musculoskeleton

Question 0

ibuprofen

Answer 0

NSAID
reversibly inhibits COX1 and COX 2–>block PG
used in antipyretic, analgestic, anti-inflammatory,
tox:interstitial nephritis, renal ischemia(PG vasodilates afferent arterioles), gastric ulcer,

Question 1

Aspirin

Answer 1

irrever inhibition of COX-1,COX-2 by acetylation–>decrease TXA2 and PG->increase bleeding time (no effect on PT, PTT)
*low dose:decrease PLT aggregation
*intermediate dose: antipyretic and analgestic
*high dose:anti-inflammatory
TOX: gastric ulceration and bleeding, tinnitus(CNVIII), renal failure ( interstitial nephritis). Reye’s. stimulate respiratory centers causing hyperventilation and respiratory alkalosis

Question 2

naproxen

Answer 2

NSAID
reversibly inhibits COX1 and COX 2–>block PG
used in antipyretic, analgestic, anti-inflammatory,
“Acute Gout”
tox:interstitial nephritis, renal ischemia(PG vasodilates afferent arterioles), gastric ulcer,

Question 3

indomethacin

Answer 3

NSAID
reversibly inhibits COX1 and COX 2–>block PG
used in antipyretic, analgestic, anti-inflammatory,
“closing PDA duct” “Acute Gout”
tox:interstitial nephritis, renal ischemia(PG vasodilates afferent arterioles), gastric ulcer,

Question 4

ketorolac

Answer 4

NSAID
reversibly inhibits COX1 and COX 2–>block PG
used in Ntipyretic, analgestic, anti-inflammatory,
tox:interstitial nephritis, renal ischemia(PG vasodilates afferent arterioles), gastric ulcer,

Question 5

diclofenae

Answer 5

NSAID
reversibly inhibits COX1 and COX 2–>block PG
used in Ntipyretic, analgestic, anti-inflammatory,
tox:interstitial nephritis, renal ischemia(PG vasodilates afferent arterioles), gastric ulcer,

Question 6

celecoxib

Answer 6

reversibly inhibit COX-2(COX-1 gastric mucosa spared and TXA2)
Used in RA and osteoarthritis, pt with gastritis or ulcers
TX: increase risk of throm(TXA2 depend on COX-1 therefore not inhibited, thus PLT aggregation) and sulfa allergy

Question 7

acetaminophen

Answer 7

reversibly inhibits COX. mostly in CNS, inactivated periperally
Use: antipyretic, analgesic, but not anti-inflammatory. used instead of aspirin to avoid Reye’s in viral infection
Tox: overdose produces hepatic necrosis; acetaminophen metabolite depletes glutathione and forms toxic tissue adducts in liver
N-acetylcysteine is antidote-regenerates glutathione

Question 8

Alendronate

Answer 8

bisphosphonate: pyrophosphate analogs, bind hydroxyapatite in bone, inhibits osteoclast activity
Used in osteoporosis, hypercalcemia, Paget’s disease of bone
corrosive esophagitis(stay upright for 30 min), osteonecrosis of the jaw, Gi absorption poor(fasting state administration with lots of water)

Question 9

misoprostol

Answer 9

PGE1 analog

use with mifepristone for termination of pregnancy

Question 10

aloprostadil

Answer 10

PGE1,

closing of PDA

Question 11

dinoprostone

Answer 11

PGE2: uterine contraction: Aid labour

Question 12

Allopurinol

Answer 12

inhibits xanthine oxidase,decrease xanthine to uric acid
used in lymphoma and leukemia to prevent tumor lysis associated urate nephropathy
increase concentration of azathioprine and 6-MP(meta by xanthine oxidase)
do not give salicylates except for the higest dose, they depress uric acid clearance

Question 13

Febuxostate

Answer 13

inhibits xanthine oxidase

Question 14

probenecid

Answer 14

inhibits reabsorption of uric acid in PCT(also inhibits secretion of penicillin)

Question 15

Colchicine

Answer 15

binds and stabilizes tubulin to inhibit polymerization,
impairing leukocyte chemostaxis and degranulation
GI side effect, especially given oral

Question 16

Acute gout drugs

Answer 16

NSAID: naproxen, indomethacin
steriods: oral or intraarticular

Question 17

Etanercept

Answer 17

TNF-alpha inhibitors
fusion protein(receptor for TNF-alpha+IgG1, Fc) produced by recombinant DNA
Used in RA, psoriasis, AS
TOX: predispose to infection!!! including reactivate latent TB (TNF blocs Macrophage activity)

Question 18

Infliximab

Answer 18

TNF-alpha inhibitors, Anti TNF-alpha monoclonal antibody
Used in CD, RA, psoriasis, AS
TOX: predispose to infection!!! including reactivate latent TB (TNF blocs Macrophage activity)

Question 19

risedonate

Answer 19

bisphosphonate: pyrophosphate analogs, bind hydroxyapatite in bone, inhibits osteoclast activity
Used in osteoporosis, hypercalcemia, Paget’s disease of bone
corrosive esophagitis(stay upright for 30 min), osteonecrosis of the jaw, Gi absorption poor(fasting state administration with lots of water)

Question 20

ibandronate

Answer 20

bisphosphonate: pyrophosphate analogs, bind hydroxyapatite in bone, inhibits osteoclast activity
Used in osteoporosis, hypercalcemia, Paget’s disease of bone
corrosive esophagitis(stay upright for 30 min), osteonecrosis of the jaw, Gi absorption poor(fasting state administration with lots of water)