msk, skin, ct - last one eeekkkk!! Flashcards
function fo LTC4 D4 and E4
increases bronchial tone
function fo LTB4
PMN chemo
function fo PGI2
decrease platelet aggregation
decrease vascular tone
function of PGE1
decreas vascular tone
function of PGE2
increases uterine tone
function fo PGF2
increases uterine tone
function of thromboxane A2
increases platelet aggregation
increases vascular tone
moa acetaminophen
reversibly inhibits cox, mostly in cns
inactivated peripherally
cx use of acetaminophen
antipyretic
analgesic
not anti inflammatory
children with viral infection to avoid reyes syndrome
toxo of acetaminophen
o/s = hepatic necrosis and NAPQI uses up all the glutathion and causes toxic tissue byproducts in the liver
antidote fo acetaminophene o/d
NAC - regenerates glutathione
moa aspirin
irreversibly linhibits cyclooxyngease one and two via acetylation - decrease txa2 and pgs
increase bleeding time (no change to pt and ptt)
low dose of aspirin?
<300 = platelet inhibit aggregation
causes secretion fo uric acid
intermediate dose of aspirin?
300-2400 = antipyretic and analgesic
high does aspirin?
2400-4000 = antiinflammatory
reabsorption of uric acid weakly
toxo of aspirin
tinnitus
gi ulceration
chornic used of aspirin?
acute renal failure, interstitial nephtiritis, gi bleeding
children with aspiring
not in viral infections unless you want to stupor/coma/hepatic encephalopathy them up
acid base balance with aspring
first - respiratory alkalaosis
progresses - mixed metabolic acidodid resp alkalaossi
used the formulat to see if compensated….somethting liek 1.5 HCO3 + /-??? LOOK UP BAH darn.
moa celecoxib
reversibly inhibits COS2
where is cox 2 found
inflammatory cells
vascular endothelium
mediates inflammation and pian
what does cox1 do?
helps maintain gastric mucosa
benefit of celecoxib
no corrosive effet like other nsaids on the gi liking
spared paltelet function as txa2 is dependent on COX1
clinical use fo celecoxib
RA and OA
treat RA and OA
celecoxib
toxo of celecoxib
sulfa
thrombotic event risk increase
list the nsaids
ibuprofen naproxen diclofenace indomethacin ketorolac
moa of nsaids
reversibly inhibit cox 1 and 2. block pg synthesis
use of msaids
antipyretic, analgesic, antiinflammatory
what is indomethacin used for
closign a pda
a/se of nsaids please
interstitial nephritis
gastric ulcer
renal iscehmia - pgs vasodilate afferent arteriole
what are bisphosphonates
DRONTES
alendronate
moa of dronates
bisphosphonates
pyrophosphate analougs that bind hydroxyapatite in bone and inhibit osteoclast activity
use of dronates
osteoporposis
hypercalcemia
paget disease of bone
treat hypercalcemia
dronate/bisphosphonates
treat pagets disease
dronates
what is teriparatide
recombinant PTH analog given subcutaneously daily
icnreased osteoblastic activity
use of teriparatide
osteoproosis - causes increased boen growth vrs antiresorptive threaphy cough cough bisphosphonates
toxo of teriparatide
transient hypercalcemia
increased risk of osteosarcomas (seen in rodents)
drug associated potentially with icnreased risk of osteosarcoma?
teriparatide
list the drugs used for chronic gout as preventative tx
allopurinol
febuxostat
pegloticase
probenecid
moa fo allopurinol
inhibites xanthine oxisase after being converted to alloxanthing
decrease conversion fo xanthine to uric acid
cxl use of allopurinol outside of preventative in chronci gout
luekemia and lymphoma to prevent tumor lysis associated urate neprhotpahty
what drugs shoudl be of concern when treating simultaenously with allopurinol
azothioprine and 6 MP = will be icnreased bc both are normally metabolized by xanthine oxidase
what is febuxostat
inhibits xanthine oxidase
preventative gout
what is pegloticase
recombinant uricase that catalyzes metabolism or uric acid to allantoin - more water soluble
what is probenecid
inhibits reabsorption of uric acid in proximal covoluted tublue - also inhibtis secretino of penicillin
a/se of probenecid
can ppt uric acid calculi
tx for acute gout pelase list all
nsaids, glucocorticoids and colchicine
which nsaids are use for acute gout
naproxen
indomethacin
how are glucocorticoids used for acute gout
oral or intra-articular
what is colchicine?
binds and stablized tubulin to inhibit mt polymerization impairing PMN chemotaxis and degranulation
a/se of colchicine
gi side effects
use of colchicine
acute and prophylactic gout
what drugs should be avoided in gout treatmetn?
salicylates - all but the highest doses depress uric acid clearance so even high doese have only minor uricosuric acitivy
what are a/se of TNFa inhibitos
predispose to infection includign reactivation of latent TB
why do you have to worry abotu TB with TNFa inhibitors
bc TNFa promotes granuloma formation and stabilization
what is etaneracept
TNFa IgG1 Fc fusion protein made by recombinat DNA
aka decoy receptor for TNFa
what do you use etaneracept for
RA, ankylosing, psoriais
what are infliximab and adalimumab?
anti TNFA monoclona abts
uses of infliximab abd adalimumab
the seronegs and RA instead of reactive/reiters
IBD, psoriasis, ankylosing,
