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Elliot > MSK and Skin Drugs > Flashcards

MSK and Skin Drugs Flashcards

1
Q

NSAID that increases uric acid excretion in urine?

A

Oxaprozin (don’t give to someone with urate stones obviously)

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2
Q

MOA of Colchicine?

A

Inhibits tubulin polymerization

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3
Q

5 drugs that inhibit microtubule construction? (not for this test)

A

Mebendazole (anti-helminthic), Griseofulvin (antifungal), Colchicine, Vinblastin/vincristin, Paclitaxol– Microtubules get constructed very poorly

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4
Q

Toxicity of colchicine? 4

A

Bloody diarrhea, burning throat pain, hematuria, shock

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5
Q

Pt presents with bloody diarrhea after starting a medication for a pain in his big toe– med? MOA?

A

Colchicine

Blocks polymerization of microtubules

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6
Q

2 Xanthine oxidase inhibitors?

A

Allopurinol and Febuxostat

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7
Q

MOA of allopurinol?

A

Purine analog that acts as a suicide inhibitor of xanthine oxidase

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8
Q

MOA of Febuxostat?

A

Non purine irreversible inhibitor of xanthine oxidase

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9
Q

When are xanthine oxidase inhibitors used?

A

Intercritical period

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10
Q

Side effects of allopurinol or febuxostat?

A

May have acute gouty attacks when first started on medication. Put pt on NSAID or colchicine, as well

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11
Q

2 drugs normally metabolized by xanthine oxidase?

A

6MP and Azothiprine (will lead to increased concentration of these two drugs, as they cannot be metabolized)

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12
Q

Pt on gout medication presents with necrosis, sloughing of skin, and high fever. Drug? What is this called?

A

Allopurinol; Steven Johnson syndrome–toxic epidermal necrolysis

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13
Q

2 drugs that increase secretion and decrease reabsorption of uric acid?

A

Sulfinpyrazone and Probenecid

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14
Q

MOA of Probenecid and Sulfinpyrazone?

A

Act on anion transporter in proximal convoluted tubule to increase secretion and decrease reabsorption of uric acid

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15
Q

Drug that inhibits urate transporter?

A

Aspirin (should not be used with sulfinpyrazone or probenecid)

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16
Q

Adverse effects of Sulfinpyrazone and Probenecid?

A

Rash and GI disturbances (take both drugs with food); increased risk for kidney stones– stay hydrated and keep urine pH above 6

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17
Q

What two measures should be taken by people using drugs that act on anion transporters in the proximal convoluted tubule to increase uric acid excretion? What are the two drugs?

A

Sulfinpyrazone and Probenecid

Keep patients hydrated and make sure urine pH does not fall below 6

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18
Q

Pegloticase MOA?

A

Pegylated uricase that converts uric acid into allantoin via oxidation

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19
Q

Uricase that lowers serum uric acid?

A

Pegloticase– converts uric acid to allantoin

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20
Q

Selective COX 2 inhibitor

A

Meloxicam

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21
Q

Nabumetone?

A

Prodrug, Cox 2 inhibitor

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22
Q

NSAIDs on platelets?

A

Acetylation of Cox1 results in inactivation of the enzyme for the lifetime of the platelet

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23
Q

Inhibits Cox irreversibly?

A

Aspirin

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24
Q

What drug should not be given with allopurinol?

A

Salicylates (all but highest doses suppress uric acid excretion)

25
Q

Side effects of salicylates?

A

CNS depression, tinnitus, headache, thirst, sweat

26
Q

Side effect of acetaminophen?

A

Hepatotoxicity due to depletion of glutathione stores

27
Q

Drug for acetaminophen overdose?

A

N- acetylcysteine

28
Q

Antiinflammatory mechanism of NSAIDs is mediated through?

A

Inhibition of Cox 2

29
Q

Anti analgesic mechanism of NSAIDs is mediated through?

A

Inhibition of prostoglandin synthesis

30
Q

Anti pyretic mechanism of NSAIDs is mediated via?

A

PGE2

31
Q

Inhibition of this leads to GI ulcerations?

A

Cox 1

32
Q

Inhibition of which cox would lead to prolonged bleeding time?

A

Cox 1

33
Q

Targets DHFR?

A

Methotrexate– supplement with folic acid

34
Q

Inhibits pyrimidine synthesis and therefore cell cycle arrest of lymphocytes?

A

Leflunomide

35
Q

Leflunomide: MOA?

A

Inhibits pyrimidine synthesis and therefore cell cycle arrest of lymphocytes

36
Q

Side effect of leflunomide?

A

TERATOGENIC– must be stopped within two years of pregnancy

37
Q

Why is sulfasalazine used in RA?

A

Sulfapyridine is thought to be active in RA

38
Q

IgA and IgM rheumatoid factor decreases with this drug?

A

Sulfasalazine

39
Q

Anti rheumatic drug that causes peripheral neuropathy?

A

Hydroxychlorquine

40
Q

When are glucocorticoids indicated for RA?

A

Flares

41
Q

MOA of etanercept?

A

Binds TNF alpha with high affinity and neutralizes its effects i.e. a decoy receptor

42
Q

Anakinra: MOA?

A

blocks cellular effects of IL-1

43
Q

Abatacept: MOA?

A

CTLA 4 Ig

44
Q

Drugs that may cause reactivation of TB?

A

TNF alpha blockers

45
Q

Cox 2 inhibitor? Why use Cox 2?

A

Celecoxib– spares GI mucosa; although may lead to thrombosis and can’t be used if one has sulfa allergy

46
Q

Corticosteroids block production of?

A

Arachidonic acid (block leukotriene and prostaglandins) by blocking phosphlipase 2

47
Q

NSAIDs and ASA act on?

A

Prostaglandins (not leukotrienes)

48
Q

Diclofenac?

A

NSAID

49
Q

Ketorolac?

A

NSAID

50
Q

3 Cox 2 selective inhibitors?

A

Meloxicam; nabumetone; celecoxib (only one you need to know for boards)

51
Q

Alendronate?

A

Bisphosphonate

52
Q

Nitrogen containing bisphosphonates block?

A

Farnesyl pyrophosphate synthase

53
Q

side effect of bisphosphonates?

A

Results in soft bone; corrosive esophagitis; osteonecrosis of jaw

54
Q

Patient with pagets presents with severe pain in throat?

A

Bisphosphonates cause corrosive esophagitis

55
Q

Worsens postmenopausal symptoms?

A

Calcitonin

56
Q

Monoclonal antibody against RANKL?

A

Denosumab

57
Q

Denosumab?

A

Antibody against RANKL (mimics osteoprotegrin– prevents osteoclast maturation)

58
Q

SERM used for osteoporosis?

A

Raloxifen– increases risk for venous thrombosis

59
Q

Osteoporosis drug that increases risk for venous thrombosis?

A

Raloxifen

Elliot (11 decks)

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