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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

A

true

24
Q

name 3 things that steroids increase

A

lipocortin (annexin)
IL-10
IKKB

25
Q

true or false

steroids reduce apoptosis

A

false
increase

26
Q

what helps corticosteroids to meet their receptor in the cytoplasm and bind to the correct gene in the nucleus

A

chaperones (heat shock proteins)

27
Q

what is the inflammatory “on” signal

A

NFKB

28
Q

what is the endogenous inhibitor of NFKB and what drugs increase this inhibitor’s synthesis

A

IKKB

steroids

29
Q

do corticosteroids have any effect on B cells?

A

no. only at VERY HIGH doses they are inhibited

30
Q

in general, macrophages are inhibited by corticosteroids
what is an exception

A

they increase phagocytosis of apoptotic cells

31
Q

true or false

corticosteroids cause both innate and adaptive immunity to decrease

A

true

32
Q

long term use of corticosteroids can cause what?

A

psychosis
if you take off cold turkey, patient is permanently psychotic

33
Q

what is one general ADR for steroids

A

risk of infection bc decreased immunity

34
Q

how are steroids a concern in pts with HTN

A

can make htn worse through sodium retention
they act as partial aldosterone agonists

35
Q

what is lipodistrophy

A

aka fat redistribution - ADR of corticosterouds
typically fat in concentrated in the upper back

36
Q

how can corticosteroids affect the skin

A

dermatitis - skin may bruise or crack when moved gently

37
Q

name an ADR that is UNIQUE to corticosteroids***

A

hypokalemic metabolic alkalosis
body pH elevated

38
Q

what is a concern that parents often have with children taking corticosteroids

A

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
Q

how can CS’s affect the GI

A

peptic ulcer disease, GERD bc no prostaglandins in stomach

40
Q

when is adrenal suppression a concern when taking corticosteroids

A

if using long term and not tapering off

41
Q

how can CS affect the bones

A

osteoporosis, osteopenia, osteomalacia

42
Q

true or false

corticosteroids can cause diabetic like syndrome

A

true because of increased cortisol - an antagonist to insulin

43
Q

how can CS affect the eyes

A

glaucoma and cataracts

44
Q

what are DMARDS

A

disease modifying antirheumatic drugs

45
Q

*******what does methotrexate inhibit

A

dihydrofolate reductase

46
Q

what are 2 different uses of methotrexate? how can you tell the difference just by looking at prescription

A

anticancer and for RA

high dose (roughly 200mg and above per week) is anticancer

low dose (roughly 20mg and below) is RA

47
Q

in a nutshell, what does methotrexate do

A

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
Q

does methotrexate increase or decrease apoptosis

A

increase

49
Q

as mentioned, methotrexate is most toxic to rapidly proliferating tissues
with this knowledge, name some ADRs/side effects of methotrexate

A

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
Q

how can methotrexate affect the kidney

A

acute tubular necrosis, renal failire, glomerular sclerosis

51
Q

methotrexate ______ uric acid
what is the result of this

A

increases

gout flares

52
Q

SJS/ Toxic epidermal necrolysis are _____ reactions.

a _____ like attack on the _______ occurs

A

cutaneous reactions (inflammatory/immune reactions)

an autoimmune like attack on the replicating layer of the skin occurs

53
Q

name 4 drugs that most commonly cause SJS

A

bactrim
carbamazepine
phenytoin
nevirapine

54
Q
A

Intro to D&D Midterm (29 decks)

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