MSK/Skin

Question 1

Celecoxib

Answer 1

COX-2 inhibitor. COX-2 is found in inflammatory cells and vascular endothelium and mediates inflammation and pain.

Celecoxib spares COX-1, which helps maintain gastric mucosa, and it spares platelet function since TXA2 production is dependent on COX-1

Question 2

Acetaminophen overdose

Answer 2

Produces hepatic necrosis. Acetaminophen metabolite (NAPQI) depletes glutathione and forms toxic tissue adducts in liver.

Antidote: N-acetylcysteine (regenerates glutathione)

Question 3

Allopurinol

Answer 3

Inhibits xanthine oxidase

Treats chronic gout and helps prevent tumor lysis-assocaited urate nephropathy in lymphoma and leukemia.

Question 4

Febuxostat

Answer 4

Inhibits xanthine oxidase (like allopurinol)

Question 5

Probenecid

Answer 5

Inhibits reabsorption of uric acid in PCT (also inhibits secretion of penicillin). High dose salicylates also inhibit urice acid reabsorption.

Low dose salicylates and diuretics inhibit uric acid secretion in the kidney.

Question 6

Etanercept

Answer 6

Etanercept is a TNF decoy receptor.

Treats RA, psoriasis, ankylosing sponylitis.

Toxicity: increased susceptibility to infections, including reactivation of TB (check PPD before beginning tx)

Question 7

Colchicine

Answer 7

Inhibits leukocyte migration and phagocytosis by blocking tubulin polymerization

Used for acute gouty arthritis and PPx of recurrent gouty arthritis.

Toxicity: n/d