Exam 4 analgesics Part 2 Flashcards
3 cytokines involved in RA?
tumor necrosis factor
interleukin 1
interleukin 6
DMARDs
disease-modifying antirheumatic drug
synthetic DMARDS
methotrexate (Trexall)
- teratogen, cell cycle depressant and inhibits dihydrofolate reductase, first choice
hydroxychloroquine (Plaquenil)
- txt malaria and lupus, calm inflam
doxycycline and minocycline
biologic DMARDS adverse effects.
What is one we must know?
etanerceot (Enbrel)
- lyphomas and malignancies
- serious infections
etanerceot (Enbrel)
soluble tumor necrosis factor
* BLACK BOX= increase risk of infection and cancer in young ppl
RA is treated with 3 classes?
1) disease-modifying antirheumatic drug DMARDs to txt disease WORK SLOWLY for long term affect
2) corticosteroids
3) Nonsteroidal antiinflammatory drugs (NSAIDs) to txt symptoms, not disease * use in ACUTE ATTACKS
most common form of arthritic?
osetoarthritus- occurs in protective cartilage as bones wear down (RA is autoimmune!)
Pyrazoline derivative NSAID
phenybutanzone -not used much, caused anemia
propionic acid derivative NSAID
ibuproten (Motrin, Rufin)
Naproxen (Naprosyn)
esomerprazole (Nexium) -protein pump inhibitor
enolic acid derivative NSAID
meloxicam (Mobic)
meloxicam (Mobic)
10x MORE selective for Cox2 than cox1
- fewer GI probs
- txt RA and OA
- BLACK BOX: fatal cardio thrmobotuc events and stroke
acetic acid dervicative NSAID
indomethacin (Indocin) - cox1, ringing in ears, initiate closer of PDA
diclofenac (Voltaren)- cox2 preferred
what two NSAID prefer cox2
meloxicam (Mobic) and diclofenac (Voltaren)
common NSAID adverse effects
HNGCHCH
hepatotoxicity nephrotoxiciity GI Cardiovascular clots hypersensitivity CNS - tinnitus heart/hypertension
