FA MSK Pharm

Question 1

Reversibly inhibit COX 1&2. Block PG synthesis. Indomethacin closes PDA
SE: interstitial nephritis, gastric ulcer, renal ischemia

Answer 1

NSAIDs.

Question 2

Reversibly inhibit COX2 (spares COX-1, wh/ helps maintain the gastric mucosa; spares platelet function as TXA2 production is dependent on COX1);
SE: increased risk of thrombosis (through PGI2?), sulfa allergy

Answer 2

COX-2 inhibitors (celecoxib)

Question 3

Reversibly inhibits COX, mostly in CNS; inactivated peripherally.
SE: centrilobular hepatic necrosis, NAPQI depletes glutathione (NAC regenerates)

Answer 3

Acetaminophen

Question 4

Pyrophosphate analogs; bind hydroxyapatite in bone, inhibiting osteoclast activity
SE: corrosive esophagitis, osteonecrosis of jaw

Answer 4

Bisphosphonates

Question 5

Inhibits xanthine oxidase. Used to prevent chronic gout and tumor lysis, increases conc of azathioprine and 6-MP. Do not give salicylates, which depress uric acid clearance.

Answer 5

Allopurinol, febuxostat

Question 6

Inhibits reabsorption of uric acid in PCT (also inhibits secretion of PCN). Don’t use in renal failure or tumor lysis.

Answer 6

Probenecid

Question 7

Binds and stabilizes tubulin to inhibit microtubule polymerization, impairing leukocyte chemotaxis and degranulation.
SE: GI

Answer 7

Colchicine

Question 8

Fusion protein (receptor for TNF-alpha and IG1 Fx), produced by recombinant DNA.
CU: RA, psoriasis, ankylosing spondylitis

Answer 8

Etanercept

Question 9

Anti-TNF-alpha monoclonal antibody.
CU: IBD, RA, ank spond, psoriasis
SE: reactivates TB

Answer 9

Infliximab, adalimumab

Question 10

Irreversibly inhibits COX-1 and COX-2 by covalent acetylation, which decreases TXA2 and PGs. Increased BT for >7 days.
SE: gastric ulcers, tinnitis, Reyes (microvesicular hepatic steatosis - mitrochondrial dysfxn) in kids, OD: resp alkalosis then met acidosis (combo)

Answer 10

ASA