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Pharmacology > ch 24: antiinflammatories > Flashcards

ch 24: antiinflammatories Flashcards

1
Q

what chemical mediator causes inflammation? What enzymes does this come from?

A
  • Prostaglandins

- cox 1 and 2 enzymes

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2
Q

What is cox 1 and cox 2 enzymes responsible for?

A
  • cox 1 protects the stomach lining

- cox 2 triggers inflammation and pain

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3
Q

what happens when you are on aspirin for a long period of time?

A

ulcers because it becomes less selective

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4
Q

what are the four types of anti-inflammatory drugs?

A
  • INSAIDs
  • courtico steroids
  • disease modified drugs (DMD)
  • antigout drugs
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5
Q

what do INSAIDs do? what are the 2 types?

A
  • they inhibit cox enzymes which inhibit prostaglandin synthesis
  • 1st generation and 2nd generation
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6
Q

what are 1st generation INSAIDs? what are the 6 types?

A
  • they are nonselective to both cox 1 and 2
  • salicylates
  • para-chlorobezoic acid
  • phenylacetic acid derevatives
  • propionic acid derevatives
  • fenamates
  • oxicams
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7
Q

what is the drug example for salicylates? what is a therapeutic dose? what is a toxic dose? what happens with warfarin? what happens with oral anti-diabetics? with cortico steroids? what can cause gout? what food items have yuric acid in them? what causes Raye’s syndrome? what is salicylism? what are the symptoms? what are the symptoms > 50mgdL?

A
  • aspirin
  • 15-30 mg-dL
  • > 30mg-dL
  • increased bleeding with warfarin
  • hypoglycemia with oral anti-diabetics
  • increase ulcers with cortico steroids
  • increase yuric acid can lead to gout
  • pruns, licorice, raisins
  • dont give to children with the flu or virus vs; can result in Reye’s syndrome
  • salicylism is toxicity ( >30)
  • tinnitus, dizziness, confusion, peptic ulcer
  • > 50mg-dL = convulsions, cardiovascular collapse
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8
Q

what does the drug example for paracloralbezoic acid? what is it used for/ what are some side effects? who do you not give this to? what should you take this with?

A
  • indomethazcine
  • arthritis
  • sodium and water retention and increase bp
  • patients with high bp
  • take with food because it upsets stomach
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9
Q

what are the 2 drug examples for phenylacetic acid derivatives?

A
  • diclofenac sodium

- ketorolac

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10
Q

what is diclofenac used for? combined with?

A
  • rhuematoid arthritis and osteoarthritus

- combined with misoprostal and is aka arthrotech to protect stomach lining

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11
Q

what is ketorolac used for? How is it given? what is it as strong as?

A
  • short term management of pain post surgery
  • via injection
  • morphine but without addiction
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12
Q

what is a drug example for propionic acid derivatives? what happens with warfarin with aspirin? what are some side effects? what should you take this wth?

A
  • ibuprofen
  • increase bleeding and effect with warfarin
  • decrease effect with aspirin
  • gastric disstress, tinnitus, dizziness, confusion, edema, nephrotoxicity
  • take with food
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13
Q

what is the drug example for fenamates? what is it used for? what is the side effects?

A
  • meclofenamate
  • acute and chronic arthritis
  • gastric irritation, edema, dizziness, and tinnitus
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14
Q

what is the drug example for oxicams? what is it used for? how long does it take? what should you not take it with?

A
  • piroxicam
  • long term arthritis
  • 1 to 2 weeks
  • aspirin
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15
Q

what are second generation NSAIDs? what is the only category and only drug? what are side effects? who is at high risks of ulcerations?

A
  • they are selective to cox 2
  • cox 2 inhibitors decrease pain and inflammation
  • inhibits cox 2 enzymes
  • celecoxib (true)
  • nabumetone (not true in high doses. it can lose selectivity)
  • peripheral edema tinnitus and dizziness
  • older adults due to taking other drugs and pregnant women in 3rd trimester
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16
Q

what are corticosteroid examples? what do they end in? what are they not used for? what are the side effects?

A
  • prednison, prednisolone, and dexamethasone
  • (-sone or -lone)
  • not used for arthritis because of side effects
  • weight gain and suppressing the immune system
17
Q

what are the 3 types of disease modified drugs? (DMD)

A
  • imuno suppressants
  • imuno modulators
  • anti-malarial
18
Q

when are imuno suppressants used? what are the 3 drug examples? what can a bad side effect be?

A
  • when other drugs fail for arthritis
  • could have impact on liver, so check enzymes
  • azathiopine, cyclophosphamide, methotrexate
19
Q

what are the 2 types of imuno modulators?

A
  • IL-1 receptor antagonists

- tumor necrosis factor blockers

20
Q

what is the drug example for IL-1 receptor antagonists?

A

anakinra

21
Q

what are the 3 tumor necrosis factor blocker drugs? how are they given? whats it used for? what does it do? how much are they?

A
  • etanercept, infliximab, adalimumab
  • via injection
  • severe rumatoid arthritis
  • delay the disease progression
  • 3500-4500 $
22
Q

what are anti-milarial drugs used for? how long do they take? what is the mechanism of action? what are they used with?

A
  • rumatoid arthritis
  • long acting; up to 3 months
  • MAO is unclear
  • use with NSAIDs when arthritis isnt under control
23
Q

what is gout? what is a main symptom? what foods contain purine?

A
  • inflammatory disease with the joints
  • large big toe because of gravitational pull due to poor purine metabolism leading to yuric acid accumulation
  • sardines, salmon, gravy, liver, alcohol
24
Q

what is colchicine used for? what does it do? what does it cause? how do you prevent this? what patients should not take this?

A
  • gout
  • blocks migration of leukocytes to innflammed cite
  • gi distress, so take with food
  • patients with renal, cardiac, or gi problems should not take this
25
Q

what are the 2 types of anti-gout drugs?

A
  • yuric acid synthesis inhibitors

- yricosurcs

26
Q

what are the drug examples for yuric acid synthesis inhibitors? what do they do? what should we monitor? what should patients avoid? what would be a good patient teaching?

A
  • allopurinol and febuxostat
  • decrease production of yuric acid to prevent gout attacks
  • monitor CBC, liver enzymes, and renal function
  • avoid alcohol, caffeine, and thiazide diruetics bc they increase yuric acid
  • increase fluid intake to increase yuric acid excretion
27
Q

what are drug examples of uricosurisc? what do thy do? what should you avoid?

A
  • probenecia and culfinpyrazone
  • increase yuric acid excretion by blocking absorbtion
  • avoid aspirin bc it causes yuric acid retention

Pharmacology (20 decks)

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