PHARM NSAIDS.GOUT Flashcards
MOA of NSAIDS
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox)
Difference between aspirin and other NSAIDS
Aspirin irreversibly inhibits cyclooxygenase
Four main actions of NSAIDS
Anti-inflammatory, analgesia, antipyretic and antiplatelet activity
Agent used for closure of patent ductus arteriosus
Indomethacin
The reason why aspirin is contraindicated in children with viral infection
Potential for development of Reye’s syndrome
SE of salicylates
Tinnitus, GI bleeding
NSAID available orally, IM, IV, nasally, and ophthalmically
Ketoralac
NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
Ketoralac
Newer NSAIDs that selectively inhibit COX-2
Celecoxib
COX 2 inhibitors may have reduced risk of
Gastric ulcers and GI Bleeding
COX 2 inhibitors should be used cautiously in pts with
Pre-existing cardiac or renal disease
Acetaminophen only has what activity?
Antipyretic and analgesic activity
SE of acetaminophen
Hepatotoxicity
Antidote for acetaminophen toxicity
N-acetylcysteine
DMARDs are slow acting drugs for
Rheumatic disease
MOA of gold salts
Alter activity of macrophages and suppress phagocytic activity of PMNs
SE of gold salts
Dermatitis of the mouth aplastic anemia and agranulocytosis
Causes bone marrow suppression
Methotrexate
SE of penicillamine
Aplastic anemia and renal
Interferes with activity of T-lymphocytes
Hydroxychloroquine
Anti-malarial drug used in rheumatoid arthritis (RA)
Hydroxychloroquine
SE of hydroxychloroquine
Retinal destruction and dermatitis
MOA of Leflunomide (newer agent)
Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
Infliximab and etanercept
Anti-rheumatic agent also used for ulcerative colitis
Sulfasalazine
NSAID used in gout
Indomethacin, ibuprofen
NSAID avoided in gout because low doses increases uric acid levels
Aspirin
MOA of Colchicine (used in acute gout)
Selective inhibitor of microtubule assembly
SE of colchicine
Kidney and liver toxicity, diarrhea, myelosuppression
Agent used to treat chronic gout by increasing uric acid excretion through inhibition of URAT1 anion transporter
Probenecid
Agent that inhibits xanthine oxidases and used to treat chronic gout
Allopurinol, febuxostat
Recombinant uricases that enhance uric acid metabolism
rasburicase, pegloticase
