DRUG LIST Flashcards

1
Q

Osteoprotegrin (OPG)

A

decoy receptor for RANKL - prevents osteoclast activation

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2
Q

glucorticosteroids

A

prolonged use - OSTEOPOROSIS

(bone resorption increased + calcium absorption gut decreased

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3
Q

raloxifene

A

SERM

  • selective oestrogen receptor modulator
  • increases oestrgenic actions in bone - reduces bone turnover-slows osteoporosis
  • only acts in BONE (not breast/uterus-malignancy)

FOR OSTEOPOROSIS

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4
Q

BISPHOSPHONATES

  • administration
  • MOA
  • name 5
A
  • oral
  • osteoclast apoptosis + decrease RANKL expression
  • ALEN/RISE/IBAN/PAMI/ZOLE-dronate

FOR OSTEOPOROSIS

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5
Q

teriparatide

A

recombinant PTH

  • stimulates Ca resorption bone + kidneys
  • stimulates osteoblast - osteoclast activity
  • stimulates active vit D formation

FOR OSTEOPOROSIS (severe cases)

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6
Q

denosumab

A

=monoclonal antibody for RANKL
=SC injection (6monthly)

(prevents RANK binding to RANKL on osteoclasts)
prevents OSTEOCLAST ACTIVITY

FOR OSTEOPOROSIS

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7
Q

Treatment for inflammatory myopathies

A
  1. corticosteroids (until CK levels normal)

2. adjunctive therapy = MTX + AZT

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8
Q

Treatment for fibromyalgia

A
  1. TCAs
  2. SSRIs
  3. exercise
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9
Q

Strontium ranelate

A

OSTEOPOROSIS
-strontium-similar size to calcium -taken up by bones
-MOA
=decreases bone resorption + increase Ca absorption gut
=stimulates osteoblasts secrete (OPG)

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10
Q

colchicine

A

GOUT
inhibits:
-microtubule formation - mitosis
-neutrophil motility + proliferation

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11
Q

riloncept

A

GOUT (+RA)
IL-1 blocker
DIMERIC fusion protein - IL1R + Fc of HUMAN IgG1

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12
Q

anakinra

A

GOUT (+RA)

  • human recombinannt IL1 receptor antagonist
  • binds IL-1R
  • SC injection
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13
Q

allopurinol

A

CHRONIC GOUT

xanthine oxidase inhibitor

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14
Q

rasburicase

A

CHRONIC GOUT

catalytic enzyme =xanthine- allantoin -more soluble

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15
Q

probenecid

A

CHRONIC GOUT
uricosuric - increase renal excretion uric acid
(less SE than allopurinol)

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16
Q

treatment pseudogout

A

intra-articular corticosteroid + NSAIDs

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17
Q

ASPIRIN

action + SE

A

CARDIOVASCULAR

3A= anti-inflammatory + analgesic + antipyretic
delays labour + antiplatelet aggr

SE= peptic ulcers + hyperuricaemia

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18
Q

NSAID - eye drops

A

KETOROLAC -cox 1 selectivity

19
Q

NSAID- exclusively for pain

A

PARECOXIB

20
Q

NSAIDs for inflammation

A

aceclofen/etodol/sulind-AC
meloxi/tenoxi-CAM
azapropa/nabumet-ONE
etoricoxib (cox2 inhibtor)

21
Q

NSAIDs for inflammation + pain

A
diclofenac
ibro/keto/dexketo/feno/fluribi-PROFEN
indomethacin
naproxen
piroxicam
celecoxib
22
Q

prostaglandins roles

A

pyretic, inflammatory, hyperalgesia + inhibit gastric acid + platelet aggregation + increase RBF

23
Q

NSAIDs selective for COX 2

A

piroxicam
meclofenamate
sulindave
diclofenac

24
Q

tramadol

A

ANALGESIA

weak mu opoid receptor agonist - centrally acting opoid

25
Q

methadone

A

most powerful OPIOD - powerful analgesia

26
Q

naloxone

A

opoid receptor antagonist - prevents opiod induced constipation (when given in combination with an opiod)

27
Q

GABAPENTINOIDS - pregabalin + gabapentin

A

CHRONIC + NEUROPATHIC PAIN

-blocks α2δ subunit VGC - reduces pain transmission

28
Q

Clonidine

A

ANALGESIA

α2 adrenergic agonist

29
Q

Capsaicin

A

TOPICAL ANALGESIA

  • activates TRPV1 channel - activate heat + pain neurons
  • lowers threshold for TRPV1 (sensitisation)
  • over time = unresponsive to pain - deplete NT Substance P (released by neurons for pain transmission)
30
Q

methotrexate (MTX)

A

RA

  • ORAL
  • FOLIC ACID ANTAGONIST- inhibits DIHYDROFOLATE REDUCTASE- reduces purine synthesis- DNA + RNA synthesis

(use in chemotherapy)

31
Q

sulfasalsine

A

RA

  • ORAL
  • acts in GUT
  • reduces extra-articular compli. -ulcerative colitis + IBD

(use as antibiotic)

SE = active metabolite - sulfapyridine - agranulocytosis

32
Q

hydroxchloroquine

A
  • ORAL
  • block toll-like receptor 9 - induce inflammatory response -by activation innate immune system

SE= nausea/cramps/diarrhoea/ worsens existing PSORASIS

33
Q

leflunomide

A

RA

inhibits DIHYDROOROTATE DEHYDROGENASSE - pyrimidine biosynthesis

34
Q

azathioprine

A

RA
immunosuppresant drug - purine synthesis inhibitor
steroid sparing drug

35
Q

ETANERCEPT

A

RA

  • biological DMARD
  • fusion protein-TNF receptor 2 + Fc HUMAN IgG1
  • SC injection once per week
36
Q

INFLIXIMAB

A

RA

  • biological DMARD
  • monoclonal antibody aganist TNFα = human Fc + MOUSE Fv
  • Infusion 2hrs 2-6weekly

SE = PUSTULAR PSORIASIS

37
Q

ADALIMUMAB

A

RA

  • biological DMARD
  • HUMAN TNFα monoclonal antibody
  • SC injection
38
Q

RITUXIMAB

A

RA

  • biological DMARD
  • chimeric monoclonal antibody against CD20 on Bcells
  • INFUSION (only 1 dose- depletes malignant + NORMAL B cells)
39
Q

ABATACEPT

A

RA

  • fusion protein = IgG + CTLA4
  • inhibits co-stimulation of T cells by APC (CTL4 has a higher affinity for APC than T cell CD28 (protein)

normal T cell activation

  1. T cell binds to MHC on APC
  2. co-stimulatory signal T cell- CD28 binds to APC -B7 protein
40
Q

TOCILIZUMAB

A

RA

  • biological DMARD
  • HUMANISED monoclonal antibody against IL6 receptor
  • IV monthly
41
Q

Biological DMARDs given in combination with MTX

A
  • Rituximab

- Tocilizumab

42
Q

CIPROFLOXACIN + PIPERACILLIN

A
SEPTIC ARTHRITIS (or OM)
-broad spectrum antibiotics used in intial treatment before a blood culture has been done to determine the specific type of infection present in the joints
43
Q

FLUCLOXACILLIN

A
SEPTIC ARTHRITIS (or OM)
-gram positive antibiotic
44
Q

VANCOMYCIN cement beads injection

A

CHRONIC OSTEOMYELITIS

  • cement- temporarily fill in the dead space created after the debridement of infected bone (+ non-toxic)
  • high antibacterial concentration directly to area of infection (maintaining low serum levels)

(Pharmacokinetic studies have shown that the local concentrations of antibiotic achieved are 200 times higher than levels achieved with systemic (oral) antibiotic administration)