exam 1 pharmacology- NSAIDs Flashcards
PGE2 causes what
redness, swelling, pain via peripheral sensory neurons, spinal cord and brain, and fever
PGI1 causes what
edema and pain from acute inflammation, vasodilation, anti-platelet, synovial fluid in arthritic knee joints
what is cox 1 responsible for
protect gastric mucosa
support renal function
promote platelet aggregation
what is cox 2 responsible for
inflammation
pain sensitivity
fever
support renal function
increased risk of colon cancer
first generation cox inhibitors
inhibit 1 and 2
- aspirin
- ibuprofen
- naproxen
- indomethacin
- meloxicam
2nd generation cox inhibitors
inhibit cox 2 only
- celecoxib
what does aspirin help with? what does aspirin cause?
decreases: pain, fever, inflammation, MI/stroke
symptoms: ulcers, renal effects, bleeding
what do other 1st gen help with? effects?
decreases: inflammation, pain, fever
causes: ulcers, renal effects, bleeding, MI/stroke
what do 2nd gen help with? effects?
decreases: inflammation and pain
causes: ulcers, renal effects, MI/stroke
what does acetaminophen help with? effects?
decreases: pain and fever
causes: liver damage
unique about aspirin
irreversible inhibition of cox- preferentially inhibits cox 1
aspirin cardio protection mechanism
reduces production of thromboxane A2
patient with ulcers would likely use which?
a preferentially cox 2 selective inhibitor + a PPI
patient with cardiovascular risk would likely use which?
a cox 1 inhibitor (inhibit platelet aggregation)
- naproxen is safest
what is unique about acetaminophen?
deactivated peripherally, so devoid of GI, CV and bleeding adverse effects while maintaining anti fever effects
- also doesn’t treat inflammation
how do prostaglandins protect gastric mucosa?
inhibits gastric acid secretion in the stomach
what is the danger of using acetaminophen
liver failure
patient with history of MI should avoid what NSAIDS?
2nd gen, selective cox 2 inhibitors
glucocorticoid examples
prednisone and prednisolone
glucocorticoid use in RA
slow disease progression and rapid relief, but toxic if used chronically
TNF alpha antagonist DMARDs
etanercept, infliximab, adalimumab
nonbiological DMARD and how it works
methotrexate: inhibits dihydrofolate reductase
biologic DMARD that is anti-CD20 on B cells
rituximab
biological DMARD that binds APCs and prevents T cell activation
abatacept
biologic DMARD that binds IL-6 receptors
tocilizumab
biologic DMARD that blocks IL-6 receptors
anakinra
which NSAID promotes closure of ductus arteriousus
indomethican
what drug promotes premature closure of ductus arterioles
celecoxib
which drug has a sulfur moiety, so cannot be used if a sulfa allergy
celecoxib
naproxen selectivity
cox 1 selective
aspirin selectivity
slightly cox 1 selective
