systems 5.txt

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emm64
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167949
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systems 5.txt
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2012-08-29 05:58:08
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  1. what are the uses and SE of aspirin?
    • use: RA, Reiter's (urethritis, arthritis, conjunctivitis)
    • SE: GI bleeding/ulcer, Reye's(encephalopathy)
  2. What is indomethacin?
    • COX: ankylosing spondylitis and OA
    • SE: GI, leukopenia, aplastic anemia
  3. What is etodolac?
    • mech weak COX
    • use: acute pain (RA OA)
  4. What does acetaminophen do?
    inhibits PG synth
  5. What is piroxicam(Feldende)?
    use: Long term RA OA
  6. What is meloxicam(mobic)?
    weak COX2
  7. What is nabumetone(felafen)?
    • COX2 weak
    • RA & OA w/ less GI toxicity
    • treat short term soft tissue injurys
  8. Describe the propionic acid derivatives?
    • use: symptomatic RA, OA, AS, acute gouty arthrits
    • ibuprofen
    • naproxen: long half life
    • ketoprofen: (PG synth inhibitor, antibradykinin)
    • oxaprozin: 1 a day?
  9. What is oxaprozin?
    1/day proprionic acid(ibuprofen class)
  10. What is diclofenac?
    • phenyl acid derivative: weak COX-2 (RA, OA, AS)
    • short term MSkel inj (sports)
    • SE: GI, uterine contraction
  11. What is ketorolac (toradol)?
    • non-selective COX
    • pyrrole derivative alalgesic, moderate AI
    • SE: similar GI
  12. What are the coxibs?
    • selective COX2
    • rofecoxib(vioxx): off market, OA,
    • celecoxib(celebrex): OA, RA
    • valdecoxib(bextra): withdrawn
    • SE: KIDNEYS, BP, CHF
  13. What are the NSAIDs implication in dentistery?
    • relieve pain from pathological process
    • TMJ disorder
  14. What are MARDs?
    • disease modifying antirhematic drugs
    • slow RA
    • paquenil: anti-malaria, ocular toxic
    • cyclosporin A: systemic imunnosuppressant
    • arava(leflunomide): pyrimidine synth inhibitor (cell cycle) TERATOGENIC
    • methotrexate: antimetabolite/folate cell growth inhibitor
    • gold: inhibit PG, suppress immune rxn, mucosal stomatitis
  15. What are the biological MARDs?
    • enbrel: TNFa inhibtor (RA, AS,)
    • humira: recombinant IgG TNFa
  16. Which TNFa receptor downstream signal leads to apoptosis and anti-inflammation like Fas?
    • TRADD, FADD, Capsase 8
    • TRAF1/2 are anti-apoptotic->inflammation
  17. What is an gout arthritis?
    • acute gout from inflammation rxn to Na-urate crystals in joints
    • Haegman factor->bradykinin
    • crystals phagocytized by neutrophiles
    • uric stones, tophi
    • tx: colchine: depolymerize mitotic spindles-> no granulocyte phagocytosis (GI, vascular toxic)
    • allopurinol: xanthine oxidase inhibitor (uric acid synth)
  18. What is the treatment of gout?
    • colchine: graulocyte microtuble depolymerizer
    • allopurinol: xanthine oxidase inhibitor (uric acid synth)
  19. What are the ucosuric drugs?
    • GOUT
    • block tubular reabsorption of urate
    • probenecid (many drug interactions)
  20. What is the physiological effects of corticosteroids?
    • carbohydrate & protein metabolism: anti-insulin
    • redist body fat and lipolysis
    • electrolyte/H2O
    • immunosuppressive/antiinflammatory (cytokine/Ab inhib)
  21. what are the mechanisms of corticosteroids AI effects?
    • lipocortin: inhibit PLA
    • COX synth suppressor
    • granulocyte inhibit
    • inhibit cytokine synth, histamine, adhesion
  22. What are steroids used for in dentistry?
    • immunosuppressive & poor healing, exogenous suppress adrenal
    • GUIDLINE: 30mg HC(hydrocort) 4+ weeks or 80mg 2+ weeks-> 2x or 3x dose routine
    • major: 8 hrs before 100mg cort IM, during 300mg HC, taper over 2-3days
    • oral ulceration (NOT HERPETIC GINGIVOSTOMATITIS)
    • pulpal sensitivity
    • TMJ
    • post-op
    • anaphylaxis/allergy
  23. What are roids contraindications?
    DM, PUD, HBP, infection
  24. what are some classes of roids?
    • short: cortisone
    • intermediate: prednisone
    • long: beta, dexa, paramethasone
  25. What are the weak COX2 inhibitors?
    • mobic
    • relafen: soft tissues
    • diclofenac: sports
  26. Never use corticosteroids for what?
    herpetic gingivostamatitis
  27. Which systems are of allergy concern?
    • respiratory, CVS
    • not so much: skin, GI
  28. What kind of pts are prone to allergies?
    atopic, watch class
  29. When is a virus treatable?
    • lytic
    • (latent hides)
  30. What is HERV?
    • endogenous
    • 8% of human genome of inherited retroviral DNA
  31. How does HIV attach?
    • gp120: surface glycoprotein->CD4 receptor of T -cells
    • CCR5 or CXCR4 co-receptor also needed
    • HTLV: gp120->GLUT1 and NRP1
  32. How does HTLV attach?
    gp120->GLUT1 and NRP1 of CD4
  33. Who is naturally HIV resistant?
    CCR5-delta32 mutants
  34. What does nef of HIV do?
    downreg MHC class I
  35. What are the accessory proteins of HIV/HLTV?
    • tat/tax: transcription activator
    • rev/rex: viral RNA export
    • nef(HIV): downreg MHC I
  36. What is the last step of HIV life cycle?
    RNA-Gag budd then mature via viral protease to become infectious
  37. How is HTLV spread?
    • virions cannot effectivly infect another cell
    • cell-cell contact then proliferation (tax)
  38. What do Tcells target in HTLV?
    • Tax
    • rex, HBZ
  39. How is HTLV dx and tx?
    • dx: ELISA (anti-HTLV)
    • tx: no specific
  40. How is HIV dx?
    • anti-HIV ELISA then confirmed with Western blot
    • p24: ELISA (low sensitivity)
    • viral RNA: expensive
  41. How is HIV tx?
    • inhibit: RT, protease, integrase CCR5 (CXCR4)
    • future: CCR5 stem cell
  42. What is HAART?
    • highly active anti-retroviral therapy
    • at least 2 drug combo for HIV
  43. what is the main diff between HIV and Herpes?
    Herpes isn't integrated, not as productive
  44. What is EBNA1?
    • Epstein Barr
    • maintains viral circular DNA in proliferating cells
    • only protein express in resting latenly-infected B-cells
  45. 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)
    • gertrude elion
  46. What is Docosanol?
    22C fatty acid inhibits intracellular HSV penetration
  47. 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
    • famciclovir: oral pro drug(liver->penciclovir)
  48. How does valacyclovir work?
    oral pro-drug(liver)
  49. What is ganciclovir?
    • anti-hsv anti CMV
    • similar to ACV
  50. What is Cidofovir?
    • acyclic necleoside phosphate inhibits CMV polymerase
    • effective against ACV and Ganciclovir-resistant CMV in AIDS pts
  51. What is the anti RSV drug?
    ribavirin, purine analogue
  52. What is the significance of a blood titer with HBsAg and/or HBeAg?
    Cancer risk (liver)
  53. Which hepatitis has no vaccine?
    C
  54. What are some Hep B tx?
    • peginterferon
    • lamivudine
    • adefovir
    • entecavir(DNA poly)
    • telbivudine(HBV DNA poly)
  55. How do anti flu drugs work?
    • typically neuraminidase inhibitors
    • tamiflu, relenza
  56. What is atripla?
    • efivirenz (NN RT inhib)
    • emtricitabine (N RT inhib)
    • Tenofovir (N RT inhib)
  57. What is tenofovir?
    • N RT inhibitor(part of atripla)
    • known to prevent HIV infection in women
  58. How does HPV induce cancer?
    • HPV 16,18
    • E6(p53)
    • E7(Rb)
  59. How does gardasil work?
    • recombinant HPV-like, activate macrophages-> induce B cell prolif-> Ab
    • 6,11, 16, 18
    • 3x over 6 months
  60. What does interferon do?
    • chr 9
    • inhibits transcription, translation, protein processing, virus maturation
  61. What is sequinavir?
    HIV protease inhibitor, binds and inactivates blocks HIV replication
  62. Are HIV drugs effective against HBV?
    yes, hep B uses RT
  63. what is lamivudine?
    nucleoside analog inhibitor of RT, HIV, HBV

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