NSAIDs

Question 1

Prostacyclins action

Answer 1

Vasodilation and inhibit platelet aggregation

Question 2

Thromboxane action

Answer 2

Vasoconstriction and promotes platelet aggregation

Question 3

Prostaglandins action

Answer 3

Vasodilation and increased vascular permeability

Question 4

Lipoxins action

Answer 4

Inhibit neutrophil adhesion and chemotaxis

Question 5

Leukotriene B4 and 5-HPETE action

Answer 5

Chemotaxis

Question 6

Leukotrienes action

Answer 6

Vasoconstriction
Bronchospasm
Increased Vascular Permeability

Question 7

Zileuton:

Answer 7

Inhibits 5-lipoxygenase

Question 8

Zafirlukast and Montelukast:

Answer 8

Inhibit CysLT1 receptors for Leukotrienes

Question 9

Aspirin Dose:

Answer 9

Anti-platelet: 81 mg/day or 325 mg every other day
Anti-pyresis/Analgesia: 325-650 mg every 4-6 hrs
Anti-Inflammatory: 3.2-6 grams/day in divided doses

Question 10

Cox-2 Selective NSAID:

Answer 10

Celecoxib

Question 11

Indomethacin:

Answer 11

• Anti-inflammatory

- Close patent ductus arteriosus

Question 12

Ibuprofen:

Answer 12

• Anti-pyresis and Analgesic
• Lower incidence of GI distress but not ulcers
• 2400 mg/day max dose

Question 13

Naproxen:

Answer 13

-Same as ibuprofen just longer half life

Question 14

Ketorlac:

Answer 14

• Pure COX-1 inhibitor

- MAJOR RISK FOR GASTRIC INJURY

Question 15

COX-1 Mainly Produces:

Answer 15

Thromboxane

Question 16

COX-2 Mainly Produces:

Answer 16

Prostacyclin

Question 17

Celecoxib:

Answer 17

• Pure COX-2 inhibitor

- Used for chronic OA

Question 18

Acetaminophen:

Answer 18

• Weak COX-1 and COX-2
• Strong COX-3
• Anti-pyretic
• Not good analgesic
• No anti-inflammatory effects
• Preferred Anti-pyresis and analgesic in kids

Question 19

Acetaminophen Dose:

Answer 19

• NO MORE THAN 4 Grams a Day

- Fever and Analgesic 325-650 mg/day

Question 20

Anti-cancer drugs used as immunosuppressants:

Answer 20

• Methotrexate
• Cyclophosphamide
• Azathioprine

Question 21

Methotrexate:

Answer 21

• Inhibits dihydrofolate reductase
• Decreasing THF and therefore purine/DNA
• DECREASES LYMPHOCYTE PROLIFERATION
• Promotes adenosine release -> suppresses inflammation
• Inhibits AICAR transformylase -> increase level of adenine intracellularly

Question 22

Azathioprine:

Answer 22

• Prodrug converted to 6-MP
• Interrupts DNA and RNA
• SUPPRESSION of T and B cell Proliferation

Question 23

Cyclosporine:

Answer 23

• Reduces T-cell responsiveness
• Inhibit cytokine formation
• IMMUNE SUPPRESSION MAJOR SE

Question 24

Mycophenolate:

Answer 24

• Inhibits inosine monophosphate dehydrogenase needed for guanosine synthesis
• Anti T and B cell proliferation only

Question 25

Phosphoramide:

Answer 25

• Alkylation of DNA

- Cytotoxic effects on lymphocytes

Question 26

Etanacept:

Answer 26

TNF-alpha soluble receptor to bind TNF-alpha before it binds the real receptor

Question 27

Anakinra:

Answer 27

Blocks IL-1 activity by blocking IL-1 Receptor

Question 28

Tocilizumab:

Answer 28

Binds IL-6 receptor to inhibit IL-6 signalling

Question 29

Abatacept:

Answer 29

Inhibits T cell activation by binding CD80 and CD86 blocking interaction with CD28 needed for T cell activation

Question 30

Tofacitinib:

Answer 30

Blocks JAK Kinase inhibiting cytokine actions

Question 31

Glucocorticoids Low dose:

Answer 31

Goes to nucleus inhibiting histone acetyl-transferase decreasing gene transcription and formation of inflammatory proteins

Question 32

Glucocorticoids High Dose:

Answer 32

Goes to nucleus and activates histone acetyl-transferase increasing gene transcription of anti-inflammatory proteins