EXAM 3 Prostanoids and Anti-Inflammatory Drugs Flashcards
what are the 3 major classes of anti-inflammatory drugs?
- nonsteroidal anti-inflammatory drugs (NSAIDs)
- glycocorticoids
- DMARDs (disease modifying anti-rheumatic drugs)
what is the mechanism of NSAIDs?
inhibit cyclooxygenase enzymes
what is the mechanism of glucocorticoids?
inhibit phospholipase A2 (PLA2)
what are the two types of DMARDs?
- traditional (non-biologic) DMARDs
- biologic DMARDs
what are eicosanoids?
- oxygenation products of poly-unsaturated long chain fatty acids
- G-coupled proteins
eicosanoids act in ___ and/or ___ fashions
autocrine and/or paracrine
what are prostanoids?
subclassification of eicosanoids
which 3 drugs are prostanoids?
- prostaglandins
- thromboxanes
- prostacyclins
prostanoids have major biological effects on what 5 things?
- smooth muscle
- platelets and blood cells
- nerve terminals
- endocrine organs
- adipose tissue
which drugs do not inhibit platelet aggregation or cause GI upset/ulceration?
COX-2 selective inhibitors
what are 3 common NSAIDs?
aspirin, ibuprofen, and naproxen
aspirin is also known as ___
acetylsalicylic acid
the following are contraindications for which drug?
avoid in patients with NSAID allergies, renal insufficiency, gout, hemophilia or other bleeding disorders, taking blood thinners, ACE inhibitors, methotrexate or oral hypoglycemic drugs, within 10 days of surgery, or near term pregnancy
avoid in children with viral-induced illness (Reye syndrome)
aspirin
___ is antipyretic and algesic (600-1000mg/day) and anti-inflammatory (3.2-4g/day)
aspirin
describe aspirins inhibition of COX enzymes
nonselective COX-1 and COX-2 inhibition
___ is the only NSAID to inhibit both COXs in an irreversible manner
aspirin (ASA)
___ is valued primarily for its antiplatelet aggregation effects at either 81mg/day or 325mg every other day
aspirin (ASA)
ibuprofen is an NSAID derivative of ___
propionic acid
___ is antipyretic and analgesic (doses <2400mg/day) and anti-inflammatory (doses >2400mg/day)
ibuprofen
if taken together, ibuprofen interferes with the ___ effect of low-dose aspirin, rendering aspirin less effective for ___ and ___
- antiplatelet
- MI and stroke prevention
___ is an NSAID with similar pharmacological profile as other NSAIDs but is available in slow-release formulation
naproxen
aka aleve
what are the main adverse effects common to all NSAIDs?
CNS, cardiovascular, GI, hematologic, hepatic, pulmonary, skin, renal, reye syndrome
describe adverse effects on the GI common to all NSAIDs
abdominal pain, dysplasia, nausea, vomiting, ulcers, or bleeding
describe reye syndrome that is an adverse effect common to all NSAIDs
rapidly progressive encephalopathy which occurs after recovery from viral infections
common in children taking salicylates after viral-induced illness