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Exam 3 Pharm > Week 8 Anti-Inflammatory > Flashcards

Week 8 Anti-Inflammatory Flashcards

1
Q

corticoidsteroid MOA

A 
Inhibit arachidonic acid metabolism
stabilize biologic membranes
inhibit production interluekins, cytokines, tumor necrois factor
impair phagocytosis
impair lymphocytes
inhibits tissue repair
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2
Q

Signs of steroid withdrawal syndrome

A

malaise, myalgia, nausea, headache, low grade fever, relapse of symptoms, hypotension

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3
Q

Hydrocortison

A

anti-inflammatory affect

bind to glucocorticoid receptors in target tissue with several MOAs

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4
Q

Corticosteroid Dosing Schedule

A

Short Term- less 1 week, large divided doses in 48-72 hours, then taper over 14 days

admin in AM, daily therapy but if long term consider double dose every other day for maintenance

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5
Q

Prevent Acute Adrenocortical Insufficiency (5)

A

Don’t abruptly stop
Give during stress
Admin short course for acute disorders then taper
Use local over systemic steroid when possible
Use alternate day when possible

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6
Q

Prednisone

Indications

A

Indication: replacement therapy for adrenal cortical insufficiency, severe allegic reactions, collagen disease, acute exacerbation COPD, asthma, RA, GI, Hem

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7
Q

Prednisone Admin

A

daily or every other in AM
Taper
Zantac or Prilosec to help with GI irritation
increase dose with stress (surgery)
assess wound healing and signs infection
DM will need more insulin, nonDM may need short term

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8
Q

Prednisone ADRs

A

suppression of response to fight infection, increase risk for TB/Herpes/Varicella, N/V/ gastric ulcers, acne and delayed wound healing, calcium loss from bone, Na and H2O retention, increased BG, anxiety, insomnia

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9
Q

Methylprednisolone (Medrol)

A

for poison Ivy

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10
Q

Methylprednisolone sodium succinate (Solumedrol)

A

IV short term acute resp problems like asthma

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11
Q

Dexamethasone

A

short term for maximum anti-inflammatory activity like cerebral edema

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12
Q

Opioid MOA

A

act on Mu, Kappa and delta receptors.

Mu- in brain and spinal cord cause feeling euphoria, respiratory depression and physical dependence

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13
Q

Opioid Agonists

Meds

A

Codeine- Tylenol #3

Norco, Vicodin, Percocet, Oxycontin

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14
Q

Mixed Agonist-Antagonist Opioid

A

Activate one type of receptor while blocking another

butorphanol (stadol)
nalpuphine (nubain)

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15
Q

Central Acting Pain Drug

A

non-opioid drug binds to mu receptor
mild to mod to severe pain
can cause resp depression, little risk for tolerance and abuse
Tramadol

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16
Q

NSAIDs compete with ______ high protein bound meds

A

warfarin, dig, sulfa

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17
Q

DMARDs

first choice in treatment

A

treat RA, slow disease progression
methotrexate first choice- folic acid antagonist inhibit synthesis of DNA and cell reproduction

cause nausea, leukopenia, anemia

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18
Q

Allopurinol

MOA
Admin
Monitor

A

prevents formation uric acid by inhibiting xanthine oxidase

daily to prevent formation of uric acid crystals

monitor- BUN, Crt, Uric Acid Levels

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19
Q

Colchicine

MOA
Admin
Monitor

A

decreased inflammation by decreasing movement of leukocytes into tissues containing urate crystals
non-analgesic or antipyretic

acute gouty attacks

Low doses- diarrhea,
high doses not recommended

Monitor: BUN, Crt, Uric Acid Levels

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20
Q

Probenecid (Benemid)

MOA
Monitor

A

chronic gout and increases urinary execration of uric acid

Monitor: BUN, Crt, Uric Acid Levels

21
Q

Sulfinpyrazone (Anturane)

MOA
Monitor

A

chronic gout

Monitor: BUN, Crt, Uric Acid Levels

22
Q

WHO Analgesic Pain Relief Ladder

A

Step 1 Mild to Moderate Pain
non-opioids- ASA, NSAIDs, acetaminophen

Step 2 Moderate to Severe Pain
mild opioids- codeine with or without non-opioids

Step 3 Severe Pain
strong opioids- morphine, with or without non-opioids

23
Q

Glucocorticoid increase

A 
circulating erythrocytes
appetite
promote fat deposits in face and cervical areas
promote lipolysis in extremities
increase uric acid excretion
dec CA levels by inhibiting Ca and Phos absorption
promote gastric acid secretion
enhance urinary excretion
24
Q

Aldosterone

A

mineralocorticoid- retain sodium and water and excrete potassium

25
Q

Hydrocortisone and Cortisone

A

natural glucocorticoid used for replacement therapy in adrenocortical deficiency, or anti-inflammatory drug

26
Q

Prednisone, prednisolone, fludrocortisone

A

synthetic steroid with mixed cortisol and aldosterone activity used for cortisol effects

27
Q

Triamcinolone, dexamethasone, methylprednisolone, betamethasone

A

synthetic with no aldosterone activity and used for potent anti-inflammatory activity

28
Q

Corticosteroid Absorption

A

well in jejunum
rapid with sodium phosphate and sodium succinate
altered pharm effects for those with altered protein-binding capacities
pregnancy- elevated total plasma level
crosses into placenta and breastmilk

29
Q

Corticosteroid Metabolism

A

by liver
1% excreted in urine
very high protein binding

30
Q

Aspirin

Class

A

Cox-1 inhibitor

pain

31
Q

Ketoprofen

class

A

Cox-1 inhibitor

pain

32
Q

flurbiprofen

class

A

Cox-1 inhibitor

pain

33
Q

indomethacin

class

A

Cox-1 inhibitor

pain

34
Q

piroxicam

class

A

Cox-1 inhibitor

pain

35
Q

sulindac

class

A

Cox-1 inhibitor

pain

36
Q

Ibuprofen

class

A

Selective Cox-1 inhibitor

pain

37
Q

naproxen

class

A

Selective Cox-1 inhibitor

pain

38
Q

diclofenac

class

A

Selective Cox-1 inhibitor

pain

39
Q

Etodolac

class

A

Selective Cox-2 inhibitor

pain

40
Q

nabumetone

class

A

Selective Cox-2 inhibitor

pain

41
Q

meloxicam

class

A

Selective Cox-2 inhibitor

pain

42
Q

Celecoxib

class

A

Selective Cox-2 Inhibitor does not inhibit Cox-1

pain

43
Q

rofecoxib

class

A

Selective Cox-2 Inhibitor does not inhibit Cox-1

pain

44
Q

caldecoxib

class

A

Selective Cox-2 Inhibitor does not inhibit Cox-1

pain

45
Q

acetaminophen

class

A

Selective Cox-2 Inhibitor does not inhibit Cox-1

pain

46
Q

Cox-1 (cyclooxygenase isoenzyme)

A

systemic, made constantly in tissue, cells, platelets, endothelia cells, GI tract, renal microvasculature,

role in homeostasis, platelet aggregation, regulate blood flow to kidney and stomach, regulate gastric acid secretion, produce protective mucus in stomach

47
Q

Cox-2 (cyclooxygenase isoenzyme)

A

made in response to pain and inflammation

some synthesis in kidney, brain, bone, female reproductive system, GI tract

48
Q

prednisone, prednisolone, fludrocortisone

A

synthetic steroid mixed cortisol and aldosterone activity used for cortisol effects

49
Q

triamcinolone, dexamethasone, methylprednisolone, betamethasone

A

synthetic with no aldosterone activity used for potent anti-inflammatory activity

Exam 3 Pharm (2 decks)

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