Chapter 13 - Antiinflammatories

Question 1

Inflammation

Answer 1

Protective mechanism that is designed to remove or neutralize the underlying cause of injury (physical, chemical, or biologic)

Question 2

What are the 5 cardinal signs of inflammation?

Answer 2

1) Redness 2) Heat 3) Swelling/Edema 4) Pain 5) Loss of function

Question 3

The two larger groups of antiinflammatory drugs used to reduce pain and discomfort

Answer 3

Steroidal antiinflammatory drugs and NSAIDs

Question 4

Nociceptor

Answer 4

Pain receptor

Question 5

Transduction

Answer 5

Conversion of physical change into a pain nerve signal

Question 6

Pain pathway

Answer 6

Painful stimulus at nociceptor -> transduction -> transmission of pain along sensory nerves to the spinal cord -> modification and modulation of pain as it ascends spinal cord -> perception of pain signals the brain

Question 7

Arachidonic Acid Cascade/Pathway

Answer 7

One of the principal mechanisms by which inflammatory mediators are generalized

Question 8

What does the arachidonic acid cascade create?

Answer 8

Eicosanois -> enzymatically generates prostaglandins, leukotrienes and other inflammatory mediators

Question 9

When trauma occurs to cell membranes what enzyme is activated?

Answer 9

Phospholipase

Question 10

Phospholipase converts phospholipid molecules (that make up the cellular membrane) into what?

Answer 10

Arachidonic acid

Question 11

What 2 enzymes may then act on Arachidonic acid?

Answer 11

Cyclooxygenase enzymes (COX) or Lipoxygenase enzymes

Question 12

What do COX enzymes produce when they act on arachidonic acid?

Answer 12

Protaglandins and thromboxanes

Question 13

What do Lipoxygenase enzymes produce when they act on arachidonic acid?

Answer 13

Leukotrienes

Question 14

How do corticosteroids (specifically glucocorticoids) reduce inflammation?

Answer 14

By blocking the action of Phospholipase in the early portion of the pathway and reducing production of most of the inflammatory mediators (also blocks COX)

Question 15

How do NSAIDs reduce inflammation?

Answer 15

NSAIDs inhibit COX (and to varying degrees) lipoxygenase - decreasing production of prostaglandins, leukotrienes and thromboxane) reducing inflammatory mediators, therefore decreasing the inflammatory effect of other inflammatory mediators (histamine, kinins, substance p and superoxide radicals)

Question 16

Mineralcorticoids

Answer 16

Affect the minerals in the body (Na, K and other lytes) involved with water and electrolyte balance but have little to no antiinflammatory effect

Question 17

Aldosterone

Answer 17

Mineralcorticoid hormone

Question 18

What is aldosterones primary effect and use?

Answer 18

Increase the sodium retained in the body - Hypoadrenocorticism (Addisons)

Question 19

What is Desoxycorticosterone Pivalate?

Answer 19

Percoten-V - mineralcorticoid, mimics effects of aldosterone and used to treat animals with addisons disease

Question 20

Where are glucocorticoid receptors found in the body?

Answer 20

Found on ALL cells in the body, but Liver is primary systemic target for many glucocorticoid effects

Question 21

What are the two natural glucocorticoids and what produces them?

Answer 21

1) Cortisol 2) Cortisone - Adrenal gland

Question 22

How long do short-acting glucocorticoids exert their biologic activity on the body?

Answer 22

less than 12 hours (Hydrocortisone/cortisone)

Question 23

How long do intermediate-acting glucocorticoids exert their biologic activity on the body?

Answer 23

12 to 36 hours (prednisone/prednisolone/methylprednisolone/Triamcinolone)

Question 24

How long do long-acting glucocorticoids exert their biologic activity on the body?

Answer 24

48 hours or longer (Dexamethasone/Betamethasone/Flumethasone and Idoflupredone)

Question 25

“Low” doses of glucocorticoids used to achieve normal physiology (addisons) are referred to as ____ doses.

Answer 25

Physiologic

Question 26

“Medium” doses of glucocorticoids Supraphysiologc doses are referred to as ____ doses.

Answer 26

Antiinflammatory

Question 27

“High” doses of glucocorticoids are referred to as ____ doses.

Answer 27

Immunosuppressive