Autocoids

Question 1

Misoprostol

Answer 1

Analog for PGE-1, protects gastric mucosa and can cause abortion.

Question 2

Alprostadil

Answer 2

Keeps open PDA(patent ductus arteriosus)

Question 3

Indomethacin: Rx and side effects

Answer 3

Rx: Closes PDA (patent ductus arteriosus)

SE: Thrombocytopenia and agranulocytosis

Reversible inhibitors of COX 1 & 2

Question 4

Dinoprostone

Answer 4

Analog for PGE-2, cervical ripening (dilation) for pregnancy.

Question 5

Dinoprost & Carboprost

Answer 5

Analog to PGF-2, smooth muscle contactions, causes abortions.
(uterine/bronchiolar contraction)

Question 6

Zileuton

Answer 6

Rx: inflammation

MOA: lipooxygenase inhibitor

Question 7

Latanoprost

Answer 7

Analog to PGF-2, used in glucoma

Question 8

Bimatoprost

Answer 8

Analog to PGF-2, used for eyelash growth

Question 9

Epoprostenol

Answer 9

Analog to PGI-2, used in pulmonary HTN

Question 10

Treprostinil

Answer 10

Analog to PGI-2, used for treatment of shortness of breath in pulmonary HTN

Question 11

Bosentan & Ambrisentan

Answer 11

Antagonist to Endothelin-1, Used in patients with pulmonary HTN

Category X drug

Question 12

Zafirlukast

Answer 12

Rx: allergies such as allergic rhinitis/asthma

Question 13

Sildenafil (revatio)

Answer 13

Rx: pulmonary HTN

MOA: vasodilation by increasing cGMP to allow for smooth muscle contraction.

Can also be used for ED (Viagra)

Question 14

Aspirin: RX & MOA

Answer 14

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.

Question 15

Aspirin: Side effects

Answer 15

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.

Question 16

Aspirin: Dosage and Toxic dose effects

Answer 16

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

Question 17

Aspirin: Allergic reaction effects & Drug Interactions

Answer 17

Allergic: Asthma, nasal polyps, and atrophic rhinitis.

Drug Interactions: Ethanol increases GI bleeding, blocks uricosurics, increases activity of hypoglycemic medication, increases warfarin toxicity.

Question 18

Aspirin overdose Rx

Answer 18

Gastric lavage by pumping stomach
Activated charcoal
Alkalization of urine

Question 19

Reye’s syndrome

Answer 19

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.

Question 20

Acetaminophen: general information & Rx

Answer 20

Not an anti-inflammaotry drug, only inhibits central nervous system COX proteins.
No GI bleeding
No effects on blood coagulation

Rx: headaches

Question 21

Acetaminophen Toxicity

Answer 21

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.

Question 22

Acetaminophen: antidote

Answer 22

Acetylcysteine: supply SH groups to inactivate N-acetylbenzoquinoneimine

Question 23

Ibuprofen: Rx

Answer 23

#1 for pain relief
Reversible inhibitors of COX 1 & 2

Question 24

Naproxen: Rx

Answer 24

Used in GOUT

Reversible inhibitors of COX 1 & 2

Question 25

Etodolac: Rx

Answer 25

Reversible inhibitors of COX 1 & 2

Question 26

Ketorolac

Answer 26

Reversible inhibitors of COX 1 & 2

Question 27

Nabumetone

Answer 27

Reversible inhibitors of COX 1 & 2

Question 28

Sulindac: SE & MOA

Answer 28

SE: cramps and rashes MOA: Reversible inhibitors of COX 1 & 2

Question 29

Tolmetin: MOA

Answer 29

MOA: Reversible inhibitors of COX 1 & 2 Does not affect the activity of oral hypoglycemics

Question 30

Diclofenac: SE & MOA

Answer 30

SE: hepatotoxicity MOA: Reversible inhibitors of COX 1 & 2

Question 31

Selective COX-2 inhibitors

Answer 31

Rofecoxib: causes MI because it causes blood clots. Rx: inflammation (arthritis). Removed from the market. Celecoxib: cross allergy with sulfonamides Valdecoxib

Question 32

Drugs that end with Triptan: MOA, SE, and RX Sumatriptan Zolmitriptan Frovatriptan

Answer 32

MOA: agonist for 5HT1D receptor in cerebral BV (agonist to serotonin) SE: asthenia and throat pressure Rx: Migraine

Question 33

Ergotamine & Methysergide

Answer 33

MOA: partial agonist at alpha 1 and 5HT2 in BV. Leads to vasoconstriction, which causes decrease pulsation of BV in acute migraine.

Question 34

Migraine Prophylaxis: Rx

Answer 34

Prevents migraines by administering 1) Beta blockers 2) Tricyclic Antidepressant 3) Calcium Channel blockers 4) Carbamazepine (Rx: for seizures) 5) Gabapentin 6) Valproic acid