Pharmacology

Question 1

Acetaminophen

Answer 1

Reversible COX inhibitor, mostly in CNS
Non-inflammatory
N-acetylcystein is antidote to regenerate glutathione

Question 2

Aspirin mechanism

Answer 2

Irreversibly inhibits COX 1/2 via acetylation–>decrease in TXA2 and protaglandins

Question 3

Aspirin clinical use

Answer 3

low dose (less than 300mg)-decreases platelet aggregation
med dose (300-2400)-antipyretic and analgesic
high dose (2400-4000)-anti-inflammatory

Question 4

Aspirin toxicity

Answer 4

Gastric ulceration, tinnitus, chronically can lead to renal failure, Risk of Reye syndrome in children with viral infections.
Causes resp. alkalosis early but transitions to mixed met. acid.-resp. alk.

Question 5

Celecoxib mechanism

Answer 5

Reversibly inhibits COX2 only-found in inflammatory cells and vascular endothelium and mediates inflammation and pain (spares COX1 so helps with gastric mucosa)
Spares platelet function as TXA depends on COX 1

Question 6

Celecoxib clinical use

Answer 6

RA, Osteoarthritis

Question 7

Celecoxib toxicity

Answer 7

Increased risk of thrombosis. Sulfa allergy

Question 8

Indomethacin

Answer 8

Closes PDA

Question 9

Bisphosphonates mechanism

Answer 9

-dronates

Pyrophosphate analygs; bind hydroxyapatite in bone. Inhibits osteoclast activity

Question 10

Bisphosphonates clinical use

Answer 10

Osteoporosis, hypercalcemia, Paget’s disease

Question 11

Bisphosphonates toxicity

Answer 11

Corrosive esophagitis, osteonecrosis of jaw

Question 12

Teriparatide mechanisms

Answer 12

Recombinant PTH analog given subcutaneously daily
^ osteoblastic activity
Teri has osteoporosis

Question 13

Teriparatide clinical use

Answer 13

Osteoporosis, causes increased bone growth (vs. -dronates that are anti-osteoclast)

Question 14

Teriparatide toxicity

Answer 14

Transient hypercalcemia

Question 15

Allopurinol

Answer 15

Chronic gout-Xanthine oxidase inhibitor (decreases production of uric acid)
Also use with lymphoma and leukemia to prevent tumor lysis associated urate nephropathy
Increases azathioprine/6-MP

Question 16

Febuxstat

Answer 16

Chronic gout-Inhibits xanthine oxidase

Gout may come out in Feb if you don’t take your febuxstat!

Question 17

Pegloticase

Answer 17

Chronic gout-Recombinant uricase that catalyze metabolism of uric acid to allantoin (more water soluble)

Question 18

Probenecid

Answer 18

Chronic gout-Inhibits reabsorption of uric acid in PCT…but can precipitate uric acid calculi

Question 19

Colchichine mechanism

Answer 19

Binds and stabilized tubulin to inhibit microtubule polymerization, impairing neutrophil chemotaxis, and degranulation
GI side effects
Acute and prophylactic value

Question 20

Corticosteroids inhibit?

Answer 20

Phospholipase A2 (decrease Arachidonic acid)

Question 21

LTB4

Answer 21

Neutrophil chemotactic agent

Neutrophils arrive B4 others

Question 22

PGI2

Answer 22

Inhibits platelet aggregation and promotes vasodilation (PGI=Platelet gathering inhibitor)

Question 23

TNF-a inhibitors

Answer 23

Predispose infection, including reactivation of TB

Question 24

Etanercept

Answer 24

TNF-a inhibitor that is a fusion protein produced by recombinant DNA
Rx: RA, psoriasis, ank. spondyl

Question 25

Infliximab, adalimumab

Answer 25

Anti-TNF1 monoclonal antibody

Rx: IBD, RA. Ank. spondyl, psoriasis