pharmacology Flashcards by Ellie Fox

what is osteoarthritis?

loss of cartilage from articulating bones, bones become brittle and develop microfractures

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why is cartilage degraded in osteoarthritis?

increase in cytokines, IL-1B inhibits type II collagen synthesis of hyaline cartilage, increase in matrix metalloprotieneases

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what is the function of COX 1?

COX1 is expressed all the time, regulates renal function and blood clotting

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what is the function of COX2?

only released under certain conditions

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name some NSAIDS?

aspirin, ibuprofen, diclofenac, meloxicam, indomethacin

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what are the actions of NSAIDS?

inhibits prostaglandin on the hypothalamus, decreases sensitivity of neurons to bradykinin, decreases vasodilation

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what are the specific actions of aspirin?

inhibit NFKB, decreasing transcription of genes for inflammation

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what are the side effects with NSAIDS?

gastric ulcer, MI risk, increased risk of cardiovascular event, angiodema, urticaria, rhinitus

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what is rheumatoid arthritis?

autoimmune condition where cytokines cause inflammation around a joint, eroding away cartilage

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what are the actions of osteoblasts?

bone formation

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what are the actions of osteoclasts?

bone reabsorption

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what are the actions of the body for bone formation?

osteoblasts, expression of pro-antinflammatory cytokines, chondrocytes synthesise matrix

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what are the actions for bone destruction?

osteoclasts, expression of pro inflammatory cytokines, chondrocytes secrete MMPs to breakdown collagen

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what are the actions of glucocorticoids?

inhibit NF-KB that is needed for B cells to release cytokines, this decreases circulating WBC and inhibiting phospholipase A2

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what is a drug that is naturally produced in the adrenal cortex?

glucocorticoids

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what are 2 examples of a short acting glucocorticoid?

cortisone, hydrocortisone

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what are 1 examples of a intermediate acting glucocorticoid?

prenisolone

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what are 1 example of a long acting glucocorticoid?

dexamethasone

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what are the side effects of glucocorticoid?

moon face, abdo fat, increased risk of infection, poor wound healing, hypertension, muscle wasting, buffalo hump

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what are 3 examples of DMARDS for the treatment of rheumatoid arthritis?

methotrexalate, sulfasalazine, penicillamire

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what are the actions of the DMARD methotrexalate in the treatment of rheumatoid arthritis?

blocks folic acid, stops t cell proliferation

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what are the side effects of methotrexalate?

blood dyschariosis, liver cirrhosis, folate deficiency

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what are the actions of the DMARD sulfasalazine in the treatment of rheumatoid arthritis?

salicylate (NSAID), sulphonamide (abx), scavenges free radicals produced by neutrophils

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what are the side effects of the DMARD sulfasalazine in the treatment of the rheumatoid arthritis?

GI upset, headache, leukopenia (decreased WBC)

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what are the effects of the DMARD penicillamire in the treatment of rheumatoid arthritis?

decrease IL-1 generation, decreasing fibroblasts and the immune response

what are the side effects of the DMARD penicillamire in the treatment of the rheumatoid arthritis?

rash, stomatitus (inflammation of the mucous lining of the mouth)

what is an example of a gold compound in the treatment of rheumatoid arthritis?

sodium auranotin

what is the action of sodium auranotin?

decrease 1L-1 and Tnf a

what are the side effects of sodium auranotin?

rash, flu like, mouth ulcer, encepathology, peripheral neuropathy, hepatisis

what is an example of a antimalarials in the treatment of rheumatoid arthritis?

chloroquine

what are the actions of chloroquine in the treatment of rheumatoid arthritis?

interferes with antigen presenting inducing cell death in T lymphcytes

what are the side effects of the antimalarial chloroquine in the treatment of rheumatoid arthritis?

nausea, vomitting, dizziness, blurring of vision

what are the examples of biologic agents in the treatment of rheumatoid arthritis?

adalimumab, entercept, infliximab, tocillizumab, abatacept, rituximab

what are the effects of biologic agents and what are they given with?

recombinant antibodies that act as decoy receptors mopping up TNF

what are the side effects of biologic agents in the treatment of rheumatoid arthritis?

develop a latent disease, worsening heart failure §

what are 3 examples of immunosuppresants used in the treatment of rheumatoid arthritis?

ciclosporin, azathioprine, leflunomide

what are the actions of the immunosuppressant ciclosporin in the treatment of rheumatoid arthritis?

inhibit IL2 gene transcription, decrease T cell proliferation

what are the side effects of the immunosuppressant ciclosporin in the treatment of rheumatoid arthritis?

N+V, gum hypertrophy, hypertension, nephrotoxicity, hepatotoxicity

what are the actions of the immunosuppressant azathioprine in the treatment of rheumatoid arthritis?

interferes with metabolism of purine to decrease DNA synthesis, targeting cells in the induction phase

what are the actions of the immunosuppressant leflunomide in the treatment of rheumatoid arthritis?

inhibitor of T cells, inhibit pyrimidine

what are the side effects of leflunomide in the treatment of rheumatoid arthritis?

diarrhoea, alopecia, hepatoxicity

what is the condition where there is a rapid onset of cerebral deficit lasting more than 24 hours?

stroke

what is the condition where there is a brief period of neurological dysfunction due to an interuption of blood supplying the brain?

transient ischaemic attack

what is the ischaemic penumbra?

area surrounding where the clot has formed, there is local hypoxia and cell death immediately

what is a thrombus made up of?

fibrinogen

what is used to treat a stroke, when the cause is a clot in the brain?

recombinant tissue plasminogen activator, altepase §

what are 4 examples of antiplatelet drugs?

aspirin, dipyramidole, clopidogrel, abiciximab

what are the main actions of antiplatelet drugs?

inhibit platelet aggregation and thrombus formation by preventing GPIIa/Ib receptor expression

what is the action of aspirin?

prevents thromboxane formation

what is action of clopidogrel?

antagonise actions of ADP receptors, preventing GPIIa/lb receptor interaction

what are the actions of abiciximab?

attaches receptors to prevent linking of fibres

what are the stages of the clotting factors?

activation of factor VIII/XII (proteins circulating in the blood) activation of prothrombin II converting fibrinogen to fibrin

what would you do to a patient who had a haemorrhagic stroke?

reverse anticoagulants using vit K as it reverse warfarin action give clotting factors

what are the actions of nitrovasodilators in the treatment of coronary heart disease?

nitrix oxide produced increases CGmp in muscle cells, meaning vasodilation

what is an example of a nitrovasodilators in the treatment of CHD?

glyceryl trinitrate

what are the side effects of nitrovasodilators (glyceryl trinitrate)

cerebral vasodilation (throbbing headache/ dizziness)

what is an example of a lipid lowering drug used in the treatment of CHD?

statins- hmG-Coa reductase inhibitors

what is the action of statins in the treatment of CHD?

uses hmG-Coa which is an enzyme that controls the metabolic pathway that produces cholesterol

what are the side effects of statins?

GI upsets/ abnormal liver test/ muscle problems

what are the actions of bronchodilators?

inhibit mediator release from mast cells

name 2 short acting bronchodilators?

salbutamol/ terbutalline

name a long acting bronchodilators?

salmeterol

what are the side effects of bronchodilator?

tremor

what is the action of theophylline in the treatment of asthma?

phosphodiesterase inhibitor that stops the breakdown of cAMP

why would theophylline be used?

when B2 agonists are inadequate

what are the side effects of theophylline in the treatment of asthma?

CNS/ tremor/ sleep disturbances/ N+V

what is an example of a muscarinic receptor antagonist?

ipratroprium (max effect 30 mins)

what are the actions of the muscarinic receptor antagonist ipratropium?

blocks endogenous acetylcholine at musarinic receptors, decreases acetylcholine release, muscarinic receptors de-activated and smooth muscles relax

what are the names of 2 leukotrienne receptor antagonist in the treatment of asthma?

montelukast, zafirlukast

what are the side effects of leukotrienne receptor antagonist?

headache, GI disturbances

what are the examples of anti-inflammatory glucocorticoids?

beclametasone, diproprionate, budenoside, fluticasone proprionate, prenisolone, hydrocortisone

what are the actions of glucocorticoids in the treatment of asthma?

decrease: cytokines, spasminogens, leukocyte chemotoxins, alter gene transcription