NSAID 1 Flashcards

1
Q

what are the 2 forms ox cyclo-oxygenase enzymes

A

COX1 and COX2

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2
Q

what is COX1

A

the constitutive form

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3
Q

what is COX2

A

the inducible form

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4
Q

which COX is the constitutive form

A

COX1

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5
Q

which COX is the inducible form

A

COX2

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6
Q

what are eicosanoids derived from

A

arachidonic acid

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7
Q

what are eicosanoids

A

large group of lipid compounds with diverse biological properties

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8
Q

what is the structure of arachidonic acid

A

C20 fatty acid with 4 unsaturated C-C bonds

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9
Q

where is arachidonic acid found

A

in most cell membranes

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10
Q

what happens during inflammation (what is released and how)

A

arachidonic acid liberation by phospholipase A2 and phospholipase C

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11
Q

what does phospholipase A2 do to arachidonic acid

A

snips it off from the phospholipid

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12
Q

what does phospholipase C do to arachidonic acid

A

snips it off from the phospholipid along with an IP/IP2/IP3 pathway (Gq)

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13
Q

what is the main pathway to get arachidonic acid

A

through phospholipid A2

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14
Q

what pathway to get arachidonic acid do muscarinic agonists use

A

the phospholipase C and IP3 pathway

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15
Q

what are the 4 oxidation pathways that stem from arachidonic acid

A

COX
lipoxygenase
P450 enzymes
isoprostane

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16
Q

what are the products made from the COX pathway

A

prostaglandins
thromboxane
prostacyclin

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17
Q

what are the products made from the lipooxygenase pathway

A

leukotrienes

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18
Q

what are prostaglandins involved in (3 things)

A

inflammation, prevention of peptic ulcers, uterine contraction

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19
Q

are prostaglandins vasoconstrictors or vasodilators

A

either or

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20
Q

what kind of blood flow are prostaglandins important for

A

regulation of renal blood flow

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21
Q

what do prostaglandins to do CNS temperature

A

cause fever

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22
Q

which COX product produces fever

A

prostaglandins

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23
Q

how do prostaglandins do its effects

A

via G protein coupled receptors

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24
Q

whats the starting point in the COX pathway

A

arachidonic acid

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25
Q

whats the starting point in the lipooxygenase pathway

A

arachidonic acid

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26
Q

do prostaglandins have a white or black cowboy hat

A

both

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27
Q

does prostacyclin have a white or black cowboy hat

A

white

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28
Q

does thromboxane have a white or black cowboy hat

A

black

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29
Q

what does prostacyclin do (3)

A

vasodilator
inhibits platelet aggregation
relaxes bronchiole smooth muscle

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30
Q

what is the short-form of writing prostacyclin

A

PGI2

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31
Q

where is prostacyclin synthesized

A

in the endothelium

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32
Q

what does thromboxane do (3)

A

vasoconstriction
platelet aggregation
constrict bronchiole smooth muscle

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33
Q

what is the short-form of writing thromboxane

A

TXA2

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34
Q

which COX product inhibits platelet aggregation

A

prostacyclin

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35
Q

which COX product causes platelet aggregation

A

thromboxane

36
Q

which 2 COX products seem to have opposite effects

A

prostacyclin and thromboxane

37
Q

which COX product always causes vasodilation

A

prostacyclin

38
Q

which COX product always causes vasoconstriction

A

thromboxane

39
Q

which COX product always causes relaxation of bronchiole smooth muscle

A

prostacyclin

40
Q

which COX product always causes constriction of bronchiole smooth muscle

A

thromboxane

41
Q

what is the main product in the lipoxygenase pathway

A

leukotrienes

42
Q

where are leukotrienes produced

A

in inflammatory cells (basophils, mast cells, eosinophils, macrophages)

43
Q

what is the leukotriene pathway of interest (2 disease states)

A

asthma and anaphylactic shock

44
Q

what are the 2 substances of anaphylactic shock and what are they called

A

LTC4 and LTD4, the “slow reacting substance” of anaphylactic shock

45
Q

what is the mechanism of action of montelukast

A

leukotriene antagonist for asthma

46
Q

what concentrations does the platelet activating factor have effect

A

very low, <10^-10 M

47
Q

what is platelet activating factor involved in (1 word)

A

inflammation (various aspects)

48
Q

what does platelet activating factor do to lungs

A

causes constriction of bronchiole smooth muscle

49
Q

where is platelet activating factor from and how

A

released from activated inflammatory cells by phospholipase A2

50
Q

what is the mechanism of action of glucocorticoids (2 things)

A

inhibit phospholipase A2 by upregulating expression of lipocortin

51
Q

how are glucocorticoids connected to platelet activating factor

A

lots of their anti-inflammatory effects may be mediated via inhibition of synthesis of platelet activating factor

52
Q

how is platelet activating factor involved in asthma

A

constricts bronchiole smooth muscle

53
Q

why is platelet activating factor an example of “lipid remodeling”

A

because in the structure of platelet activating factor, arachidonic acid is replaced by an acetyl group

54
Q

what are the 4 steps in platelet activating factor synthesis

A

phosphatidyl choline –> phospholipase A2 –> arachidonic acid –> PAF

55
Q

what are the cardinal signs of the inflammatory response

A
  • redness (rubor)
  • swelling (tumor)
  • heat (calor)
  • pain (dolor)
  • loss of function
56
Q

what is the inflammatory response (broad, why does it happen)

A

powerful response to protect from invading pathogens

57
Q

what are the 3 phases of the inflammatory response

A
  • acute inflammation
  • immune response
  • chronic inflammation
58
Q

what is released in acute inflammation (1 word for the general class)

A

autocoids

59
Q

what are 5 things being released in acute inflammation

A
(all autocoids)
histamine
serotonin
bradykinin
prostaglandins
leukotrienes
60
Q

what are 4 things that happen in acute inflammation

A
  • vasodilation
  • vascular permeability
  • chemotaxis
  • pain
61
Q

what is chemotaxis

A

white blood cells leaving vessel to site of injury

62
Q

what is the innate immune response

A

activation of immunologically competent cells

63
Q

what does the innate immune response help activate

A

the adaptive immune response (more specific, antibodies)

64
Q

why can the innate immune response be beneficial

A

if invading organisms can be phagocytosed or neutralized

65
Q

how can the innate immune response become harmful

A

if it leads to chronic inflammation

66
Q

what does acute inflammation lead to

A

innate immune response

67
Q

what are the 2 main mediators of chronic inflammation

A

interleukins and tumor necrosis factor alpha

68
Q

what can interleukins and tumor necrosis factor alpha initiate

A

chronic conditions such as rheumatoid arthritis

69
Q

what happens to cells with chronic inflammation

A

cell damage

70
Q

what do leukocytes do in chronic inflammation

A

release lysosomal enzymes

71
Q

what do lysosomal enzymes do

A

cause the release of arachidonic acid

72
Q

what causes the release of lysosomal enzymes in chronic inflammation

A

leukotrienes

73
Q

what facilitates the release of lysosomal enzymes in chronic inflammation

A

mediators like bradykinin that stimulate phospholipase A2

74
Q

what does bradykinin stimulate the release of in chronic inflammation

A

phospholipase A2

75
Q

what are 3 cells that are normally present in tissue that cause the inflammatory response

A
vascular endothelial cells
mast cells (histamine) 
tissue macrophages
76
Q

what are 2 cells that gain access from blood that cause the inflammatory response

A

platelets (thrombocytes)

leucocytes (WBC)

77
Q

where do corticosteroids affect the inflammatory response compared to NSAIDS +where do they effect

A

much higher (block phospholipids–> arachidonic acid)

78
Q

which COX is the constitutive prostaglandin synthesis

A

COX1

79
Q

which COX is the inducible prostaglandin synthesis

A

COX2

80
Q

which COX does mucous gut secretion

A

COX1

81
Q

which COX does platelet aggregation

A

COX1

82
Q

what does COX1 do to platelets

A

aggregation

83
Q

which COX does inflammation

A

COX2

84
Q

which COX does pain

A

COX2

85
Q

which COX has a white hat

A

COX1

86
Q

which COX has a black hat

A

COX2