Pharm7 - Pharm7 Flashcards
which leukotriene is a neutrophil attractant?
LTB4
which LT –> bronchoconstriction
LTC4, D4, E4
what reaction does phospholipase A2 catalyze
phospholipids –> arachidonic acid
what rxn does COX catalyze?
arachidonic acid –> PGG, PGH (endoperoxides)
what rxn does lipoxygenase catalyze?
arachidonic acid –> HPETEs (hydroperoxides)
what drug blocks lipoxygenase
zileuton
what drug blocks COX
NSAIDS acetominophen cox-2 inhibitors
what drugs block the effects of leukotrienes?
zafirleukast montelukast
actions of PGE?
increased uterine tone decreased bronchial tone decreased vascular tone
examples of nsaids
ibuprofen naproxen indomethacin ketorolac
mech of nsaids
reversibly inhibits cox 1 and 2, blocking PG synth
uses for nsaids
antipyretic analgesic anti-inflammatory
what drug is used to close PDA
indomethacin
toxicity of nsaids
renal damage aplastic anemia GI distress ulcers
MOA cox2 inhibitors
reversibly inhibits cox2, maintaining gastric mucosa (cox2 is found only in inflammatory cels that mediate inflamm and pain)
risks associated with cox 2 inibitors
thrombosis less gi risk
MOA actaminophen
reversibly inhibits cox (mostly in cns) inactivated peripherally
uses of acetaminophen
antipyretic analgesic NOT AN ANTI INFLAMMATORY!!!!!!!
toxicity of acetaminophen how?
hepatic necrosis a metabolite of acetaminophen depletes glutathione and forms toxic tissue adducts in liver
how is toxic hepatic damage from acetaminophen treated moa?
n-acetylcysteine - it regenerates glutathione
drugs that treat gout
colchicine allopurinol probenecid indomethacin
NSAIDS
And said: ‘I be napping in Keto’ ibuprofin naproxen indomethacin ketorolac
which gout drugs are used to treat chronic gout?
allopurinol probenecid
which gout drugs are ued to treat acute gout
colchicine indomethacin
MOA colchicine
depolymerizes MT, impairing WBC chemotaxis and degranuation
side effects of colchicine
gi
what drug is a good alternative to colchicine?
indomethacin (less toxic, more commonly used)
MOA probenecid
inhibits resorption of uric acid
MOA allopurinal
inhibits xanthine oxidase, so less formation of uric acid
aside from gout, what else can allopurinal be used to treat?
can help with sx of tumor lysis syndrome, seen in lymphoma/leukemia following chemo
what is the original source of uric acid
purines from diet and broken down nucleic acids
fxn of xanthine oxidase
hypoxanthine –> xanthine –> uric acid (blocked by allopurinol)
describe interference of probenecid and penicillin
inhibits secretion of penecillin
what promotes tubular secretion of uric acid
diuretics and low dose salicylates
MOA etanercept
recombinant form of TNF receptor that binds TNF-alpha
uses for etanercept
RA psoriasis ankylosing spondylitis
MOA infliximab
TNF-alpha AB
uses for infliximab
crohns dz RA ankylosing spondylitis
toxicity of infliximab
predisposes to infection (reactivates latent TB)
MOA cyclosporine
binds to cyclophilins, blocking differentiation and activiation of t cells by inhibiting calcineruin (prevents the production of IL2 and receptor)
fxn of calcineurin
phosphatase that activates IL2
use for cyclosporine
suppress organ transplants treats some autoimmune d/o
toxicity of cyclosporine
predisp to viral infx and lymphoma NEPHROTOXIC (prevent w mannitol diuresis)
MOA tacrolimus
binds FK-binding protein, inhibiting the secretion of IL2 and other cytokines
uses of tacrolimus
immunosuppression following organ transplant
toxicity of tacrolimus
nephrotoxic peripheral neuropathy HTN pleural effusion hyperglycemia
moa azathioprine
interferes with metabolism and synth of nucleic acids toxic to prolif wbc
uses of azathioprine
kidney transplant autoimmune d/o glomerulonephritis hemolytic anemia
toxicity of azathioprine
bone marrow suppression
what is the active metabolite of azathioprine how is it metabolized implication
mercaptopurine xanthine oxidase toxic effects may be increased by allopurinol