MSK Drugs Flashcards
Aspirin
Irreversibly acetylates COX I and II in platelets, decreases thromboxane and prostaglandins. Increases bleeding time. Anti inflammatory at higher doses, anticoagulant at low doses.
Aspirin SE
Gastric ulcers, tinnitus, renal failure, interstitial nephritis, upper GI bleeding. Reye syndrome decreases mitos and causes fatty liver. Stimulates respiratory centers leading to respiratory alkalosis, then causes metabolic acidosis
NSAIDS
Ibuprofen, naproxen, diclofenac, indomethacin. Irreversibly inhibit COX.
NSAID toxicity
Interstitial nephritis, gastric ulcers, renal iscemia (PG’s dilate the afferent arteriole).
Celexocib
COX II inhibitor that reversibly inhibits cox 2, which is found in inflammatory cells and vascular endothelium. These mediate pain. THIS DRUG SPARES PLATELET FUNCTION and GI lining Used for RA.
Sulfa drug
Acetaminophen
Reversibly inhibits COX mostly in CNS. Inactivated peripherally. Used as an antipyretic and analgesic but is not an antiinflammatory.
Overdose of acetaminophen
Causes hepatic necrosis due to the accumulation of NAPQI which depletes glutathione and forms toxic tissue aducts. Antidote is NAC which regenerates glutathione
Bisphosphonates
Alendronate– pyrophosphate analog that binds hydroxyapetite in bone. Decreases osteoclast activity. used for osteoporosis, hypercalcemia, pagets
Bisphosphonates toxicity
Can cause esophagitis and osteonecrosis of the jaw
Allopurinol
Xanthine oxidase inhibitor used in lymphoma and leukemia. Increases the concentration of azathioprine and 6MP.
Proenecid
Inhibits uric acid absorption at PCT. Also inhibits secretion of penicillin.
Etanercept
Soluble fusion protein of the TNF receptor and IgG FC. Produced by recombinant DNA.
Ifliximab and adalimumab
Anti-TNF monoclonal antibody.
