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Module 1: Mali Rheum/MSK > Pharm MOA and buz words from the table > Flashcards

Pharm MOA and buz words from the table Flashcards

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1
Q

what is the MOA of acetaminophen?

A

CNS anti-prostaglanding, blocks periphreal pain impulse generation! Inhibits hypothalmic heat regulation!

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2
Q

Acetminophen: Kidneys? Liver?

A

Kideys YES, liver NO

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3
Q

acetaminophen: increases what?

A

uric acids in the body

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4
Q

acetaminophen with alocohol?

A

absolutely not!

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5
Q

acetaminophen: max ped dose?

A

160/5 ml

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6
Q

acetaminophen interacts with which 3 drugs? what does it do?

A

anticonvulsants
decrease APAP
increase warfarin

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7
Q

what is the MOA for tramadol?

A

opioid analgesic, mu receptor antagonist and inhibits uptake NE and 5HT-both modify ascending pain pathways

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8
Q

what is the max dose of tramadol in 24 hours?

A

400mg

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9
Q

if a person with hepatic or renal impairment and wants to take tramadol what do you have to do?

A

extended release

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10
Q

what is the MOA for ibuprophen?

A

inhibit COX1 and COX2 enzymes, reducing PG, prostacyclin, thromboxane

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11
Q

what are the contraindications for ALL NSAIDS?! (4)

A

HTZ, CKD, HF, CVD

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12
Q

what is a contraindication for ibuprophen?

A

GI bleeding or ulcer!! causes increased bleeding in 20%

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13
Q

what are common side effects of ALL NSAIDS?!

A

increase BP

fluid retention

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14
Q

Celecoxib side effects…..this is why you must do what monitor?

A

increased BP
fluid retention
CV disease, increased clotting

this is why CrCl, CBC, LFT, AND EKG!!!

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15
Q

of the NSAIDS, which is better for a patient with a stomache/gastric bleed/ulcer?

A

celecoxib since only COX-2 involved

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16
Q

what is the MOA for methotrexate?

[dy at the thought of spiders!!]

A

inhibits dihydrofolate reductase and DNA production, inhibits production of cytokines

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17
Q

when do you use methotrexate?

A

recent RA

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18
Q

what is the pregnancy warning for methotrexate?

A

X

DO NOT GET PREGNANT!!

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19
Q

what are common sideffects of methotrexate? (6)

A

arachnoiditis, motor paralysis, CN palsey, coma, pulmonary fibrosis, SJS

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20
Q

when should you not use methotrexate in a patient?

A

AIDS, alcoholic liver disease, peptic ulcer disease, ulcerative colitis

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21
Q

what two things should you not use methotrexate with?

A

live vaccines and ethanol!

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22
Q

what is the mode of action of hydroxychloroquine?

A

possibly suppression of T cell response to mitogens

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23
Q

what are the indications for hydroxycholoroquine?

A

SLE, RA, malaria

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24
Q

what are interesting things hydroxychloroquine can cause?

A

nightmares, ocular toxiticity (need eyes checked q6-12 months)

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25
what are some contraindications that are for hydroxychloroquine?
retinal field changes, | G6PD deficiency
26
what are the only two drugs on our list that are contraindicated with a G6PD deficiency?
sulfasalazine and hydroxycholoroquine
27
where is hydroxycholorquine bound in the tissues? how long does it take to get the full effect and what is the halflife?
exclusively in the melanin 3-6 months T 45 days!
28
what is the MOA of tofacitinib?
inhibits JAK enzymes and prevents gene expression and intracellular activity of immune cells IgG, IgA, IgM
29
Tofactitinib is the only drug that has a ______ it can cause_____ _____ _____
Tofactitnib is the only drug that has a BLACK BOX WARNING and can cause INFECTION, TB, MALIGNANCY
30
how common is infection when taking tofacitinib which is the black box drug?
20 %!!! holy cow
31
who do you use tofactitnib in? can you combine this with biologic DMARDS?
only those not responding to methotrexate, it still is a non-biologic dmard, DO NOT COMBINE WITH BIOLOGIC DMARDS!!
32
what is the MOA of Etanercept? what is it used for?
binds TNF preventing it from binding to TNF receptors. Aggressive RA that won't work with NB-DMARDS
33
what drug class is etanercept?
TNF-alpha blocker (biologic DMARDS
34
what is an interesting thing that etanercept is known for doing?
reactivation of TB, hepatitis, lymphoma, infection, varicella
35
what is the MOA of abatacept?
inhibits T cell activity by binding to CD80, CD86 on APC, and CD28 in interaction
36
what is the indication for abatacept
RA non responsive to other DMARDs
37
what drug class is abatacept?
T-cell activator inhibitor (biologic dmards)
38
what is the drug class for rituximab?
monoclonal antibody (biologic dmard)
39
what is the MOA of rituximab?
chimeric monoclonal antibody that inhibits CD20 on B celss, and decreases presentation to T cells
40
what is the indication for rituximab? | 1 major and 3 others!
severe RA that didn't respond to etanercept and methotrexate combination - leukemia - non-hodgkins lymphoma - granulomatosis with polyangitis
41
what is a interesting side effect experienced by 30% of people on rituximab?
a rash with first infusion so important to put them on a steroid first to pre-treat them
42
what is the drug class for anakinra?
IL-1 receptor agonist
43
what is the MOA of anakinra? what is this used for?
NATURALLY OCCURING antagonist of IL-1 which reduces degredation of cartilage and inhibits bone reabsorption so used for RHEUMATOID ARTHRITIS
44
what are the negative side effects of anakinra? (3)
infections malignancy neutropenia
45
what is the drug class for mycophenolate mofeti?
semi-synthetic DMARDS
46
what is the MOA for mycophenolate mofetil?
supresses the t and b cells, pretty generic huh
47
what are the indications for mycophenolate mofetil?
TRANSPLANTS!!
48
what is the drug class for sulfasalazine?
synthetic NONBIOLOGIC DMARD
49
what is the MOA of sulfasalzine? (2, systemic and local)
sulfapryradine inhibits PG, and decreases IgA, IgM, and RF SYSTEMICALLY 5-aminoblahblahblah acid reduces colon inflammation LOCAL
50
what are the indications for sulfasalzine? On and off label? (5 total)
RA, ulcerative colitis off-label: chrohns, psoriasis, psoratic arthritis
51
what is a interesting thing sulfasalzine can cause? (2)
``` reversible oliospermia (infertility) MEN ONLY cholestatic jaundice ```
52
what percent of the oral dose of sulfasalzine is absorbed?
10-20%
53
what drug class does prednisone?
glucocorticoids
54
what is the MOA of prednisone?
inhibits cytokines and inflammatory mediators
55
what are some interesting side effects seen with prednisone?
``` weight gain osteoporosis mood changes striae EVERYTHING ELSE ```
56
what is the drug class for colchicine?
leukocyte migration inhibitor (gout)
57
what is the MOA of colchicine?
inhibits leukocytes from migrating and phagocytosis
58
what is the most common and stark side effect of colchicine?
D, N, V in 80%!!!!!!!! wow thats a ton!
59
does colchicine have a high or low therapeutic index?
LOW! means that there is increased risk if you get out of that range you will have negative effects!!!
60
what is the drug class of probenicid?
uriosuric (gout)
61
what is the MOA of probenicid?
blocks PCT reabsorption of uric acid (gout), so avoid in people who have history of kidney stones!
62
what drug can cause nephrolithiasis?
colchicine
63
what CrCl level should you avoid in probenicis??
64
how long does it take to see the effects of colchicine?
6-12 months! aw boo they have to wait!
65
what is the drug class for allopurinol?
xanthine oxidase inhibitor
66
what is the MOA of allopurinol?
inhibits xanithine oxidase and blocks the formation of uric acid
67
what is the indication for allopurinol?
gout prophylaxis
68
what does allopurinol do when combined with ampicillin/amoxicillin?
A RASH!
69
what is the primary metabolite of allopurinol and what happens in people who have CKD?
oxypurinol | it has a long half life and accumulates in people with CKD
70
what is the drug class for febuxostat?
non purine xanthine oxidase inhibitor, anti gout
71
what is the MOA of febuxostat?
selectively inhibits xanthine oxidase to reduce uric acid levels (anti gout)
72
what should you use with febuxostat?
azathioprine or mercaptapurine (anti gout)
73
what is the drug class for baclofen? when do you use it?
centrally acting muscle relaxant, used for MS and spinal cord lesions
74
what is the MOA of baclofen?
inhibits transmission of synaptic reflexes at spinal cord level
75
what are some interesting side effects seen with baclofen?
vertigo, psych disturnances, slurred speech need to monitor mental status!
76
what are some common drug interactions with baclofen?
- increases opiates/benzos - increase alcohol - clindamycin - CNS depressants
77
what should you never do with baclofen
NEVER STOP ABRUPTLY!!
78
what is the max dose for baclofen
80 mg, dose 5 mg
79
what drug class is cyclobenzapine? what is it related to?
centrally acting muscle relaxant, related to tricyclic antidepressants to reduce tonic somatic motor activity
80
what patient population should you avoid with cyclobenzapine?
elderly!!
81
how much does it cost for 60 capsuls of cyclobenzapine the the ER?
~1500 wow! keep this in mind!!
82
cyclobenzaprine can cause? (3)
xerostomia, anticholinergic effects, CNS depression
83
what is the drug class for dantrolene?
preiphreally acting muscle relaxant
84
what is the MOA of dantrolene?
acts directly on the skeletal muscle to inhibit the release of CA+++ from sacroplasmic reticulum
85
what enzymes does dantrolene rely on? therefore you shouldn't have it with what thing?
CYP34A | DON"T HAVE GRAPEFRUIT JUICE!!!
86
what is the drug class of amitriptyline?
tricyclic antidepressant (neurologic pain)
87
what is the MOA of amitriptyline?
inhibits the reuptake of serotonin, NE in CNS?
88
what are the indications for amitriptyline?
depression, diabetic neuropathy, migraine
89
what should you be monitoring in someone taking amitriptyline?
SUICIDE IDEATION!!!!! IT IS A BLACK BOX WARNING WITH SUICIDE RISK!!!
90
what is the drug class for cyclophosphamide?
anti-neoplastic alkylating agent
91
what is the MOA of cyclophosphamide?
alkalating agent prevent cell division and cross linking
92
what drug class is pillocarpine?
cholingeric effect
93
what is the MOA of pillocarpine?
agnonist impact on muscarinic receptors that stimulate salivary gland secretion
94
what do you use pillocarine for?
sjrogrens
95
if the patient has closed angle glaucoma should you use pillocarpine
NO!
96
what do you need to monitor in a patient taking pilocarpine?
IOP, fundiscopic changes, visual fields
97
what forms does pilocarpine come in?
oral and opthalmic drops!

Module 1: Mali Rheum/MSK (4 decks)

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