Pharmocology Flashcards
Name 3 classes of Anti-Inflammatory Drugs?
- NSAIDS (non-steroidal antiinflammatory drugs)
- DMARDS (Disease-modifiying antirheumatic drugs )
- Glucocorticoids
What pathway is effected by a variety of anti-inflammatory durgs?
The arachidonic acid pathway
What are the 2 major types of NSAIDS?
- Non-Selective
- Selective
What do non-selective NSAIDS inhibit?
What do selective NSADIS inhibit?
- Non-Selective - COX-1 and COX-2 enzymes
- Selective - COX-2 enzymes more so than COX-1
Name 4 non-selective NSAID drugs and 2 selective NSAID drugs.
Non-Selective (COX-1 & COX-2):
- Ibuprofen (advil, motrin)
- Aspirin
- Indomethacin
- Naproxen (Aleve)
Selective (COX-2):
- Celecoxib (Celebrex)
- Meloxicam
What metabolic products do NSAIDS inhibit? What effect do those products have on the body?
Prostaglandins
- Vasodilation
- Bronchodilation
Thromboxane (Only Aspirin effects this product)
- Vasoconstriction
- Bronchoconstriction
- Increase Platlet Aggregation
What do glucocorticoids inhibit?
What metabolic products will this decrease?
- COX-2 enzymes
- Phospholipase A2 (turns membranes into arachidonic acid)
Glucocorticoids will decrease
- Prostaglandins
- Leukotrienes
Name 3 major pharmacologic effects of NSAIDS.
- Analgesic (pain relief)
- Antipyretic (fever reducer)
- Anti-inflammatory (reduces inflammation)
Name some side effects of NSAIDS.
- CNS – headaches, tinnitus (ringing of ear)
- Cardiovascular – fluid retention, hypertension (selective mostly)
- GI – nausea, vomiting, ulcers/bleeding (non-selective mostly)
- Hematologic – Rare thrombocytopenia
- Hepatic – abnormal liver function
- Pulmonary – asthma
- Rashes – all types
- **Renal – kidney damage. **
Does Aspirin reversibly or irreversibly inhibit cyclooxygenase (both COX-1 and COX-2)?
Irreversibley - This drives down the synthesis of Thromboxane and Prostaglandins. This can cause low platlets for days.
All other NSAIDS and Acetaminophen are reversible.
Asprin is considered a weak acid (acetylsalicylic acid). What would be an antidote for an overdose of aspirin?
Bicarbonate (alkaline)
Beside pain, fever, and inflammation relief, what is another effect of aspirin on the body? Why does it have this effect?
Blood thinner - aspirin inhibits Thromboxane which normally increases platlet aggregation in the body.
My nine month old has a fever, should I give her tylenol or aspirin? Why?
Tylenol - Aspirin can cause liver toxicity and death in children.
What is Reyes Syndrome?
A disease that occurs when you give a child aspirin. The child can get liver toxicity and die.
The one exception is children who have Kawasakis disease (inflammation of medium blood vessels).
What is the treatment for Patent Ductus Arteriosis (PDA)? Why is it an effective treatment?
NSAIDS - PDA occurs when the ductus arteiosis remains open in newborn’s hearts. Prostaglandins keep it open (vasodilation). Inhibiting Prostaglandin will close the hole.
Indomethacin is the NSAID typically prescribed.
