analgesic, especially in patients who cannot tolerate aspirin or NSAIDs
Side effects?
fatal hepatotoxicity with OD, dizziness
Similar drugs?
Contraindications?
Prednisone
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs? (5)
Contraindications?
Class?
Synthetic corticosteroid; antiinflammatory agent
Mechanism?
mimics endogenous glucocorticoids
Net effect?
vasoconstriction, stimulation of hepatic gluconeogensis, protein catabolism, decrease circulating leukocytes, inhibit prostaglandin/leukotriene formation, stimulation of gastric acid/pepin production
Clinical Uses?
adreno-cortical insufficiency
allergic reactions
collagen vascular disorders (SLE, RA, polymyositits)
IBS
Asthma
spinal cord compression
immunosuppression (arthritis, MS, nephrotic syndrome)
Side effects?
Symptoms of Cushing’s syndrome (osteoporosis, hyperglycemia, fat redistribution)
Impaired wound healing
Similar drugs? HPBBF
Hydrocortisone
Prednisolone
Betamethasone
Fluticasone
Blecomethasone (inhaled, for asthma, minimal side effects)
Contraindications?
Clopidogrel
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Anti-platelet agent; must be activated via liver metabolism
Mechanism?
blocks ADP-P2Y12 receptor interaction on platelets
Net effect?
blocks ADP-mediated palatlet aggregation/platelet plug formation
Clinical Uses?
prevent ischemic events in acute coronary syndrome (with aspirin)
prevent thrombosis in patients undergoing PCI or in patients who cannot tolerate aspirin
Side effects?
Bleeding, GI upset
Similar drugs?
Contraindications?
patients with mutations in CYP enzymes -> decreased activation clopidogrel -> greater risk for stent thrombosis
Abciximab
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Anti-platelet agent
Mechanism?
blocks Glycprotein IIb/IIIa receptor on platelets from binding to vWF and fibrinogen
Net effect?
blocks platelet aggregation
Clinical Uses?
acute coronary syndrome
prevent thrombosis in patients undergoing PCI or in patients who cannot tolerate aspirin
Side effects?
Bleeding, thrombocytopenia, diffuse alveolar hemorrhage
Similar drugs?
Contraindications?
patients with mutations in CYP enzymes -> decreased activation clopidogrel -> greater risk for stent thrombosis
Acetylsalicyclic Acid/Aspirin
Class?
Mechanism?
Net effect?
Clinical Uses?
Side effects?
Similar drugs?
Contraindications?
Class?
Anti-platelet agent/anti-inflammatory agent
Mechanism?
IRREVERSIBLE COX1/2 inhibitor
Net effect?
decrease prostaglandin synthesis of PGE2 (decrease pain sensation, decrease production of gastric mucus), PGI2 (increase gastric secretion), TXA2 (decrease platelet aggregation)
Clinical Uses?
anti-pyretic, analgesic, antiinflammatory, anti-platelet
Side effects?
Bleeding (esp in GI tract), increase incidence of gastric ulcers, allergic reaction
can cause REYES syndrome in children with viral infections, which can sometimes lead to liver failure
- when taken in toxic amounts, can cause respiratory and metabolic acidosis (treat with bicarb)
Similar drugs?
Contraindications?
Aspirin, irreversibly inhibits COX1/2. (compared to Ibuprofen does NOT have a significant anti-platelet effect since it is a reversible COX1/2 inhibitor, so the platelets can eventually replensih TXA2 levels)
