Pharma in rheumatic disease Flashcards
1
Q
2 mechs in NSAIDs
A
COX-1 - prostaglandins for mucosal protection - thromboxane for hemostatis COX-2 - prostaglndins for pain and inflammation
2
Q
4 As of NSAID effects
A
Anti-inflamm
Analgesic
Antipyretic
Antiplatelet
3
Q
5 things that differentaite NSAIDs
A
- cost - COX2 is expensive
- antiplatelet effect - ASA more than others
- Duration of action
- Route - most oral
- GI tolerance - unpredicatable
4
Q
6 adverse effects of all NSAIDs
A
- bleeds - ASA most
- interference with renal funct
- Na retention
- dyspep and ulceration
- inhib. uterine motility
- allergic hypersens. reactions
5
Q
def. NSAID gastropathy
A
endoscopic erosions in 20-40% of ppl
6
Q
presentation of gastropathy
A
- none for most
- dyspepsia
- bleeds
- ulcer complications
7
Q
5 risk factors for dev. of gastropath
A
- > 60
- Hx of ulcer
- use of glucocorticoids
- high dose/ multi NSAIDs
- anticoag use
8
Q
3 ways to help prevent
A
- rational drug choice
- try others or COX2 - acid supression
- prostagandin E1 analog
- misoprostol
9
Q
5 rheum uses of NSAIDs
A
- acute crystalline
- acute.subacute polyarth
- alternative analgesic for non-inflammatory
- adjunct to DMARD in RA, SpA
- first line mgmt in axial SpA
10
Q
adv. of glucocoorticoids
A
cheap and powerful
11
Q
3 general mechs. of glucocort
A
- non-genomic activation
- DNA-dep regulation
- protein interference mechs.
12
Q
3 effects of glucocort.
A
- inhib. leukocyte access to inflammed tissue
- interfere with cell processes involved in inflammation
- supress the production of humoral factors involved in inflamm. (cytokines etc.)
13
Q
4 acute SE of glucos
A
- infection
- avasc. necrosis
- steroid psychosis
- steroid myopathy
14
Q
what is effect on osteoporosis
A
- increase rate of bone loss
- effects are dose dependent
15
Q
2 preps of glucos
A
oral - prednisone
IV
- doses based on prednisone and need to be adjusted
