MSK I Flashcards

1
Q

acetaminophen

A

reversible inhibition COX

no anti-inflammatory

antipyretic, analgesic

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2
Q

avoid reye syndrome

A

tx child with viral infection
-with acetaminophen

not ASA

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3
Q

adverse acetaminophen

A

OD - hepatic necrosis

metabolite - NAPQI - deplete glutathione

toxic byproducts form

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4
Q

tx acetaminophen toxicity

A

N-acetylcysteine - regenerate glutathione

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5
Q

LTB4

A

chemotactic

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6
Q

PGI2

A

prostacyclin

platelet aggregation inhibitor

decreased vascular tone

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7
Q

TXA2

A

thromboxane

increased platelet aggregation and vascular tone

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8
Q

PGE1

A

decreased vascular tone

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9
Q

PGE2

A

increased uterine tone

with PGF2

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10
Q

corticosteroids

A

inhibit PLA2

decreased arachidonic acid synthesis

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11
Q

two pathways of arachidonic acid

A

lipoxygenase - form leukotrienes

COX - form prostacyclin, PGs, thromboxane

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12
Q

phospholipase A2

A

synthesis of AA

inhibited corticoisteroids

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13
Q

triamcinolone/methylprednisone

A

corticosteroid

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14
Q

dexamethasone/betamethasone

A

corticoisteroids

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15
Q

zileuton

A

inhibit lipoxygenase - leukotriene synthesis inhibitor

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16
Q

montelukast

A

inhibit leukotriene receptors

LTC4, D4, E4

17
Q

zafirlukast

A

inhibit leukotriene receptors

LTC4, D4, E4

18
Q

alprostadil

A

PGE1 analog

19
Q

dinoprostone

A

PGE2 analog

20
Q

carboprost

A

PGF2 analog

21
Q

aspirin

A

irreversible inhibit COX1 and 2

via acetylation

type of NSAID

22
Q

clinical use aspirin

A

low dose (300mg) - decreased platelet aggregation

intermediate dose (300-2400mg) - antipyretic and analgesic

high dose (2400-4000mg) - anti-inflammatory

23
Q

adverse aspirin

A

gastric ulceration

tinnitus - CN VIII

chronic use - acute renal failure - interstitial nephritis

24
Q

reye syndrome

A

aspirin use in child with viral infection

25
aspirin toxicity
early - respiratory alkalosis | late - mixed metabolic acidosis/resp alkalosis
26
celecoxib
selective COX-2 inhibitor affect inflammatory and vascular endothelium spares COX1 - maintain gastric mucosa also no TXA2 effect - dependent on COX1
27
adverse celecoxib
rheumatoid arthritis osteoarthritis sulfa allergy
28
ibuprofen
NSAID
29
naproxen
NSAID
30
indomethacin
NSAID
31
ketorolac
NSAID
32
diclofenac
NSAID
33
NSAID
reversible inhibit COX 1 and 2 block PG synthesis antipyretic, analgesic, anti-inflammatory
34
tx to close PDA
indomethacin - NSAID
35
adverse NSAID
``` interstitial nephritis gastric ulcer (PG protect gastric mucosa) ``` renal ischemia - PG vasodilate afferent arteriole
36
alendronate
bisphosphonate
37
bisphosphonate
pyrophosphate analog | -bind hydroxyapatite bone - inhibit osteoclast activity
38
clinical use bisphosphonate
osteoporisis hyperCa paget disease of bone inhibit osteoclast actdivity
39
adverse bisphosphonate
corrosive esophagitus pt should take with water and not lay down after taking it also - osteonecrosis of jaw