Crossword Pharm Clues Flashcards by Sarah Gillen

Peptide blocker of N-type voltage gated calcium channels administered intrathecally for refractory pain

Ziconotide

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PEGylated version of recombinant mammalian uricase used to treat chronic gout in those refractory to conventional therapy

Pegloticase

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NSAID ingredient of topical gel that is perhaps the most effective topical pain remedy for osteoarthritis

Diclofenac

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Can occur in the jaw of people using bisphosphonates (or denosumab); can be triggered by dental work

Osteonecrosis

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Osteoporosis monoclonal antibody therapy that binds RANKL (receptor activator of nuclear factor kappaB ligand) to decrease formation and function of osteoclasts

Denosumab

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Patients with pain due to rheumatoid arthritis are often administered NSAIDs or glucocorticoids despite their lack of effect on disease progression while waiting for a drug from this class to begin exertings its effects

DMARD

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Classic NSAID with COX1 selectivity, remains a drug of choice for treating acute gouty arthritis

Indomethacin

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The interaction between cyclooxygenase and aspirin is _________, which is not the case as with the other NSAIDs

Irreversible

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Patient population at greater risk for serious adverse effects of NSAIDs

Elderly

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Uricosuric agent acting similar to probenicid, both require GFR >60 ml/min

Sulfinpyrazone

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Disrupts pyrimidine synthesis, a second-choice traditional DMARD due to more common serious adverse effects

Leflunomide

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Exerts its pain-relieving effects by binding to the alpha-2-delta subunit of N-type voltage-gated calcium channels

Gabapentin

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Anti-TNF biologic DMARD, this humanized monoclonal antibody is administered subcutaneously every 2 weeks; also used for psoriatic arthritis, ankylosing spondylitis, and Crohns disease

Adalimumab

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Antagonist at NMDA-type glutamate receptors that relieves pain; also used to reduce amount of morphine needed by humans; adverse effects include agitation and hallucinations

Ketamine

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Fusion protein made from Fc portion of IgG and two TNF receptors, a biologic DMARD administered 1-2x/week by subcutaneous injection; also used for psoriasis

Etanercept

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______ syndrome is associated with swelling of the liver and brain due to use of aspirin by children with viral illness

Reye

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_________ of methotrexate is associated with its low-dose ability to treat RA and the persistence of beneficial effects for some time after drug discontinuation

Polyglutamation

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Drugs such as lidocaine and pramoxine that can help treat neuropathic pruritis or pruritis due to CKD

Local anesthetics

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Cyclooxygenase that is induced in response to pathologic stimuli; unfortunately, its selective blockade was found to increase risk for vascular thrombosis as balance between local TXA2 and PGI2 was altered to favor platelet aggregation and vasoconstriction

COX-2

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Refers to the use of methotrexate, hydroxychloroquine, and sulfasalazine together to treat RA

Triple therapy

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Relieves inflammation from gout if administered within 12-24 hrs of symptom onset by blocking the tubulin polymerization (microtubule formation) needed by leukocytes of migration and phagocytosis; can cause GI distress when used for prophylaxis

Colchicine

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Cleaved from cell membrane phospholipids by PLA2 in response to ‘stimuli’, converted to eicosanoids such as prostaglandins and thromboxanes

Arachidonic acid

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Synthesized by platelets; causes vasoconstriction and promotes platelet aggregation

TXA2

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Classic alpha2-adrenergic agonist administered PO to reduce blood pressure, also administered intrathecally as adjunct therapy for severe cancer pain not treated effectively by opioids alone

Clonidine

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Can be triggered by aspirin, presumably because local leukotriene effects predominate over prostaglandin effects

Asthma

Enzyme that converts uric acid to allantoin, mutated/nonfunctional in humans

Uricase

Biologic DMARD of limited efficacy, recombinant version of endogenous human IL-1 receptor antagonist

Anakinra

Calcium-receptor sensitizer, acts to lower PTH secretion in chronic kidney disease

Cinacalcet

Most effective and fastest acting of the traditional DMARDs, monitor for myelosuppression but generally well tolerated at low doses, often added to biologic DMARDs

Methotrexate

Formed by endothelial cells that causes local vasodilation and inhibits platelet aggregation

PGI2

Antiepileptic drug also used to treat neuropathic pain of diabetes, shingles, and fibromyalgia

Pregabalin

Dexamethasone, betamethasone, and triamcinolone are among the _________ prednisolones, which have much greater potency and/or half life than natural hydrocortisone

Fluorinated

Allopurinol is among the widely used drugs that can cause this potential syndrome of epidermal necrolysis

Stevens Johnson

Class of drugs widely used for tx of pain and inflammation, but significant CV/Resp/Renal/GI contraindications and can cause HSR skin reactions

NSAIDs

Cells that are particularly vulnerable to the effects of ASA as they cannot synthesize replacement cyclooxygenase

Platelets

Class of antidepressant drugs having the most evidence of benefit for treating neuropathic pain; AEs include dry mouth, constipation, tachycardia, palpitations, nausea, and sedation

TCAs

Nonpegylated recombinant uricase administered for prevention of acute uric acid nephropathy due to tumor lysis syndrome

Rasburicase

Capsaicin and camphor stimulation of ________ gives a sensation of “heat” that can be a useful counterirritant to reduce pain

TRPV1

“Cold” receptor stimulated by menthol in IcyHot

TRPM8

Prostaglandin that has widespread effects throughout the body including increasing vascular permeability, mucosal protection in the gut, fever in CNS, pain sensation in the periphery, and salt/water homeostasis in the kidney

PGE2

Cyclooxygenase that is constitutive in all tissues; has physiologic role and contributes to pathologic responses

COX-1

Blocking the effects of ______ inflammatory mediator is a common target in tx of RA and various other autoimmune diseases

TNF

Chimeric (human and mouse) monoclonal antibody directed against TNF that can be administered IV every 6 weeks as a biologic DMARD

Inflixumab

COX-2 inhibitor that can be administered to tx pain and inflammation of RA if benefits > risks (e.g., if pt has ulcers, bleeding risk); only member of its class still marketed in US

Celecoxib

JAK3 antagonist used as a biologic DMARD, novel in that it is orally active

Tofacitinib

Expensive non-purine xanthine oxidase inhibitor useful for reducing urate levels in those with allopurinol intolerance

Febuxostat

Blocks urate reabsorption by URAT1 transporter in proximal tubule to increase fractional excretion of filtered urate in urine

Probenicid

Alpha-2-adrenergic agonist administered IV for pain and sedation

Dexmedetomidine

Agent used as a traditional DMARD alone or in combo and also to tx IBD, GI side effects are a common reason for discontinuing

Sulfasalazine

Glucocorticoid, prednisolone prodrug, short-term use is useful in therapy for RA until DMARD effects are seen

Prednisone

Non-aspirin NSAID with long half-life that can be useful for treating inflammation and/or pain of arthritis, a recommended drug of choice when benefis still outweigh concurrent cardiovascular risks

Naproxen

Along with chondroitin, widely used in hope of treating osteoarthritis but little evidence of benefit beyond placebo effect

Glucosamine

Damage to the ______ is a serious side effect of hydroxychloroquine, but little risk from low doses now used to treat RA

Retina

Antidote for acetaminophen poisoning, substitutes for depleted glutathione in liver cells

N-acetylcysteine

Targets CD20 antigen of B cells to cause a B cell “do-over”, used to treat NHL and CLL and can be effective in some antibody-dependent autoimmune diseases

Rituximab

Absolute contraindication for tx of RA with methotrexate, reason to choose hydroxychloroquine instead

Pregnancy

Bisphosphonate administered by IV injection once per year; also associated with highest incidence of osteonecrosis of the jaw

Zolendronic acid

NSAID notable for often being administered IV or IM

Ketorolac

Suppresses fever and pain but not inflammation, presumably in part by inhibiting prostaglandin synthesis in the CNS

Acetaminophen

Drugs that lower serum urate levels by increasing its fractional excretion by the kidneys

Uricosurics

Refers to the pt with hyperuricemia due to excess synthesis, excess diet intake, and/or excess cell turnover (e.g., tumor lysis syndrome)

Overproducer

Antimalarial also used as a traditional DMARD; used alone or in combo, alters antigen presentation by disrupting lysosomal pH

Hydroxychloroquine

1-34 PTH, only agent that forms bone but must be administered in PULSED manner...otherwise leads to bone resorption

Teriparatide

Methotrexate, hydroxychloroquine, and sulfasalazine are examples of this type of DMARD

Traditional

A weak mu agonist that also blocks 5-HT and NE reuptake, used by many to tx moderate to severe pain

Tramadol

Biologic DMARD that is a humanized antihuman IL-6 receptor antibody, among its effects is to decrease acute-phase response of liver

Tocilizumab

Drug class associated with atypical bone fractures (e.g., simple fracture of compact bone like femur)

Bisphosphonates

Calcitonin from this species has a longer half-life and greater potency than human calcitonin, can be administered intranasally or parenterally to treat established osteoporosis

Salmon

_______ accumulates outside the cell as a consequence of AICAR accumulation inside cells due to action of polyglutamated methotrexate; binds to purinergic GPCR on cell surface to exert anti-inflammatory response

Adenosine

Competitive xanthine oxidase inhibitor that lowers serum urate levels, preferred/standard-of-care therapy for tx of recurrent gout if low GFR or past urate stone or to reduce effects of urate overproduction (e.g., due to tumor lysis)

Allopurinol

SERM with agonist effects on bone but not breast or uterus used to treat osteoporosis

Raloxifene

Prototypical example in drug class of first choice for treating osteoporosis, its incorporation into bone inhibits the number and activity of osteoclasts

Alendronate

Irreversible COX inhibitor used to relieve inflammation and pain of RA, dose not alter disease progression

Aspirin

Biologic DMARD, fusion protein blocks T cell CD80/86 co-stimulatory signal needed for activation

Abatacept