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Pharmacology > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

Penicillin G/V

A

Beta Lactam Abx
M: bind penicillin binding proteins blocking cross linking of peptidoglycan. activate autolytic enzymes.
C: bactericidal for gram + organisms, n. meningitidis, t. pallidum, gram - cocci, and spirochetes. penicillinase sensitive.
T: hypersensitivity rxn, hemolytic anemia

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2
Q

Ampicillin

Amoxicillin

A

Beta Lactam Abx-aminopenicillins
M: wider spectrum but similar to penicillin. combine with clavulanic acid to protect against beta-lactamase.
C: H. influenzae, E. coli, Listeria monocytogenes, Proteus mirabilis, Salmonella, Shigella, and enterococci.
T: hypersensitivity rxn, rash, psuedomembranous colitis.

HELPSS kill enterococci.

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3
Q

Oxacillin
nafcillin
dicloxacillin

A

Beta Lactam Abx-penicillinase resistant
M: narrow spectrum, resistant because of bulky R group blocks beta-lactamase
C: staph aureus (not MRSA)
T: hypersensitivity rxn, interstitial nephritis

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4
Q

Ticarcillin

Piperacillin

A

Beta Lactam Abx-antipseudomonals
M: extended spectrum penicillin
C: Pseudomonas spp. and gram - rods; susceptible to penicillinase. use beta-lactamase inhibitor

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5
Q

cefazolin

cephalexin

A

Beta-Lactam- Cephalosporin 1st Gen
M: same as penicillin but less susceptible to penicillinases.
C: gram + cocci; proteus mirabilis, e. coli, Klebsiella pneumoniae, zolin used prior to sx to prevent S. aureus infections.
T: for all, Hypersensitivity rxn, vit. K deficiency, increase nephrotoxicity of amino glycosides. do not mix with etoh.

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6
Q

cefoxitin
cefaclor
cefuroxime

A

Beta-Lactam: cephalosporin 2nd gen
C: gram + cocci, h. influenzae, enterobacter aerogenes, Neisseria spp., Proteus mirabilis, E. coli, Klebsiella pneumoniae, Serratia marcescens

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7
Q

ceftriaxone
cefotaxime
ceftazidime

A

Beta-Lactam: cephalosporin 3rd gen
C: serious gram - infections resistant to other beta-lactams. Ceftriaxone-meningitis and gonorrhea. ceftazidime-pseudomonas

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8
Q

Cefepime

A

Beta-Lactam: cephalosporin 4th gen

C: increased activity against pseudomonas and gram + spp.

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9
Q

Ceftaroline

A

Beta-Lactam: cephalosporin 5th gen

C: broad gram +/-, covers MRSA, not pseudomonas.

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10
Q

Aztreonam

A

Beta-Lactam: monobactam
M: resistant to B-lactamases, binds PBP 3. works synergistically with amino glycosides. no cross allergy with penicillins.
C: gram - rods only, no activity with gram + or anaerobes. used for penicillin allergic patients and those with renal insufficiency who cannot tolerate amino glycosides.
T: minimal hypersensitivity, gi upset.

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11
Q

Imipenem
meropenem
ertapenem
doripenem

A

Beta-Lactam: carbapenems
M: Beta-lactamase resistant; give with cilastatin to inhibit renal dehydropeptidase and prevent drug inactivation in kidneys
C: gram + cocci, gram - rods, and anaerobes. wide spectrum, but significant side effects limit use to life-threatening infection or after other drugs have failed.
mero-decrease seizure risk and stable to dehydropeptidase.
T:GI distress, hypersensitivity, and CNS toxic at high levels.

imipenem: the kill is lastin’ with cilastatin.

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12
Q

Vancomycin

A

M: inhibits cell wall peptidoglycan formation by binding D-ala D-ala portion of cell wall precursors, bactericidal.
C: gram + only, serious multi-drug resistant organisms including MRSA, enterococci, and C. diff (oral dose).
T: red man syndrome ie flushing, nephrotoxicity, ototoxicity, and thrombophlebitis.

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13
Q

Bacitracin

A

M: blocks incorporation of amino acids and nucleic acids into cell wall
C: broad spectrum gram +/-. used for topical and ophthalmic ointments. often combined with other agents such as neomycin, polymyxin B, and hydrocortisone.
T: rare hypersensitivity rxns

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14
Q

Fosfomycin

A

M: blocks cell wall synthesis by preventing UDP-N-acetylmuramic acid synthesis. broad spectrum gram +/-.
C: uncomplicated UTI in females
T: hypersensitivity rxns rarely

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15
Q 
gentamicin
neomycin
amikacin
tobramycin
streptomycin
A

Protein synthesis inhibitors- Aminoglycosides
M: bectericidal; inhibit formation of initiation complex and cause misreading of mRNA and block translocation. active on 30S ribosome, require O2.
C: severe gram - infections, synergistic with beta lactams. neomycin for bowel surgery
T: nephrotoxicity (especially with cephalosporins), neuromuscular blockade, ototoxicity (especially with loop diuretics), and teratogen. resistance through bacterial inactivation
-Streptomycin is one of the first used drugs in resistant TB and the atypical TB’s.

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16
Q

azithromycin
clarithromycin
erythromycin

A

protein synthesis inhibitors-Macrolides
M: bacteriostatic; block translocation on 50S subunit. cidal at high concentrations.
C: atypical pneumonias (mycoplasma, chlamydia, legionella), STDs (chlamydia), and gram + cocci in penicillin allergic patients.
T: GI motility issues, arrhythmia by prolonged QT, acute cholestatic hepatitis, rash, eosinophilia, P450 inhibition.

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17
Q

Clindamycin

A

Protein synthesis inhibitors
M: blocks peptide transfer at 50S subunit. bacteriostatic.
C: anaerobic infections in aspiration pneumonia, lung abscesses, and oral infections. also group A strep. community acquired MRSA of skin and soft tissue.
T: psuedomembranous colitis, fever, diarrhea. GI upset.

treats anaerobes above the diaphragm, metronidazole below.

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18
Q

Chloramphenicol

A

protein synthesis inhibitor
M: bacteriostatic; blocks peptidyltransferase at 50S subunit.
C: tx meningitis (h. influenzae, N. meningitidis, S. pneumo) and Rocky Mountain Spotted fever. (rickettsia reckettsii). limited use in US, but used world wide because its cheap.
T: anemia, aplastic anemia, gray baby syndrome in premies. (lack UDP-glucuronyl transferase)

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19
Q

linezolid

A

protein synthesis inhibitor: oxazolidinones
M: binds P-site of 50S subunit and inhibits formation of ribosomal-fMET-tRNA complex. (at beginning)
C: because of unique mechanism, it is effective against many penicillin, methicillin, and vanco resistant strains.
T: myelosuppression, leukopenia, pancytopenia, thrombocytopenia, GI upset, and MAOI inhibitor.

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20
Q

tetracycline
doxycycline
minocycline

A

protein synthesis inhibitor-tetracyclines
M: bacteriostatic; binds 30S subunit and prevents amino acid addition to peptide chain. limited CNS penetration.
C: borrelia burgdorferi, M. pneumoniae. intracellular penetration makes it effective against reckettsia and chlamydia. tx acne.
doxy is fecally eliminated-used with renal failure pts. no not take with sources of Ca and Mg-inhibit absorption.
T: GI distress, nutrient interaction leading to teeth discoloration and inhibition of bone growth in children, photosensitivity, and disrupts normal gut flora. do not use when pregnant.

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21
Q

sulfadiazine
sulfamethoxazole (SMX)
sulfamethizole
sulfisoxazole

A

DNA synthesis inhibitor- antifolate
M: para-aminobenzoic acid antimetabolites inhibit dihyropteroate synthase. bacteriostatic.
C: gram +/-, nocardia, chlamydia. triple sulfas of SMX for simple UTI
T: hypersensitivity, hemolysis with G6PD, nephrotoxic, photosensitivity, kernicterus in infants, displace other drugs from albumin, steven-johnson syndrome. can precipitate in urine.

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22
Q

Trimethoprim

A

DNA synthesis inhibitor-antifolate
M: inhibits bacterial dihydrofolate reductase. bacteriostatic.
C: used in combo with sulfonamides to tx UTIs, shigella, salmonella, pneumocystis jirovecii for tx and prophylaxis, and toxoplasmosis prophylaxis.
T: megaloblastic anemia, leukopenia, granulocytopenia. (lessened with folinic acid supplementation)

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23
Q 
Ciprofloxacin
norfloxacin
levofloxacin
ofloxacin
sparfloxacin
moxifloxacin
gemifloxacin
enoxacin
nalidixic acid
A

DNA synthesis inhibitors-fluoroquinolones
M: inhibit DNA gyrase (topo 2) and topoisomerase 4. bactericidal.
C: gram - gods of urinary and GI tracts (including pseudomonas) neisseria, and some gram + and anthrax. must not be taken with antacids.
T: GI upset, superinfections, skin rashes, HA, dizziness. can cause tendonitis and tendon rupture, leg cramps, myalgias, and QT prolongations. bind divalent cations and prevent absorption.
do not use in pregnant, nursing mother, or if under 18 years old.

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24
Q

Metronidazole

A

DNA damager
M: prodrug (activated by pyruvate ferrodoxin oxidoreductase) that forms free radical metabolites in the bacterial cell that damage DNA. bactericidal. antiprotozoal.
C: giardia, entamoeba, trichomonad (only trophozoite), gardnerella vaginalis, anaerobes below the diaphragm. (c. diff). use with clarithromycin and PPI for triple therapy against H. pylori.
T: disulfiram like rxn (flushing, tachycarida, hypotension) with etoh, HA, and metallic taste. neuropathy and GI upset.

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25
Q

Daptomycin

A

Cell Membrane-lipopeptide
M: binds to membrane and causes depolarization. bactericidal. insertion is Ca dependent.
C: gram +, complicated skin/soft tissue infections, bacteremia, and endocarditis.
T: myopathy, rhabdomyolysis

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26
Q

Polymyxin B

A

Cell membrane-detergent
M: binds phospholipids in cell membrane and punches holes. specifically LPS
C: primarily gram -, topically used with bacitracin.
T: rare

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27
Q

Isoniazid (INH)

A

M: decrease synthesis of mycolic acids. bacterial catalase peroxidase needed to convert INH to active metabolite. encoded by KatG.
C: mycobacterium tuberculosis. only agent used as solo prophylaxis against TB. latent used for 9 months. active, used in combo.
T: neurotoxicity, hepatotoxicity, pyridoxine (b6) can prevent neurotoxicity, lupus. slow acetylators have higher rate of toxicity.

INH injures neurons and hepatocytes

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28
Q

Rifampin

rifabutin

A

Rifamycins
M: inhibits DNA dependent RNA polymerase
C: mycobacterium tuberculosis active, alternative for latent; delays resistance to dapsone when used for leprosy. meningococcal prophylaxis and chemoprophylaxis in contacts of children with h. influenza type B
T: minor heptotoxicity and drug interactions. increase p450; orange body fluids (non hazardous) Rifabutin favored in HIV pts due to less p450 stimulation and used in M. avium.

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29
Q

Pyrazinamide

A

M: uncertain; thought to acidify intracellular environment via conversion to pyrazinoic acid. effective in acidic pH of phagolysosomes.
C: mycobacterium tuberculosis
T: hyperuricemia very common and hepatotoxicity

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30
Q

Ethambutol

A

M: decrease carbohydrate polymerization of mycobacterium cell wall by blocking arabinosyltransferase.
C: mycobacterium tuberculosis
T: red green color blindness (reversible) and impaired visual acuity. hyperuricemai

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31
Q

Dapsone

A

M: inhibitor of folic acid synthesis
C: treatment of M. leprae.
T: anemia, hemolytic in G6PD

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32
Q

Clofazamine

A

M: uncertain
C: M. leprae, especially lepromatous form
T: skin red-brown to black

33
Q

Paromomycin

A

aminoglycoside abx
C: effectively eliminates both trophozoite and cysts forms of E. histolytic from lumen of intestine. no activity on invasive trophozoites.
T: diarrhea. less toxic and shorter use than iodoquinal.

34
Q

Nitazoxanide

A

M: interferes with pyruvate:ferrodoxin oxidorecuctase.
C: cyrptosporidium and giardiasis

35
Q

Chloroquine

A

M: blocks detoxification of heme into hemozoin. heme accumulates and is toxic to plasmodia
C: plasmodial species other than P. falciparum (high resistance due to membrane pump)
T: retinopathy, pruritus (especially in dark skinned individuals)

36
Q

Quinine

A

M: similar to chloroquine
C: poorest therapeutic to toxic ratio of antimalarial drugs. used in other countries
T: cinchonism (tinnitus, temporary hearing loss, HA, nausea, vomiting and visual disturbances), hypoglycemia

37
Q

Mefloquine

A

M: similar to chlroquine
C: prophylaxis and tx. works against all species
T: neuropsychiatric rxn’s, vivid dreams, sleep walking.

38
Q

Primaquine

A

M: ?
C: only drug available that has activity against the liver hypnozoite forms of P. vivax and oval
T: G6PD deficiency must be tested or hemolytic anemia will occur.

39
Q

Malarone

A

M:
C: highly effective against P. falciparum. often used for prophylaxis
T:

40
Q

Albendazole
mebendazole
thiabendazole

A

Benzimidazoles
M: cause paralysis of helminths, poorly absorbed so stays in gut
C: alb/meb-ascariasis, pinworm, hookworm, whipworm.
Thia-cutaneous larval migrans and 2nd line for strongyloidiasis
T: thia-cns disturbances and GI upset. do no use in young children or pregnant women.

41
Q

Ivermectin

A

M: paralysis of helminths
C: strongyloidiasis drug of choice and obscure tropical
T:

42
Q

Pyrantel Pamoate

A

M:
C: drug of choice of pinworms; often treat entire house

43
Q

Praziquantel

A

M: increases calcium permeability of worms tegument
C: tx of tapeworm (cestode) and fluke (trematode) infections and schistosoma
T: minor GI problems.

44
Q

Amphotericin B

A

M: binds ergosterol; forms membrane pores that allow leakage of electrolytes
C: serious systemic mycoses. cryptococcus (amph b with or without flucytosine), blastomyces, coccidioides, histoplasma, candida, nucor. intrathecally for fugal meningitis. supplement with K and Mg because of altered renal tube permeability.
T: fever and chills, hypotension, nephrotoxicity, arrhythmias, anemia, IV phlebitis. hyrdration decrease nephrotox, liposomal amph B decrease toxicity.

45
Q 
Fluconazole
ketoconazole
clotrimazole
miconazole
itraconazole
voriconazole
A

Azoles
M: inhibit fungal ergosterol synthesis by inhibiting the cytrochrome p450 enzyme that converts lanosterol to ergosterol.
C: local and less serious systemic mycoses. fluconazole for chronic suppression of cryptococcal meningitis in AIDs patients and candidal infections of all types. Itraconazole for blastomyces, coccidioides, histoplasma. clotrimazole and miconazole for topical fungal infections . voriconazole tx of choice for aspergillus
T: testosterone synthesis inhibition>gynecomastia especially with ketoconazole. liver dysfunction>inhibits p450

46
Q

Flucytosine

A

M: inhibits DNA and RNA biosynthesis by conversion to 5-fluorouracil by cytosine deaminase.
C: systemic fungal infections esp. meningitis caused by cryptococcus in combo with amphotericin B. also tx some candida
T: bone marrow suppression.

47
Q

Caspofungin
micafungin
anidulafungin

A

echinocandins
M: inhibits cell wall synthesis by inhibiting synthesis of beta-glucan
C: invasive aspergillosis, candida
T: GI upset, flushing due to histamine release.

48
Q

Griseofulvin

A

M: interferes with microtubule function; disrupts mitosis. deposits in keratin-containing tissues
C: orals tx of superficial infections; inhibits growth of dermatophytes (tinea, ringworm)
T: teratogenic, carcinogenic, confusion, headaches, increase p450 and warfarin metabolism.

49
Q

Terbinafine

A

M: inhibits the fungal enzyme squalene epoxidase
C: dermatophytoses (esp. onychomycosis-fungal infection of finger or toe)
T: GI upset, HA, hepatotoxicity, taste disturbance.

50
Q

Nystatin

A

M: same as amphotericin B, used topically only because too toxic for systemic use.
C: swish and swallow for oral candidiasis, topical for diaper rash or vaginal candidiasis.
T:

51
Q

acyclovir
famciclovir
valacyclovir

A

M: monophosphorylated by HSV/VZV thymidine kinds and not phosphorylated in uninfected cells. >few side effects. gaunosine analog, triphosphate formed by cellular enzymes. preferentially inhibits viral NDA polymerase by chain termination .
C: HSV and VZV. weak activity against EBV. none against CMV. used for HSV mucocutaneous, genital, and encephalopathy. no effect on latent infections. Vala has better oral bioavailability, fan preferred for herpes zoster.
T: obstructive cyrstalline nephropathy and acute renal failure if not adequately hydrated.

mutated thymidine kinase offers resistance

52
Q

Foscarnet

A

M: viral DNA polymerase inhibitor that binds to the pyrophosphate binding site of the enzyme. does not require activation by viral kinase
C: CMV retinits in immunocompromised patients when ganciclovir fails; acyclovir resistant HSV
T: nephrotoxicity

mutated DNA polymerase offers resistance

53
Q

Ganciclovir

A

M: 5’-monophospahte formed by a CMV viral kinase. guanosine analog. triphosphate formed by cellular kinases. preferentially inhibits viral DNA polymerase.
C: CMV, especially in immunocompromised patients. valganciclovir has better bioavailability.
T: leukopenia, neutropenia, thrombocytopenia, renal toxicity. more toxic to to host enzymes than acyclovir.

mutated CMV DNA polymerase or lack of viral kinase offers resistance.

54
Q

trifluridine

A

M: phosphorylated by cellular enzymes
C: used mostly to tx keratoconjunctivitis and recurrent epithelia keratitis due to HSV 1/2

55
Q

cidofovir

A

M: preferentially inhibits viral DNA polymerase. does not require phosphoyrlation by viral kinase.
C: CMV retinitis in immunocomprosed patients. acyclovir resistant HSV with long half life
T: nephrotoxicity. administer with probenecid and IV saline to decrease toxicity.

56
Q

oseltamivir

zanamivir

A

M: inhibit influenza neuramindase>decrease release of progeny virus
C: tx and prevention of influenza A and B. zana is inhaled instead of oral and has less resistance but can only be given to 7 yo or greater and more respiratory side effects.
T: nausea, vomit, ab pain, HA, rash

57
Q

Ribavirin

A

M: inhibits synthesis of guanine nucleotides by competitively inhibiting inosine monophosphate dehydrogenase.
C: RSV (aerosol) limited to and chronic hep C (oral)
T: hemolytic anemia and severe teratogen

58
Q 
Abacavir
didanosine
emtricitabine
lamivudine
stavudine
tenofovir
zidovudine
A

Nucleoside Reverse Transcriptase Inhibitors
M: competitively inhibit nucleotide binding to revers transcriptase and terminate the DNA chain. Tenofovir is a nucleotide, rest are nucleosides and require phosphorylation to be active. zidovudine is used for general prophylaxis and during pregnancy to reduce fetal transmission.
C: HIV/AIDS and Hep B
T: bone marrow suppression (reversed with G-CSF and EPO), peripheral neuropathy, lactic acidosis, rash, anemia, pancreatitis (didanosine)

59
Q

Efavirenz
nevirapine
delavirdine

A

Non-Nucleoside Reverse Transcriptase Inhibitors
M: bind to revers transcriptase at site different from NRTIs. do not require phosphorylation to be active.
C: HIV/AIDS
T: rash, stevens johnson syndrome, and hepatotoxicity common to all. Vivid dreams and CNS symptoms with efavirenz. Delvirdine and efavirenz are contraindicated in pregnancy, nevirapine can be used to prevent vertical transmission.
drug interactions due to p450 effects.

60
Q 
Atazannavir
darunavir
fosamprenavir
indinavir
lopinavir
ritonavir
saquinavir
A

Protease Inhibitors
M: targets HIV-protease and prevents maturation of new viruses. Ritonavir inhibits p450 enzymes boosting other drug conc.
T: hyperglycemia, GI intolerance, lipodystrophy, nephropathy, hematuria with indinavir

61
Q

Maraviroc

A

Fusion Inhibitor
M: binds CCR-5 on surface of T cells/monocytes, inhibiting interaction with gp120.
T: cough, URT infections, postural hypotension, increased cardiac events.

62
Q

Enfuvirtide

A

Fusion Inhibitor
M: binds gp41, inhibiting viral entry. large peptide drug that must be given SQ
C: used with tx EXPERIENCED pts with HIV replication even with ARV treatment.
T: skin reaction at injection site, insomnia, HA, dizziness

63
Q

Raltegravir

A

Integrase Inhibitors
M: inhibits HIV genome integration into host cell chromosome by reversibly inhibiting HIV integrase.
T: hypercholesterolemia, myopathy, rhabdomyolysis, creatine kinase elevation.

64
Q 
Cortisone
Hyrdrocortisone
Prednisone
Prednisolone
Mehtyprednisolone
Dexamethasone
Betamethasone
A

Glucocorticoids
M:inhibit NF-kB. suppress both B and T cell function by decreasing transcription of cytokines.
C: transplant rejection prophylazis, many autoimmune disorders, graft vs host, and inflammation.
T: hyperglycemia, osteoporosis, central obesity, muscle breakdown, psychosis, acne, hypertension, cataracts, peptic ulcers. adrenal crisis upon rapid discontinuation

65
Q

Cyclosporine

A

Calcineurin Inhibitors
M: binds cyclphilin and blocks T cell activation by preventing IL-2 transcription.
C: transplant rejection prophylaxis, psoriasis, rheumatoid arthritis.
T: nephrotoxicity, hypertension, hyperlipidemia, hyperglycemia, tremor, hirsutism, and gingival hyperplasia.
no grapefruit

66
Q

Tacrolimus

A

Calcineurin Inhibitor
M: binds to FK506 binding protein to prevent IL-2 transcription.
C: transplant rejection prophylaxis.
T: nephrotoxicity, increase risk of diabetes and neurotoxicity; no gingival hyperplasia or hirsutism.
no grapefruit

67
Q

Azathioprine

A

M: antimetabolite precursor of 6-MP. inhibits lymphocyte proliferation by blocking nucleotide synthesis (de novo pathway)
C: transplant rejection prophylaxis, RA, crown disease, glomerulonephritis and other autoimmune diseases.
T: leukopenia anemia, thrombocytopenia. hepatotoxicity, increased susceptibly to VZV and HSV. increased risk of lymphoma.

68
Q

Sirolimus (Rapamycin)

A

M: binds FKBP and inhibits mTOR blocking IL-2 signal transduction at the G1-S phase.
C: kidney transplant rejection prophylaxis; used in combo with calcineurin inhibitors.
T: anemia, thrombocytopenia, leukopenia, insulin resistance, hyperlipidemia. non-nephrotoxic

69
Q

Muromonab

A

M: binds CD3 and causes inactivation or lysis
C: used to revers glucocorticoid resistant organ transplant rejection episodes.
T: can only be given once. cytokine storm from TNF-alpha and interferon-y. (prevent with glucocorticoids)

70
Q

Infliximab
adalimumab
Etanercept

A

M: prevents TNF-alpha from binding to its receptors. inflix is part human part mouse. adalim is 100% human ab. Etan is part Ab part receptor
C: RA, crohns, ulcerative colitis, ankylosing spondylitis, plaque psoriasis, and psoriatic arthritis.
T: increase risk for serious infections and lymphomas.

71
Q

Aspirin (acetylsalicylic acid)

A

M: irreversibly inhibits cyclooxygenase (1 and 2) by covalent acetylation, which decreases synthesis of both thromboxane A2 and prostaglandins. increased bleeding time until new platelets are produced (7 days), no effect on PT,PTT.
C: low dose (<300 mg/day): decrease platelet aggregation. intermediate does (300-2400 mg/day): antipyretic and analgesic. High does (2400-4000 mg/day): anti-inflammatory.
T: gastric ulceration, tinnitus (CN VIII), chronic use can lead to acute renal failure, interstitial nephritis, and upper GI bleeding. reye syndrome in children when treated for viral infection. stimulates respiratory centers, causing hyperventilation and respiratory alkalosis.

72
Q 
ibuprofen 
naproxen 
indomethacin
ketorolac
diclofenac
A

NSAIDS
M: reversibly inhibit COX1/2, block PG synthesis.
C: antipyretic, analgesic, anti-inflammatory. indomethacin is used to close a patent ductus arteriosis, and in gout.
T: interstitial nephritis, gastric ulcer, renal ischemia (PG vasodilates afferent arteriole)

73
Q

celecoxib

A

selective COX-2 inhibitior
M: reversibly inhibit COX-2, which is found in inflammatory cells and vascular endothelium and mediates inflammation and pain; spares COX-1, which helps maintain the gastric mucosa. thus, should not have the corrosive effects of other NSAIDS on the GI lining. spares platelet function as TXA2 production is dependent on COX-1.
C: RA and osteoarthritis; patients with gastritis or ulcers.
T: risk of thrombosis. sulfa allergy. potential heart effects.

74
Q

Rasburicase

A

M: metabolizes uric acid to allantoin
C: gout, tumor lysis syndrome. expensive
T: anaphylaxis, methemoglobinemia with G6PD deficiency

75
Q

Methotrexate

A

M: inhibits AICAR transformylase to increase extracellular adenosine and inhibit T-cell activation, cytotoxic to proliferating lymphocytes following antigen exposure.
C: first line for RA
T: myelosuppression, pneumonitis, ulcerations, hepatotoxicity

76
Q

Leflunomide

A

M: inhibits ribonucleotide synthesis and causes cell cycle arrest
C: RA symptomatic improvement and retardation of structural joint damage
T: myelosuppression, GI upset , hepatotoxicity

77
Q

Anakinra

A

M: IL-1 inhibitor
C: RA
T: injection site reaction

78
Q

ergotamine

dihydroergotamine

A

M: vasconstriction due to stimulation of alpha adrenergic and 5-HT receptors
C: effective low cost tx of micraines
T: GI upset. complex pharmacology

79
Q 
Sumatriptan 
zolmitriptan
rizatriptan
almotriptan
eletriptan
A

M: selective 5-HT1d and 1b agonists.
C: migraine. more selective and simpler than ergot derivatives.
T: restrictions with CV disease . GI upset. dizziness and drowsiness. can mimic angina

Pharmacology (4 decks)

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