MSK/Skin/Conn Drugs

Question 1

Lipoxygenase products and effects

Answer 1

LTB4: neutrophils (neutrophils arrive B4 everyone)

LTC/D/E4: bronchoconstriction, vasoconstriction, smooth muscle contraction, vascular contraction

Question 2

Cyclooxygenase products and effects

Answer 2

Prostacyclin (PGI2): decrease plate agg, vascular tone, bronchial tone, uterine tone
Prostaglandins (PGE/PGF): increase uterine tone, decrease bronical and vascular tone
Thromboxane: increase plate aggregation, vascular tone, bronchial tone

Question 3

Aspirin Mech

Answer 3

Irreversible block of cyclooxygenase 1 and 2 by acetylation. TXA and prostaglandins go down. increase bleed time, no effect on PT, PTT.

Question 4

Asprin uses

Answer 4

low dose(2400): anti-inflammatory

Question 5

Aspirin tox:

Answer 5

gastric ulcers, tinnitus, acute renal failure, interstital nephritis, upper GI bleed. Reyes in children with viral. hyperventalation/resp alkalosis

Question 6

Reyes syndrome

Answer 6

Asprin to kids with virus. rash, vomiting, and liver damage

Question 7

NSAIDS drugs

Answer 7

Ibuprofen, naproxen, indomethacin, diclofenac, ketorolac

Question 8

NSAID use

Answer 8

antipyretic, analgesic, anti inflamm, idometh used to close PDA

Question 9

NSAID toxicity

Answer 9

interstital nephritis, gastric ulcers, renal ischemia (PG vasodialate afferent arteriole)

Question 10

COX-2 inhibitor name, use, mech, tox

Answer 10

celecoxib. spares cox1 and gastric mucosa and spares TXA so plates. just knocks down infamm. used for RA, osteoarthritis, gastritis, ulcers. tox is increase thrombosis and sulfa allergy

Question 11

acetominophen mech

Answer 11

reversibly inhibs COX in the CNS inactivated peripherally

Question 12

acetominophen use

Answer 12

antipyretic, analgesic but not anti inflamm. used in kids with virus to avoid reyes

Question 13

acetominophen tox

Answer 13

overdose causes hepatic necrosis, depletes glutathione. treat overdose with N-acetylcystine (replenish glutathione)

Question 14

Bisphosphonates

Answer 14

Alendronate(-dronate). pyrophosphate analog which binds hydroxyapatite in bone to inhib osteoclast. used for osteoporosis, hypercalcemia, pagets. Tox: corrosive esophagitis, osteonecrosis of jaw

Question 15

Allopurinol

Answer 15

inhibits xanthine oxidase to inhibit xanthine to urate. gout, used in lymphoma/leukemia (prevent tumor lysis)

Question 16

Drugs that allopurinol increases concentrations of

Answer 16

azathioprine and 6-MP

Question 17

dont give with allopurinol

Answer 17

salicylates

Question 18

febuxostat

Answer 18

also inhibs xanthine oxidase like allopurinol

Question 19

Probenecid

Answer 19

inhibits urate resorption in PCT (and inhibs penicillin secretion)

Question 20

Colchicine

Answer 20

binds tublin to inhib polymerization. inhibs leukocyte chemotaxis and degranulation. GI sides

Question 21

TNF-alpha inhibs risk

Answer 21

reactivate TB cause block of macrophages

Question 22

Etanercept

Answer 22

TNF-alpha receptor decoy. used in RA, psoriasis, ankylosing spondylitis

Question 23

Infliximab, adalimumab

Answer 23

Anti TNF-alpha monoclonal antibody. Crohns, RA, ankylosing spondylitis, psoriasis