Asthma & COPD & NSAIDs & Gout & RA Flashcards
Bosentan
- Competetively inhibited endothelin-1 receptors.
- Use: pulmonary arterial HTN
- decreased pulmonary vascular resistance.
Celecoxib
- Selective COX2 inhibitor
- Use: Analgesia, antipyretic, and anti-inflammatory
- No GI ditress or platelet depression (b/c both of these are COX1 mediated).
- Tox: pro-thrombotic, nephrotoxic.
Methotrexate
- dihydrofolate reductase inhibitor. suppresses bone marrow, less lymphocytes = less rheumatoid factor.
- Use: anti-cancer, Rheumatoid arthritis
- Tox: teratogen, mucosal ulcers, nausea, hepatotox.
Colchicine
- inihibits MT assembly (inhibits leukocyte migration/degranulation): anti-inflammatory
- Use: Gout, cancer
- Tox: Diarrhea/GI distress
Probenecid
- inhibits renal resorption of uric acid in PCT
- also inhibits secretion of PCN in PCT.
- Use: Chronic gout
- Tox: sulfa drug, exacerbation of acute gout, inhibits renal secretion of weak acids (like PCN, methotrexate).
Allopurinol
- irreversibly inhibits xanthine oxidase and lowers production of uricacid.
- Use: Chronic gout
- Tox: stevens-johnsons, hypersensitivity, bone marrow suppresion.
Salmeterol, formoterol, indacaterol
- beta-2 agonists, potentiation of corticosteroid action
- Use: asthma prophylaxis. They are long acting.
- PK: inhaled aerosol
- Tox: tremor, tachy, CV events
isoproterenol
- beta agonist
- Use: asthma (obsolete)
- Tox: excessive sympathetic effect
Ephedrine
- releases stores catecholamines
- Use: asthma (obsolete)
- Tox: insomnia, anorexia, tremor, arrythmias
Theophylline
- PDE inhibition, adenosine receptor antagonist
- Use: Asthma, esp. prophylaxis against noctural attacks
- Tox: Insomnia, tremor, anorexia, seizures, arrhythmias
- caffeine is similar but w/more CNS effects
Ipratropium, tiotropium
-M3 blocker
-Use: Asthma and chronic obstructive pulmonary disease
(stops bronchoconstriction + mucus prod).
-Tox: dry mouth, cough
Cromolyn, nedocromil
- prevents degranulation of mast cells
- Use: Asthma prophylaxis (rare), ophthalmic, nasopharyngeal, and gastrointestinal allergy
- Tox: Cough
Montelukast, zafirlukast
- leukotriene antagonist (LTD4 receptor)
- Use: Prophylaxis of asthma
- Tox: minimal
Zileuton
- Inhibitor of lipoxygenase • reduces synthesis of leukotrienes
- Use: Prophylaxis of asthma
- Tox: elevation of liver enzymes
Inhaled Beclomethasone
-Inhibition of phospholipase A2, reduces expression of
COX
-Use: DOC for asthma prophylaxis
-Tox: Pharyngeal candidiasis, minimal systemic steroid
toxicity (eg, adrenal suppression)
Systemic Prednisone
- inhibits phospholipase A2
- Use: severe refractory chronic asthma
- given orally
- Tox: cortisol effects
Omalizumab
-Binds IgE antibodies on mast cells; reduces reaction to
inhaled antigen.
-Use: Prophylaxis of severe, refractory asthma not
responsive to all other drugs.
-parenteral, very expensive.