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M4: Pharmacology-Pharmacokinetics > Rheumatologic Drugs > Flashcards

Rheumatologic Drugs Flashcards

1
Q

Increase in uric acid (product in purine metabolism) and inflammation of joints

A

Gouty Arthritis

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2
Q

Inflammation (Cardinal Signs)
1. Rubor -
2. Calor -
3. Tumor -
4. Dolor -
5. Functio laesa -

A
  1. Rubor - Redness
  2. Calor - Heat
  3. Tumor - Swelling
  4. Dolor - Pain
  5. Functio laesa - loss of function
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3
Q

What disease is stated below:

▪️non-inflammatory: No Rubor & Calor
▪️morning joint stiffness (5 mins.)

A

Osteoarthritis (OA)

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4
Q

Drugs for Rheumatics

A

Analgesic
DMARDs
Glucocorticoids
Antigout Agents

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5
Q
  1. 1st line: Osteoarthritis
  2. Better than analgesic
  3. Even @ high doses
A
  1. Analgesic
  2. Antipyretic
  3. Anti-inflammatory
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6
Q

What is the Uric Acid level for Gouty Arthritis

M:
F:

A

M: > 7 mg/dL
F: > 6 mg/dL

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7
Q

What treatment is given for acute gouty arthritis if:

▪️If unable to tolerate NSAIDs
▪️If pain is severe
▪️Short course only

A

Glucocorticoids

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8
Q

What Disease is stated below:

▪️ASA + child w/ viral infection
▪️Fatal: hepatic failure encephalopathy

A

Reye’s Syndrome

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9
Q

▪️Power anti-inflammatory and analgesic
▪️Withdrawn due to T/E

A

Pyralazone derivatives
(Phenylbutazone, Dipyrone, Oxyphenbutazone)

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10
Q

What drug is it:

▪️Indole Derivatives
▪️(-) COX ↓ PG=closes the ductus arteriosis
▪️Mgt. of Patent Ductus Arteriosis
▪️Tx. pain in acute gout, mgt. of Bartter’s Syndrome

A

Indomethacin

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11
Q

What drug is it:

▪️Propionic Acid Derivatives
▪️Anti-inflammatory, antipyretic, analgesic

A

Ibuprofen
Naproxen
Ketoprofen
Flubiprofen

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12
Q

What drug is it:

Added antipyretic

A

Ibuprofen & Naproxen

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13
Q

What drug is it:

Analgesic, Anti-inflammatory

A

Ibuprofen & Flubiprofen

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14
Q

What drug is safest NSAID in children

A

Ibuprofen

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15
Q

What drug is use for fever of malignancy

A

Naproxen - kapag yung lagnat gumaling lang sa Naproxen my cancer

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16
Q

What drug is it:

Phenylacetic Derivatives

A
  1. True Phenylacetates
    - Sulindac (sulfonamide like), Alclofenac, Diclofenac
  2. Acetic Acid Derivatives
    - Ketorolac, Etidolac, Nabumetone (prod drug)
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17
Q

What drug is it:

▪️Fenamates/Fenamic Acid Der.
▪️Used as analgesic only
▪️NOT given in children

A

Mefenamic Acid
- 250mg (OTC)
- 500mg (Rx)
Meclofenamic Acid

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18
Q

What drug is it:

▪️Oxicam Derivatives
▪️Greates Risk: GI Effects
▪️longest t1/2 (half-life)
▪️Under Non-Selective NSAIDs

A

Piroxicam

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19
Q

What drug is it:

▪️Selective NSAIDs
▪️COX-2 Inh.
▪️Highly Selective/ Specific

A

-coxib
Celecoxib, Etoricoxib, Rofecoxib

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20
Q

What drug is it:

Papaver Somniferum

A

Morphine

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21
Q

What drug is it:

Papaver bracteatum

A

Thebaine

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22
Q

What are the 3 activation of opiod receptors (MKD)

A
  1. Mu (u) - majority
  2. Kappa (K) - additional analgesia in women
  3. Delta (δ) - spinal analgesia
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23
Q

What drug is stated below:

Use: Tx of pain (visceral pain)

A

Narcotics (such as Morphine, Thebain)

24
Q

What drug is used for the ff:

  1. Somatic pain
  2. Visceral pain (laman loob)
A
  1. NSAIDs
  2. Narcotics
25
Q

What drug used for Visceral Pain Types:

  1. Mild Pain
  2. Moderate
  3. Severe
A
  1. Tramadol
  2. Codeine
  3. Morphine & Friends
26
Q

What drug is it:

Mgt. of Acute Pulmonary Edema

27
Q

What drug is it:

▪️Anesthetic adjuncts
▪️General Anesthesia

A

IV: Fentanyl

28
Q

What drug is it:

Derivative of Codeine

29
Q

What type of Opiates is stated below:

Reference Standard: Analgesic

30
Q

What type of Opiates is stated below:

▪️Reference Standard: Antitussive
▪️Less efficacy vs Morphine

31
Q

What type of Opiates is stated below:

Precursor in the synthesis of Naloxone

32
Q

What type of Opiods-Semi-synthesis is stated below:

▪️Diacetylmorphine/Diamorphine
▪️Equal efficacy vs Morphine
▪️Drug of abuse

33
Q

What type of Opiods-Semi-synthesis is stated below:

▪️Not analgesic (no affinity at u)
▪️D2 agonist reuptake Inh.
▪️↑DA=Mgt. of Parkinsonism

A

Apomorphine

34
Q

What drug is it:

▪️Opiods: Synthetic
▪️Same efficacy w/Morphine
▪️Good oral BA & longer DOA=Less rapid dvplmt. of tolerance
▪️Use: To wean off Morphine/Heroin addicts

35
Q

What drug is it:

Use: To wean off Morphine/Heroin addicts

36
Q

What drug is it:

▪️Opiods: Synthetic
▪️5-7x more potent than Morphine
▪️D-isomer: Dextromethorphan-antitussive

A

Levorphanol

37
Q

What drug is it:

▪️Opiods: Synthetic
▪️Partial Kappa agonist

A

Pentazocine

38
Q

Full Antagonists: Antidotes for Narcotic Poisoning

A

Naloxone
Naltrexone
Nalorphine
Nalmefene
Levallorphan

Nal-

39
Q

DMARDs (Non-Biological)

▪️1st line DMARD
▪️MOA: (-) ALCAR transformylace & Thimidylate synthase
▪️Use: For CA (100mg/day) For RA (7.5-20mg)

A

Methotrexate (MTX)

40
Q

What is the Rescue Drug for Methotrexate T/E Hepatotoxicity (dose-dependent)

A

Folinic Acid (Leucovorin)

41
Q

DMARDs (Non-Biological)

▪️2nd line DMARDs
▪️MOA: (-) T cell response to mitogens chemotaxis DNA & RNA synthesis

A

Chloroquine
Hydroxychloroquine (Plaquenil)

42
Q

DMARDs (Non-Biological)

▪️prodrug -> A77-1726 (active)

A

Leflunomide

43
Q

DMARDs (Non-Biological)

▪️Gold cmpds.
1. Parenteral: (?)
2. Oral: (?)

A
  1. Aurothiomalate, Aurothioglucose
  2. Auranofin
44
Q

DMARDs (Biologicals)

What drug is it:

Target: T cell activation Inh.

45
Q

DMARDs (Biologicals)

What drug is it:

Target: B cell Depeleting Agent

46
Q

DMARDs (Biologicals)

What drug is it:

Target: IL-6 Inh.

A

Tocilizumab

47
Q

DMARDs (Biologicals)

What drug is it:

Target: IL-1 neutralizing Inh.

48
Q

DMARDs (Biologicals)

What drug is it:

Target: TNF-alpha Inh.

A

Adalimumab
Infliximab
Etanercept

49
Q

What drug is it:

▪️Glucocorticoids
▪️For life-threatening SLE
▪️BN: Solu-Medrol

A

Methylprednisone IV

50
Q

Antigout Agents

What drug is it:

▪️ MOA: (-) tubulin polymerization, target microtubules
▪️1st line: Acute Gout
▪️T/E: Watery Diarrhea, Bloody Biarrhea

A

Colchicine

51
Q

What type of Gouty Arthritis is stated below:

▪️Big Toe is affected: Podagra of Gout

A

Acute Gout

52
Q

What type of Gouty Arthritis is stated below:

▪️Gouty Neuropathy
▪️Chronic Tophaceous Gout= inflammatory bumps, SQ deposits of MSU crystals

A

Chronic Gout

53
Q

Drugs in Acute Gout

A
  1. Colchicine
  2. NSAIDs (Indomethacin, Etoricoxib)
  3. Glucocorticoids (use NMT 5 days)
54
Q

Steps Tx. for Chronic Gout

A
  1. Colchicine only (1st 2-3 weeks)
  2. Colchicine + Hypouricemic Agents - xanthine oxidase inh.
55
Q

What drug is it:

▪️MOA: (-) xanthine oxidase
▪️1st line: Chronic tophaceous Gout
▪️Purine analogue
▪️Irreversible

A

Allopurinol

56
Q

What drug is it:

▪️MOA: (-) xanthine oxidase
▪️Non-Purine
▪️Alternative

A

Febuxostat

57
Q

What drug is it:

▪️MOA: enhance urine excretion of UA
▪️Uricosuric Agent

A
  1. Penicillamine
  2. Sulfinpyrazone
  3. Probenecid

M4: Pharmacology-Pharmacokinetics (50 decks)

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