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Intro to D&D Midterm > pharmacology part 2 > Flashcards

pharmacology part 2 Flashcards

1
Q

besides NSAIDS, steroids, and immunosuppressants, name 4 other drugs that can be used to treat arthritis pain

A

capsaicin
tramadol
opioids
duloxetine

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2
Q

what is capsaicin and how does it work

A

it will burn first. member of vanilloid family
binds and desensitizes TRPV1 receptor and depletes substance P

TRVP1 is stimulated by heat and physical abrasion

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3
Q

where can capsaicin NOT be applied

A

to mucous membranes

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4
Q

capsaicin desensitizes _____ and depletes __________

A

desensitizes TRVP1 and depletes substance P (pain neurotransmitter)

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5
Q

what is tramadol and how does it work

A

a less potent opioid

a mu-opiod receptor agonist

suppresses serotonin and NE mediated pain

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6
Q

how is duloxetine used to treat pain in arthritis patients

A

SNRI – minimizes the perception of pain
direct SEROTONIN agonist at halluninator receptor

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7
Q

what is a MAJOR concern of taking high dose corticosteroids

A

the risk for unusual and dangerous infections that should normally be fought off easily

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8
Q

which has more side effects - inhaled corticosteroids or topical?
what about IV?

A

topical is least
then inhaled
then IV

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9
Q

true or false

corticosteroids are highly lipophilic

A

true

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10
Q

where does steroid-receptor binding occur

A

in the cytoplasm (highly lipophilic)

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11
Q

how do steroids have a ____ effect**

A

catabolic

protein is lost and fat is redistributed

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12
Q

steroids increase the synthesis of ____ which inhibits _________**

A

increase synthesis of lipocortin (annexin) which inhibits PLA2

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13
Q

TRUE OR FALSE

steroids inhibit the synthesis of NFKB

A

true

this is the “on” signal for inflammation

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14
Q

true or false

steroids increase the production of eicosanoids

A

FALSE

decrease
these are prostaglandins – responsible for inflammation

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15
Q

what is IKKB and what do steroids do to it

A

the INHIBITOR of NFKB

steroids increase the synthesis of this, thus having an anti inflammatory effect

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16
Q

True or false

steroids increase the synthesis of IL10

A

TRUE

it has anti inflammatory properties – gives an off signal for inflammation to stop

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17
Q

how do steroids affect the cell cycle

A

inhibit it
this causes increase in apoptosis, especially of immune cells

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18
Q

note – he said specifcally to know MOA of steroids and wrote all this down

A

so study it bitch

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19
Q

what do steroids do to IL-1

A

repress

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20
Q

true or false

steroids enhance immune cell activity

A

FALSE - repress, including macrophages which are resident WBC that protect us

this is why more prone to infections

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21
Q

corticosteroids are __________ regulators

A

transcriptional

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22
Q

where does the steroid-receptor complex bind

A

to HREs (promoter regions)

23
Q

true or false

steroids DECREASE adhesion molecules like iCAM and vCAM

24
Q

name 3 things that steroids increase

A

lipocortin (annexin)
IL-10
IKKB

25
true or false steroids reduce apoptosis
false increase
26
what helps corticosteroids to meet their receptor in the cytoplasm and bind to the correct gene in the nucleus
chaperones (heat shock proteins)
27
what is the inflammatory "on" signal
NFKB
28
what is the endogenous inhibitor of NFKB and what drugs increase this inhibitor's synthesis
IKKB steroids
29
do corticosteroids have any effect on B cells?
no. only at VERY HIGH doses they are inhibited
30
in general, macrophages are inhibited by corticosteroids what is an exception
they increase phagocytosis of apoptotic cells
31
true or false corticosteroids cause both innate and adaptive immunity to decrease
true
32
long term use of corticosteroids can cause what?
psychosis if you take off cold turkey, patient is permanently psychotic
33
what is one general ADR for steroids
risk of infection bc decreased immunity
34
how are steroids a concern in pts with HTN
can make htn worse through sodium retention they act as partial aldosterone agonists
35
what is lipodistrophy
aka fat redistribution - ADR of corticosterouds typically fat in concentrated in the upper back
36
how can corticosteroids affect the skin
dermatitis - skin may bruise or crack when moved gently
37
name an ADR that is UNIQUE to corticosteroids***
hypokalemic metabolic alkalosis body pH elevated
38
what is a concern that parents often have with children taking corticosteroids
decreased growth hormone - worried that it will stunt growth however, this is really no often phsyiologically observed -- if you have lower levels to begin with then it may be a problem
39
how can CS's affect the GI
peptic ulcer disease, GERD bc no prostaglandins in stomach
40
when is adrenal suppression a concern when taking corticosteroids
if using long term and not tapering off
41
how can CS affect the bones
osteoporosis, osteopenia, osteomalacia
42
true or false corticosteroids can cause diabetic like syndrome
true because of increased cortisol - an antagonist to insulin
43
how can CS affect the eyes
glaucoma and cataracts
44
what are DMARDS
disease modifying antirheumatic drugs
45
*********what does methotrexate inhibit
dihydrofolate reductase
46
what are 2 different uses of methotrexate? how can you tell the difference just by looking at prescription
anticancer and for RA high dose (roughly 200mg and above per week) is anticancer low dose (roughly 20mg and below) is RA
47
in a nutshell, what does methotrexate do
inhibits dihydrofolate reductase messes up immune cells and causes rapidly proliferating cells to die interfere with nucleic acid synthesis and this DNA/RNA synthesis
48
does methotrexate increase or decrease apoptosis
increase
49
as mentioned, methotrexate is most toxic to rapidly proliferating tissues with this knowledge, name some ADRs/side effects of methotrexate
watery or bloody diarrhea - GI mucosal cells rapidly proliferate alopecia - hair loss -anorexia - bc insult to GI anemia - decreased RBC and WBC. hemapoeitic tissues affected decreased gamatogenesis (sperm production)
50
how can methotrexate affect the kidney
acute tubular necrosis, renal failire, glomerular sclerosis
51
methotrexate ______ uric acid what is the result of this
increases gout flares
52
SJS/ Toxic epidermal necrolysis are _____ reactions. a _____ like attack on the _______ occurs
cutaneous reactions (inflammatory/immune reactions) an autoimmune like attack on the replicating layer of the skin occurs
53
name 4 drugs that most commonly cause SJS
bactrim carbamazepine phenytoin nevirapine
54

Intro to D&D Midterm (29 decks)

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