Muscle, Skin, Connective Tissue Flashcards
The lipoxygenase pathway yields what?
Leukotrienes
Which leukotriene
is a neutrophil chemotactic agent
LTB4
Neutrophils are B4 others
Which leukotrienes (3)
cause bronchoconstriction, vasoconstriction, smooth muscle contration and increased vascular permeability
LTC4, LTD4, LTE4
Which leukotriene
inhibits platelet aggregation and promotes vasodilation
PGI2
Platelet Gathering Inhibitor
Irreversible cyclooxygenase inhibitor
by acetylation (decreased TXA2, prostaglandins)
Increases bleeding time
No effect on PT, PTT
Low dose: decreased platelet aggregation
Medium dose: antipyretic, analgesic
High dose: anti-inflammatory
Aspirin
Gastric ulceration
Tinnitus (CN VIII)
Reye’s syndrome
Chronic- renal failure, intersitial nephritis, upper GI bleeding
Stimulates respiratory centers: hyperventilation, respiratory alkalosis
Toxicity of Aspirin
Reversible cyclooxygenase inhibitors
Block prostaglandin synthesis
Anti-pyretic, analgesic, anti-inflammatory
Which one closes patent ductus arteriosus?
Interstitial nephritis, gastric ulcer, renal ischemia
NSAIDs
Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac
Indomethacin closes PDA
Reversibly inhibit COX-2
Spares gastric muscosa, platelet function (COX-1 effect)
Rheumatoid arthritis, osteoarthritis, gastritis, ulcers
SE: increased risk of thrombosis. Sulfa allergy
COX-2 inhibitors
Celecoxib
Reversible cyclooxygenase inhibitor
CNS- inactivated peripherally
Antipyretic, analgesic
OD- hepatic necrosis, toxic tissue adducts
(depletes what?)
Antidote?
Acetaminophen
Depletes glutathione
N-acetylcysteine (regenerates glutathione)
Pyrophosphate analogs
Binds hydroxyapatite in bone (osteoclast inhibition)
Osteoporosis, hypercalcemia, Paget’s
SE: corrosive esophagitis, osteonecrosis of jaw
Bisphosphonates
Alendronate
(-dronates)
Inhibits xanthine oxidase
decreased conversion of xanthine to uric acid
Gout, lymphoma, leukemia
(prevent tumor lysis-associated urate nephropathy)
Increases concentrations of azathioprine, 6-MP
Withhold salicylates
Allopurinol
Febuxostat also inhibits XO
Inhibits uric acid reabsorption
in proximal convoluted tubule
also inhibits penicillin secretion
Chronic gout
Probenecid
Binds, stabilizes tubulin,
inhibits polymerization
Impairs leukocyte chemotaxis and degranulation
Gout
SE: GI upset
Colchicine
Acute gout attacks (3)
NSAIDs: naproxen, indomethacin
Glucocorticoids
Colchicine
Which class predisposes to infection
and reactivation of latent TB?
TNF-alpha inhibitors
Prevents activation of macrophages, destruction of phagocytosed microbes
