DRUGS ACTING ON THE BLOOD INFLAMMATION AND GOUT Flashcards

(94 cards)

1
Q

Absence of adequate iron result in

A

small erythrocytes with insufficient hemoglobin are formed resulting in microcytic hypochromic anemia.

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2
Q

What are the causes of Iron Deficiency Anemia?

A
  1. Nutritional deficiency
  2. Chronic blood loss
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3
Q

What is the daily requirement of Iron in male?

A

Male 10mg

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4
Q

What is the daily requirement of Iron in female?

A

Female 15 mg

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5
Q

What are the dietary sources of iron?

A

Meat, cereals

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6
Q

How much total content of Iron in the male adult?

A

About 4000mg in an adult male

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7
Q

How much total content of Iron in the female adult?

A

About 2500 mg

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8
Q

Which part of duodenum the iron absorbed?

A

Duodenum and proximal jejunum.

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9
Q

What are the factors that deceases iron absorption?

A

Antacids
Gastric resection
Phytates

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10
Q

Iron is stored as

A

ferritin

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11
Q

Ferritin is a storage form of

A

Iron

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12
Q

What part of body iron (ferrtin) is stored?

A

Intestinal mucosal cells

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13
Q

How does iron elimination occurs from human body?

A

Very small amount are execrated in stool
Trace amounts are execrated in bile
Urine and sweat with total daily excretion not more than 1mg/day

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14
Q

What are oral iron therapy preparations for anemia?

A

Ferrous sulfate
Ferrous gluconate
Ferrous fumarate

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15
Q

What are the side effects of oral therapy drugs?

A

Nausea, vomiting
Epigastric discomfort,
Constipation
Diarrhea

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16
Q

What are the drugs used for parenteral administration?

A
  • Iron dextran
  • Iron sorbitol
    They may be given by deep IM or occasionally IV.
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17
Q

Intravenous iron administration may result

A

in very severe allergic reactions and thus should be avoided if possible.

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18
Q

Which drug is used in acute iron toxicity?

A

Deferoxamine - A potent iron chealating compound should be given systemically to bind iron and promote excretion through urine

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19
Q

How does a chealating compound work?

A

The chelating agent has a structure that allows it to bind to the metal (e.g. ferritin) ion at multiple points, forming a ring-like structure known as a chelate.

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20
Q

What is chelation therapy?

A

In the case of heavy metal (e.g. ferritin, lead) poisoning, the agent may be given intravenously or orally. During chelation therapy, the chelating agent will bind to the metal ions in the bloodstream and other tissues, and facilitate their excretion through urine or feces.

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21
Q

Vitamin B12 is also called

A

Cobalamin

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22
Q

What is the synthetic form of vitamin B12?

A

Cyanocobalamin

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23
Q

What is difference between cobalamin and cyanocobalamin?

A

Cobalamin and cyanocobalamin are two different forms of vitamin B12. Cobalamin is the natural form of vitamin B12 that is found in foods
Cyanocobalamin is a synthetic form of vitamin B12 that is commonly used in dietary supplements and fortified foods.
The main difference between the two forms is that cyanocobalamin contains a cyanide molecule.

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24
Q

What is the physiologic function of B12?

A

Acts as a coenzyme in the synthesis of DNA and is also essential for various metabolisms in the body.

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25
How does b12 absorb in human body?
It absorbed after combined with intrinsic factor secreted by stomach
26
Where B12 is absorb in human body?
Distal ileum
27
Deficiency of Vit B12 results in:
- Megaloblastic anemia - Neurological syndrome involving spinal cord and peripheral nerves
28
What is the reason of megaloblastic anemia?
It occurs due to a deficiency in vitamin B12 or folic acid.
29
What are the characteristics of megaloblastic anemia?
It is characterized by the production of abnormally large red blood cells (megaloblasts) in the bone marrow, which are immature and unable to function properly.
30
If intrinsic factor secretion is defective, what type of anemia it will cause?
Pernicious anemia
31
Intrinsic factor secretion is required to absorb:
B12
32
Defective Intrinsic factor secretion leads to:
Pernicious anemia
33
What is required to absorb the B12 in human body?
Intrinsic factor secretion (in stomach)
34
What are the causes defective secretion of intrinsic factor?
- Partial or total gastrectomy, - Diseases that affect distal ileum, - Malabsorption syndrome e.g inflammatory bowel disease
35
Almost all cases of vit B12 deficiencies are caused by:
Malabsorption
36
What are the Vit B12 therapeutic preparations?
Cyanocoblamin Hydroxycobalamin
37
If case of intrinsic factor deficiency the B12 vitamin should be given:
Parenterally and patients with pernicious anemia will need life-long therapy.
38
What is daily requirement of Folic acids?
Daily requirement is 50 -100μg.
39
Why folic acid is important for human body?
Folic acid is needed for the production of DNA and RNA, which are essential for the formation of new cells. This is particularly important during periods of rapid cell growth, such as during pregnancy and infancy.
40
Folic acid, also known as
Folate
41
What are the natural sources of folic acids?
Yeast Liver Kidney Green vegetables
42
Folic acids provide precursors for:
Synthesis of amino acids, purines and DNA
43
What is the physiologic functions of folate (folic acid)?
It plays a role in the biosynthesis of purines and pyrimidines, i.e., DNA.
44
Folic acid is absorb in:
Proximal jejunum
45
How much folate stored in human body?
5 -20 mg of folates are stored in the liver and other tissues
46
Folate deficiency result in:
Megaloblasiic anemia
47
Megaloblasiic anemia are due to deficiency of:
Folate
48
What is the consequences of folate deficiency during pregnancy?
Spina bifida (congenital malformation in newborn)
49
How much amount of folic acid given in anemia?
Folic acid 1mg orally per day.
50
What is Hemostasis?
Hemostasis is spontaneous arrest of bleeding from a damaged blood vessel. Steps: Vascular injury -> vasospasm-> platelate adhesion -> platelate aggregation -> coagulation cascades -> fibrin formation
51
What are anticoagulants?
Anticoagulants are the drugs which inhibit fibrin formation.
52
What are the classification of anticoagulants?
1. Fast and direct acting - IV or subcutaneous e.g: Heparin 2. Slow and indirect acting - Oral anticoagulants e.g Warfarin and Dicumarol
53
What is the drug used as fast and direct acting anticoagulants?
Heparin
54
What are the drugs used as slow and indirect acting anticoagulants?
Warfarin Dicumarol
55
What is the heparin mechanism of action?
The mechanism of action of heparin involves its ability to enhance the activity of antithrombin III, a natural protein that helps to prevent blood clots.
56
What are the steps of heparin mechanism of actions?
Blood vessel injury -> Activation of clotting factors, including thrombin -> Thrombin converts fibrinogen to fibrin -> Fibrin forms a mesh-like structure -> Clot formation -> Prevention of further bleeding
57
What are the clinical uses of heparin?
Prevention and treatment of venous thrombosis Treatment of coronary occlusion Acute myocardial infarction Prevention of post operative thrombosis and embolism
58
Why heparin is always administered by IV or subcutaneous?
Oral therapy is ineffective because it is inactivated by gastric acids and absorption is minimal because of large molecular size. Heparin must never be administered intramuscularly because of danger of hematoma formation at injection site.
59
Why heparin is not administered by IM?
Heparin must never be administered intramuscularly because of danger of hematoma formation at injection site.
60
Why heparin is not administered by oral route?
Oral therapy is ineffective because it is inactivated by gastric acids
61
What are the side effects of heparin?
Bleeding is the major side effect Thrombocytopenia Osteoporosis
62
What are the contraindications of heparin?
If patient - is actively bleeding - has hemophilia - has thrombocytopenia - has sever hypertension
63
Which compound was originally employed as a rodent poison?
WARFARIN
64
What is the drug of choice as an oral anticoagulant?
WARFARIN
65
What is the warfarin mode of action?
The anticoagulant prevents reductive metabolism of the inactive vitamin K epoxide back to its active form
66
Warfarin should nor administered during:
Pregnancy.
67
Which drugs increase the effect of warfarin?
Cimitidine Metronidazole Cephalosporin (3rd generations)
68
Which drugs decrease the effect of warfarin?
Barbiturates Rifampincin Diuretics Vit K
69
What are the THROMBOLYTIC AGENTS? Name them?
Streptokinase Urokinase Anistreptase Tissue plaminogen activator
70
How does streptokinase work as THROMBOLYTIC AGENTS?
Streptokinase- a protein synthesized by streptococci, combines with plasminogen to convert it to active plasmin.
71
How does Urokinase work as THROMBOLYTIC AGENTS?
It is human enzyme synthesized by the kidneys that directly converts plasminogen to active plasmin
72
What is indications (clinical use) of THROMBOLYTIC AGENTS?
Multiple pulmonary emboli Central deep vein thrombosis Acute myocardial infarction
73
What are ANTIPLATELET DRUGS?
Aspirin Ticlopidine Dipyridamole.
74
What is therapeutic Uses of Aspirin?
Prophylaxis against myocardial infarction Prevention of stroke in patients at risk e.g. those with transient ischemic attacks.
75
How does Aspirin work?
Aspirin irreversibly blocks the enzyme cyclooxygenase; the drug decreases the formation of both the prostaglandins and thromboxane A2.
76
Aspirin provide the following effects in human body:
Anti-inflammatory Effects Analgesic Effects Antipyretic Effects Platelet Effects - inhibits platelet aggregation
77
What are the clinical uses of aspirin?
used as analgesic, antipyretics, and anti-inflammatory and Inhibition of platelet aggregation drug.
78
What is the common side effect of aspirin in GI?
Gastritis
79
What is the common side effect of aspirin in CNS?
Tinnitus, decreased hearing, and vertigo
80
Aspirin in a low daily dose usually increases:
Serum uric acid levels
81
Which NSAIDs have more effect in GI? Aspirin or Ibuprofen?
Ibuprofen effects gastrointestinal irritation and bleeding , though less frequently than with aspirin.
82
Which NSAIDs is potent cyclooxygenase inhibitor?
Diclofenac
83
Which NSAIDs is potent cyclooxygenase inhibitor? Diclofenac or naproxen?
The potency of diclofenac as a cyclooxygenase inhibitor is greater than that of naproxen.
84
What are indication (clinical use) of diclofenac?
Rheumatoid arthritis and Osteoarthritis Acute musculoskeletal pain.
85
What are the adverse effects of diclofenac?
Gastrointestinal distress Gastric ulceration
86
Name few Nonsteroidal Anti-Inflammatory Drugs?
Ibuprofen Diclofenac Rofecoxib Sulindac Mefenamic Acid
87
Which NSAIDs is slightly more toxic than others?
Indomethacin
88
What are the clinical uses of Indomethacin?
Patent ductus arteriosus Acute gouty arthritis Ankylosing spondylitis, pericarditis
89
Which NSAIDs possesses no significant anti-inflammatory effects?
Acetaminophen
90
What are the indications of acetaminophen?
It is an effective analgesic and antipyretic agent, but it lacks of anti-inflammatory properties.
91
What is Gout?
Gout is a metabolic disease characterized by recurrent episodes of acute arthritis due to deposits of monosodium urate in joints and cartilage. Formation of uric acid calculi in the kidneys may also occur.
92
What are the drugs used in gout?
Colchicine Probenecid sulfinpyrazone Allopurinol
93
Which NSAIDS is used in gout?
Indomethacin
94
What are the Indications of Allopurinol?
* in chronic tophaceous gout * for recurrent renal stones * in patients with renal functional impairment; * When serum urate levels are grossly elevated.