Musculoskeletal Module Drug Lists

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Musculoskeletal Module Drug Lists
2011-10-30 12:20:42
Ross University Medical med school pharmacology s3m2 musculoskeletal anti inflammatory arthritic gout relaxant

Drug lists for name recognition for the musculoskeletal module of block 2
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  1. 6 classes of NSAIDs
    • Salicylates
    • Propionic Acid Derivatives
    • Acetic Acid Derivatives
    • Indole Derivatives
    • Oxicams
    • Coxibs
  2. 2 Salicylates
    • Aspirin: irreversible COX inhibition
    • Sulfasalazine: COX inhibition, esp. ulcerative colitis and Crohn's disease
  3. 4 Propionic Acid Derivatives
    • Flurbiprofen: nonselective COX, TNF-α, NO
    • Ibuprofen: nonselective COX, close ductus arteriosus; dental
    • Naproxen: nonselective COX
    • Oxaprozin: more useful in gout
    • (all end in -en/-in)
  4. 3 Acetic Acid Derivatives
    • Diclofenac: nonselective COX, low level LOX; pre/post op use
    • Ketorolac: nonselective COX; analgesic to replace/reduce opioids
    • Sulindac: sulfoxide pro-drug/sulfide metabolite
    • (ACetic ACid - "-ac" suffix)
  5. 1 Indole Derivative
    Indomethacin: potent nonselective COX; gout, postlaminectomy syndrome, close ductus arteriosus
  6. 2 Oxicams
    • Meloxicam: highly selective COX-2, TXA2
    • Piroxicam: nonselective COX; high peptic ulcer bleed risk
  7. 1 Coxib
    Celecoxib: Highly selective COX-2; black box for cardiovascular
  8. 1 class, drug of Analgesic/Antipyretic
    Acetominophen: potent CNS COX with little peripheral effect; NAPQI buildup
  9. 3 classes of Glucocorticoids
    • Short to medium acting
    • Intermediate acting
    • Long acting
  10. 5 Short/Medium Glucocorticoids
    • Cortisone
    • Hydrocortisone
    • Methylprednisolone
    • Prednisolone
    • Prednisone
  11. 1 Intermediate Glucocorticoid
    Triamcinolone (acetonide/hexacetonide)
  12. 2 Long Glucocorticoids
    • Betamethasone
    • Dexamethasone
  13. 3 classes of Arthritic Disease Drugs
    • Against circulating antibodies
    • Miscellaneous
    • Cytotoxic Drugs
  14. 4 drugs against circulating antibodies (DMARDs)
    • Infliximab: human/mouse TNF-α IgG
    • Adalimumab: human TNF-α IgG; black box for opportunistic infection
    • Etanercept: human recomb TNF receptor
    • Anakinra: human recomb IL-1 receptor antagonist
  15. 3 "Miscellaneous" DMARDs
    • Penecillamine: unknown MOA; marrow suppression
    • Hydroxychloriquine: stops WBC action
    • Sulfasalazine: COX block, PG downreg for Crohn's, ulcerative colitis
  16. 4 cytotoxic DMARDs
    • Methyltrexate: mimics folate
    • Azathioprine: PPRP synthetase/aminotransferase block
    • Leflunomide: dihydroorate dehydrogenase (rate-limiting enzyme)
    • Cyclosporine: calcineurin blockade (no IL-2)
  17. 3 stages of gout treatment
    • Acute gout
    • Acute gouty attack
    • Chronic gout
  18. 2 classes, 3 drugs for acute gout
    • NSAIDs: ibuprofen, indomethacine
    • Glucocorticoids: prednisone
  19. 2 drugs for Acute Gouty Attack
    • Cochicine: inhibition of leuk migration (binds microtubules)
    • Indomethacine: potent NSAID
  20. 2 classes, 3 drugs for Chronic Gout
    • Uricosurics: probenecid, sulphinpyrazone (both inhibit PCT reabs of urate)
    • Xanthine Oxidase Inhibitors: allopurinol
  21. 3 classes of Skeletal Muscle relaxants
    • Motor end plate activity (depolarizing and non-depolarizing)
    • Spasmolytics (hit CNS synapses in spinal cord, cortex)
    • Other relaxants
  22. 7 non-depolarizing motor end plate drugs
    • Tubocurarine: slow on, long off; no metab; high dose Nn block; drop BP; raise HR, histamine
    • Pancuronium: quick on, long off; 25% liver metab; moderate M2 block; raise BP, HR
    • Rocuronium: quick on, medium/long off; liver metab
    • Vecuronium: slow on, medium off; liver metab; good for hypertension (only endplate activity)
    • Atracurium: medium on, medium off; esterase metab; drop BP; slight histamine
    • Mivacarium: quick on, quick off; cholinesterase metab; drop BP; slight histamine
    • Cisatracurium
  23. Only depolarizing motor end plate drug
    Succinyl choline: very quick on, very quick off; cholinesterase metab; Nn and M2 stim; Raise BP, HR; slight histamine
  24. 4 spasmolytic muscle relaxants
    • Diaz-/lorazepam: increase Gaba-A aff to receptor, increasing Cl- channel opening λ (peripheral)
    • Baclofen: Gaba-B receptor (Gi) agonist, blocks neurotransmitter release (central)
    • Tizanidine: α2 agonist for cerebral/spinal disorders
    • Gabapentin: decreases presynaptic excitatory AP; tonic-clonic seizures
  25. 2 "other" muscle relaxants
    • Dantrolene: blocks RyR, good for cerebral palsy, paralytics, malig hyperthermia, neuroleptic malignant syndrome, and serotonin syndrome
    • Botulinum toxin: blocks Ach release from pre-synaptic neuron