Autocoids Flashcards
Misoprostol
Analog for PGE-1, protects gastric mucosa and can cause abortion.
Alprostadil
Keeps open PDA(patent ductus arteriosus)
Indomethacin: Rx and side effects
Rx: Closes PDA (patent ductus arteriosus)
SE: Thrombocytopenia and agranulocytosis
Reversible inhibitors of COX 1 & 2
Dinoprostone
Analog for PGE-2, cervical ripening (dilation) for pregnancy.
Dinoprost & Carboprost
Analog to PGF-2, smooth muscle contactions, causes abortions.
(uterine/bronchiolar contraction)
Zileuton
Rx: inflammation
MOA: lipooxygenase inhibitor
Latanoprost
Analog to PGF-2, used in glucoma
Bimatoprost
Analog to PGF-2, used for eyelash growth
Epoprostenol
Analog to PGI-2, used in pulmonary HTN
Treprostinil
Analog to PGI-2, used for treatment of shortness of breath in pulmonary HTN
Bosentan & Ambrisentan
Antagonist to Endothelin-1, Used in patients with pulmonary HTN
Category X drug
Zafirlukast
Rx: allergies such as allergic rhinitis/asthma
Sildenafil (revatio)
Rx: pulmonary HTN
MOA: vasodilation by increasing cGMP to allow for smooth muscle contraction.
Can also be used for ED (Viagra)
Aspirin: RX & MOA
Rx: reduce pain, antipyretic, decrease risk of MI, and anti-platelet
MOA: blocks pain receptors from bradykinin and histamine, COX-1 inhibitor, COX-2 inhibitor, inhibits vitamin K factor formation.
Aspirin: Side effects
Low dose: hyperuricemia
High dose: Uricosuric (decreased tubular reabsorption), respiratory alkalosis, metabolic acidosis, gastritis, increased bleeding time, increased prothrombin time, salycism,
Buzz word: Tinnitus (ringing when no sound is present), vertigo, and decreased hearing.
Aspirin: Dosage and Toxic dose effects
Dose: 85mg (baby aspirin, MI reduction), 1-2 tablets (headaches), 3-5g (inflammatory conditions, high dose).
Toxic dose 30 tablets (A)/4-6 tablets (C): respiratory alkalosis then respiratory acidosis, hypokalemia, metabolic acidosis, and fever. T
Aspirin: Allergic reaction effects & Drug Interactions
Allergic: Asthma, nasal polyps, and atrophic rhinitis.
Drug Interactions: Ethanol increases GI bleeding, blocks uricosurics, increases activity of hypoglycemic medication, increases warfarin toxicity.
Aspirin overdose Rx
Gastric lavage by pumping stomach
Activated charcoal
Alkalization of urine
Reye’s syndrome
Patient gets an upper respiratory illness or influenza because of taking aspirin.
This happens if a patient takes aspirin when they have a virus such as hepatitis.
Acetaminophen: general information & Rx
Not an anti-inflammaotry drug, only inhibits central nervous system COX proteins.
No GI bleeding
No effects on blood coagulation
Rx: headaches
Acetaminophen Toxicity
Will cause Hepatotoxicity because of N-acetylbenzoquinoneimine
Produced by p450 and is conjugated with reduced glutathione (GSH).
If too much is taken then can’t be reduced with GSH.
Acetaminophen: antidote
Acetylcysteine: supply SH groups to inactivate N-acetylbenzoquinoneimine
Ibuprofen: Rx
#1 for pain relief Reversible inhibitors of COX 1 & 2
Naproxen: Rx
Used in GOUT
Reversible inhibitors of COX 1 & 2
Etodolac: Rx
Reversible inhibitors of COX 1 & 2
Ketorolac
Reversible inhibitors of COX 1 & 2
Nabumetone
Reversible inhibitors of COX 1 & 2
Sulindac: SE & MOA
SE: cramps and rashes
MOA: Reversible inhibitors of COX 1 & 2
Tolmetin: MOA
MOA: Reversible inhibitors of COX 1 & 2
Does not affect the activity of oral hypoglycemics
Diclofenac: SE & MOA
SE: hepatotoxicity
MOA: Reversible inhibitors of COX 1 & 2
Selective COX-2 inhibitors
Rofecoxib: causes MI because it causes blood clots. Rx: inflammation (arthritis).
Removed from the market.
Celecoxib: cross allergy with sulfonamides
Valdecoxib
Drugs that end with Triptan: MOA, SE, and RX
Sumatriptan
Zolmitriptan
Frovatriptan
MOA: agonist for 5HT1D receptor in cerebral BV (agonist to serotonin)
SE: asthenia and throat pressure
Rx: Migraine
Ergotamine & Methysergide
MOA: partial agonist at alpha 1 and 5HT2 in BV.
Leads to vasoconstriction, which causes decrease pulsation of BV in acute migraine.
Migraine Prophylaxis: Rx
Prevents migraines by administering
1) Beta blockers
2) Tricyclic Antidepressant
3) Calcium Channel blockers
4) Carbamazepine (Rx: for seizures)
5) Gabapentin
6) Valproic acid
