Antiinflammatory drugs Flashcards
Infliximab
(Remicade)
in-FLICKS-ih-mab
TNG blocker
Disease-Modifying Antirheumatic Drugs
(DMARDS)
When NSAIDs cannot control immune-mediated arthritis disease, DMARDs are prescribed despite being more toxic
Anti-inflammatory drugs
-treat Cronh’s, moderate to severe rheumatoid arthritis
- Bind to TNF-> blocks from attaching to TNF receptors on synovial cell surface.
- Reduce infiltration of inflammatory cells-> delays inflammatory process.
CNS: fatigue, fever, headache, pain, systemic and cutaneous vasculitis.
CV: HTN, chest pain, flushing, hypotension, tachycardia, bradycardia.
EENT: conjunctivitis, rhinitis, sinusitis, pharyngitis.
GI: abdominal pain, D, N, dyspepsia.
Hematologic: leukopenia, neutropenia, anemia, hematoma.
Musculoskeletal: arthralgia, back pain, arthritis, myalgia, bone fracture.
Respiratory: cough, URI, bronchitis, dyspnea, pneumonia.
Skin: rash, pruritus, candidiasis, urticaria, cellulitis, skin ulceration, abscess.
Other: hypersensitivity reactions, sepsis, anaphylaxis, chills.
Colchicine
Colchicum autumnale alkaloid
Also: Allopurinol
Antigout drugs
- Treat gout and hyperuricemia
- Prevent urate calculi
*Inhibit migration of leukocytes
Not inhibit uric acid synthesis nor uric acid excretion
CNS: Fatigue, headache
EENT: pharyngolaryngeal pain.
GI: Diarrhea, N, V, abdominal pain.
Hematologic: aplastic anemia, granulocytopenia, leukopenia, pancytopenia, thrombocytopenia
Probenecid (Benemid)
Antigout drugs
Uric Acid Inhibitor
Block reabsorption of uric acid-> promote excretion
CNS: fever, headache, dizziness
CV: flushing
GI: Urinary frequency, renal colic, nephrotic syndrome
Hematologic: aplastic anemia, anemia.
Hepatic: hepatic necrosis.
Skin: dermatitis, pruritus, rash
Other: Worsening of gout, hypersensitivity reaction including anaphylaxis
ASA (Aspirin) 81mg PO
QD
Nonsteroidal Antiinflammatory
Nsaids
- Reduce pain and inflammation
- ↓ body temperature
- Inhibit platelet aggregation.
- CNS: dizziness
- EENT: hearing loss, tinnitus
- GI: N/V/D, heartburn, abdominal pain, anorexia, GI bleeding, ulceration.
- Hematologic: Agranulocytosis, hepatotoxicity, thrombocytopenia, hemolytic anemia.
- Skin: rash, urticaria.
- Reye’s syndrome, anaphylaxis.
Ibuprofen (Motrin, advil)
NSAIDS
NSAIDS
Treat:
Reduce fever, pain reducer, reduce inflammatory process, anti-inflammatory agent for arthritic condition.
*Inhibit prostaglandin synthesis
CNS: dizziness, headache, nervousness
CV: edema, fluid retention.
GI: abdominal pain, bloating, constipation, decrease appetite, diarrhea, dyspepsia, epigastric distress, N, V, heartburn
GU: acute renal failure, cystitis, hematuria.
Hematologic: agranulocytosis, aplastic anemia, leukopenia, neutropenia, thrombocytopenia, anemia.
Metabolic: hypokalemia, hypoglycemia.
Skin: pruritus, rash, injection-site irritation.
Celecoxib (CeleBREX)
Coyclooxygenase-2 inhibitors
NSAIDs
Treat:
-osteoarthritis and rheumatoid arthritis
-dysmenorrhea (painful menstrual periods)
*inhibits COX-2 selectively
CNS: headache, dizziness, insomnia
CV: HTN, peripheral edema
EENT: pharyngitis, rhinitis, sinusitis
GI: Abdominal pain, D, N, dyspepsia, GI reflux.
Metabolic: hyperchloremia ( an elevated level of the chloride ions in the blood)
-Musculoskeletal: Back pain.
-Respiratory: dyspnea, URI.
-Skin: erythema multiform, exfoliative dermatitis, SJS, rash.
Ketorolac
-first injectable of NSAIDs.
NSAIDS
-short-term management of pain
*Inhibits prostaglandin synthesis like traditional NSAIDS, but it has great analgesic properties than other anti-inflammatory agents.
CNS: headache, dizziness, drowsiness.
CV: edema, HTN
EENT: tinnitus
GI: dyspepsia, GI pain, nausea, constipation, diarrhea, flatulence, peptic ulceration, stomatitis, vomiting.
GU: renal impairment
Hematologic: enema, decreased platelet adhesion, prolonged bleeding time, purpura.
Skin: diaphoresis, pruritus, rash.
Pyridostigmine (Mestinon)
Cholinesterase inhibitors
Muscle stimulants
- Control and treat MG.
- also used as a non-depolarizing muscle relaxant.
*Transmission of neuromuscular impulses by preventing
CNS: headache with high doses, weakness, syncope.
CV: bradycardia, cardiac arrest, hypotension, thrombophlebitis.
EENT: miosis (excessive constriction of pupil), rhinorrhea.
-GI: N, V, D, abdominal pain, excessive salivation, increased peristalsis.
-GU: urinary frequency, urinary urgency.
Musculoskeletal: muscle cramps, muscle fasciculations, muscle weakness, tingling in extremities.
-Respiratory: bronchospasm, bronchoconstriction, increased bronchial secretions.
-Skin: rash, diaphoresis.
methylprednisolone
Glucocorticoids
Corticosteroids
- treat multiple sclerosis: autoimmune attacking myelin sheath of nerve fibers in the brain and spinal cord causing lesions.
- Treat acute exacerbations
-CNS: euphoria, insomnia, psychotic behavior, pseudotumor cerebri, vertigo, headache, depression, personality changes, paresthesia, seizure, malaise, emotional lability.
CV: arrhythmias, HF, cardiomyopathy, HTN, bradycardia, tachycardia, syncope, edema, thrombophlebitis, thromboembolism, cardiac arrest.
GI: peptic ulceration, GI irritation, increase appetite, pancreatitis, N, V.
Metabolic: hypokalemia, hyperkalemia, sodium and water retention, hypocalcemia.
Musculoskeletal: growth suppression in children, muscle weakness, osteoporosis, tendon rupture, aseptic necrosis.
Respiration: pulmonary edema
Skin: hirsutism, delayed wound healing, acne, skin eruptions.
-Other: cushingoid state, susceptibility to infections, acute adrenal insufficiency after increased stress or abrupt withdrawal after long-term therapy, hypersensitivity reaction.
Cyclobenzaprine
(Flexiril)
TCA derivatives
Skeletal muscle relaxants
-Short-term treatment of muscle spasm.
*relieve muscle spasms through a central action: possibly at level of brain stem.
-CNS: dizziness, drowsiness, seizure, headache, tremor, insomnia, fatigue, asthenia, nervousness, confusion, paresthesia, depression.
CV: arrhythmias, palpitations, hypotension, tachycardia.
EENT: visual disturbances, blurred vision.
GI: dry mouth, dyspepsia, abnormal taste, constipation, nausea.
-Skin: rash, pruritus, acne.
