Card Set Information
what are the uses and SE of aspirin?
: RA, Reiter's (urethritis, arthritis, conjunctivitis)
: GI bleeding/ulcer, Reye's(encephalopathy)
What is indomethacin?
: ankylosing spondylitis and OA
: GI, leukopenia, aplastic anemia
What is etodolac?
mech weak COX
: acute pain (RA OA)
What does acetaminophen do?
inhibits PG synth
What is piroxicam(Feldende)?
use: Long term RA OA
What is meloxicam(mobic)?
What is nabumetone(felafen)?
RA & OA w/ less GI toxicity
treat short term soft tissue injurys
Describe the propionic acid derivatives?
: symptomatic RA, OA, AS, acute gouty arthrits
: long half life
: (PG synth inhibitor, antibradykinin)
: 1 a day?
What is oxaprozin?
1/day proprionic acid(ibuprofen class)
What is diclofenac?
phenyl acid derivative
: weak COX-2 (RA, OA, AS)
short term MSkel inj (sports)
: GI, uterine contraction
What is ketorolac (toradol)?
pyrrole derivative alalgesic, moderate AI
: similar GI
What are the coxibs?
: off market, OA,
: OA, RA
: KIDNEYS, BP, CHF
What are the NSAIDs implication in dentistery?
relieve pain from pathological process
What are MARDs?
disease modifying antirhematic drugs
: anti-malaria, ocular toxic
: systemic imunnosuppressant
: pyrimidine synth inhibitor (cell cycle) TERATOGENIC
: antimetabolite/folate cell growth inhibitor
: inhibit PG, suppress immune rxn, mucosal stomatitis
What are the biological MARDs?
: TNFa inhibtor (RA, AS,)
: recombinant IgG TNFa
Which TNFa receptor downstream signal leads to apoptosis and anti-inflammation like Fas?
TRADD, FADD, Capsase 8
TRAF1/2 are anti-apoptotic->inflammation
What is an gout arthritis?
acute gout from inflammation rxn to Na-urate crystals in joints
crystals phagocytized by neutrophiles
uric stones, tophi
: colchine: depolymerize mitotic spindles-> no granulocyte phagocytosis (GI, vascular toxic)
: xanthine oxidase inhibitor (uric acid synth)
What is the treatment of gout?
: graulocyte microtuble depolymerizer
: xanthine oxidase inhibitor (uric acid synth)
What are the ucosuric drugs?
block tubular reabsorption of urate
probenecid (many drug interactions)
What is the physiological effects of corticosteroids?
carbohydrate & protein metabolism
redist body fat and lipolysis
immunosuppressive/antiinflammatory (cytokine/Ab inhib)
what are the mechanisms of corticosteroids AI effects?
: inhibit PLA
COX synth suppressor
inhibit cytokine synth, histamine, adhesion
What are steroids used for in dentistry?
immunosuppressive & poor healing, exogenous suppress adrenal
: 30mg HC(hydrocort) 4+ weeks or 80mg 2+ weeks-> 2x or 3x dose routine
: 8 hrs before 100mg cort IM, during 300mg HC, taper over 2-3days
oral ulceration (NOT HERPETIC GINGIVOSTOMATITIS)
What are roids contraindications?
DM, PUD, HBP, infection
what are some classes of roids?
: beta, dexa, paramethasone
What are the weak COX2 inhibitors?
: soft tissues
Never use corticosteroids for what?
Which systems are of allergy concern?
not so much
: skin, GI
What kind of pts are prone to allergies?
atopic, watch class
When is a virus treatable?
What is HERV?
8% of human genome of inherited retroviral DNA
How does HIV attach?
: surface glycoprotein->CD4 receptor of T -cells
CCR5 or CXCR4 co-receptor also needed
: gp120->GLUT1 and NRP1
How does HTLV attach?
gp120->GLUT1 and NRP1 of CD4
Who is naturally HIV resistant?
What does nef of HIV do?
downreg MHC class I
What are the accessory proteins of HIV/HLTV?
: transcription activator
: viral RNA export
: downreg MHC I
What is the last step of HIV life cycle?
RNA-Gag budd then mature via viral protease to become infectious
How is HTLV spread?
virions cannot effectivly infect another cell
cell-cell contact then proliferation (tax)
What do Tcells target in HTLV?
How is HTLV dx and tx?
: ELISA (anti-HTLV)
: no specific
How is HIV dx?
anti-HIV ELISA then confirmed with Western blot
: ELISA (low sensitivity)
How is HIV tx?
: RT, protease, integrase CCR5 (CXCR4)
: CCR5 stem cell
What is HAART?
highly active anti-retroviral therapy
at least 2 drug combo for HIV
what is the main diff between HIV and Herpes?
Herpes isn't integrated, not as productive
What is EBNA1?
maintains viral circular DNA in proliferating cells
only protein express in resting latenly-infected B-cells
How does acyclovir work?
400mg 5/day 7-14 days
open ring guanosine analogue via viral(herpes) thymidine kinase
HSV, VZV, EBV
NOT CMV (altered TK)
What is Docosanol?
22C fatty acid inhibits intracellular HSV penetration
How does penciclovir (or famciclovir) work?
topical (herpes labialis drug of choice) converts MP by HSV or VZV TK to TP(triphospate) which inhibits DNA POLYMERASE
: oral pro drug(liver->penciclovir)
How does valacyclovir work?
What is ganciclovir?
anti-hsv anti CMV
similar to ACV
What is Cidofovir?
acyclic necleoside phosphate inhibits CMV polymerase
effective against ACV and Ganciclovir-resistant CMV in AIDS pts
What is the anti RSV drug?
ribavirin, purine analogue
What is the significance of a blood titer with HBsAg and/or HBeAg?
Cancer risk (liver)
Which hepatitis has no vaccine?
What are some Hep B tx?
telbivudine(HBV DNA poly)
How do anti flu drugs work?
typically neuraminidase inhibitors
What is atripla?
efivirenz (NN RT inhib)
emtricitabine (N RT inhib)
Tenofovir (N RT inhib)
What is tenofovir?
N RT inhibitor(part of atripla)
known to prevent HIV infection in women
How does HPV induce cancer?
How does gardasil work?
recombinant HPV-like, activate macrophages-> induce B cell prolif-> Ab
6,11, 16, 18
3x over 6 months
What does interferon do?
inhibits transcription, translation, protein processing, virus maturation
What is sequinavir?
HIV protease inhibitor, binds and inactivates blocks HIV replication
Are HIV drugs effective against HBV?
yes, hep B uses RT
what is lamivudine?
nucleoside analog inhibitor of RT, HIV, HBV