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Pharmacology > DRUGS FOR INFLAMMATION > Flashcards

DRUGS FOR INFLAMMATION Flashcards

1
Q

what are the signs of inflammation?

A

pain, warmth, redness, edema

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2
Q

causes of inflammation

A

infection, cell death, hypersensitivity reactions, extreme heat, chemical injury, physical trauma

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3
Q

what is acute inflammation?

A
  • associated with minor physical injury, chemical damage, infection, antigens
  • typically lasts 8-10 days, followed by repair an healing
  • usually self limiting; consider non pharmacological methods, topical antiinflammatories should be used whenever possible
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4
Q

what is chronic inflammation?

A
  • may occur if the body is not able to contain or neutralize the trigger of the into; inflammation; associated with many chronic conditions (SLE, rheumatoid arthritis)
  • leads to tissue damage, with symptoms becoming worse overtime
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5
Q

what is maladaptive?

A

body unable to adapt to pain on its own

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6
Q

bradykinin

A

present in an active form in plasma and also stored an released by mast cells; vasodilator that causes pain; effects are similar to those of histamine

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7
Q

complement

A

series of at least 20 proteins that combines in a cascade fashion to neutralize or destroy an antigen

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8
Q

histamine

A

stored and released by mast cells; causes dilation of blood vessels, smooth muscle constriction, tissue swelling and itching

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9
Q

leukotrienes

A

stored an released by mast cells; effects are similar of those of histamine

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10
Q

prostaglandins

A

present in most tissues and stored and released by mast cells; increase capillary permeability, attract white blood cells to site of inflammation, an cause pain

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11
Q

arachidonyl ester is covered into arachidonic acid by which enzyme?

A

phospholipase A2

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12
Q

when tissue is damaged, what acid is produced?

A

arachidonic acid (AA)

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13
Q

cyclooxygenase

A

converts AA into prostaglandins

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14
Q

prostaglandins

A

enhance vasodilation, gastric cytoprotection, decrease gastric acid secretion

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15
Q

thromboxane A2

A

stimulates platelet aggregation

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16
Q

lipoxygenase

A

converts AA into leukotrienes

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17
Q

leukotrienes

A

phagocyte activation, neutrophil chemotaxis, bronchoconstriction

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18
Q

what are the two anti-inflammatory drug classes?

A

NSAIDS, glucocorticoids drugs

19
Q

what’s the difference between NSAIDS and glucocorticoids drugs?

A

NSAIDS: used for management of mild to moderate pain, inflammation an fever
Glucocorticoids drugs: used for short term management of severe or disabling inflammation

20
Q

additional drug classes have been developed for which diseases?

A

IBD (ulcerative colitis, crohn’s disease), rheumatoid arthritis

21
Q

what additional drug classes were developed for specific disease states?

A

immunosuppressive drug, anti-TNF agents

22
Q

are NSAIDS non specific or specific?

A

non specific - all prostaglandin synthesis is inhibited

23
Q

is aspirin irreversible inhibitor or reversible?

A

irreversible inhibitor of cyclooxygenase enzyme
- significant impact on platelets; potent anticoagulant effect

24
Q

what do non selective NSAIDS inhibit?

A

COX-1 an COX-2 enzymatic activity

25
Q

what are the function of non selective NSAIDS?

A
  • reduces inflammation an fever
  • inhibits the formation of gastric mucosa, increases gastric acid secretion
  • inhibits platelet aggregation (significant inhibition - thromboxane A2)
26
Q

what is the second leading cause of peptic ulcer disease?

A

NSAIDS, significant risk GI bleeding

27
Q

what are the risks of selective NSAIDS?

A

high risk of MI, stroke and asymptomatic hypertension

28
Q

what are the 3 examples of aspirin?

A

A. coated
B. original strength
C. with stomach guard

29
Q

what is coated aspirin?

A

enteric coated products are intended to absorb in the alkaline environment of the small intestine (NOT ABSORBED IN THE STOMACH)

30
Q

what is original strength aspirin?

A

regular product that dissolves and begins to absorb in the stomach

31
Q

what is stomach guard aspirin?

A

buffered products contain ions that decrease gastric acidity and slow absorption

32
Q

prolonged excessively high fevers can induce what?

A

febrile seizures (especially in children), tissue damage, reduced mental acuity, delirium or coma

33
Q

what are the two antipyretic therapies?

A

NSAIDS and acetaminophen

34
Q

NSAIDS (Reye’s syndrome) - antipyretic therapy

A
  • most common between 4-14 years
  • associated with previous viral illness (chicken pox, influenza) and use of aspirin, causing brain inflammation, fatty deposits in the liver, death within days
  • overdose of aspirin
35
Q

acetaminophen - antipyretic therapy

A

direct action on hypothalamus and dilation of peripheral blood vessels (enables sweating and fever)

36
Q

why should you never use aspirin in paediatric patients with a fever?

A

you don’t know what’s causing the fever

37
Q

when is histamine released?

A

during an allergic reaction

38
Q

what are antihistamines?

A

block the action of histamine at the H1 receptor for the treatment of allergic rhinitis; provide symptomatic relief of runny nose, sneezing, itchy eyes an throat, most effective when administered prophylactically

39
Q

what effects do antihistamines produce?

A

sedative effects - more prominent in 1st general H1 antagonists (eg. diphenhydramine (Benadryl) vs loratadine (Claritin))
- can also be used for treatment of motion sickness an vertigo

40
Q

anaphylaxis

A
  • hyperimmune and hyper inflammatory response to an antigen
  • body responds within minutes to the antigen, releasing massive amounts of histamine and other chemical mediators of inflammation
41
Q

symptoms of anaphylaxis

A

itching, hives, tightness in throat and chest, swelling of the larynx, causing cough, rapid decrease in BP, reflex tachycardia, difficulty breathing (bronchoconstriction)

42
Q

anaphylaxis of pharmacological management (epinephrine (IM) adrenergic agonist drug)

A

alpha1 receptor - increases BP
beta2 receptor - bronchodilation
beta1 receptor - cardiac output

43
Q

anaphylaxis of pharmacological management (in cases of continued upper airway obstruction - what should be given?)

A

nebulized epinephrine

44
Q

anaphylaxis of pharmacological management (in cases of persistent wheeze - what should be given?)

A
  • beta2 adrenergic agonists (eg. salbutamol - inhaled) - promotes bronchodilation
  • systemic glucocorticoids (eg. prednisolone - PO) or hydrocortisone (IV); inhibits immune and inflammatory responses to the antigen

Pharmacology (20 decks)

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