Anti-inflammatory 1

Card Set Information

Author:
Neda317
ID:
231313
Filename:
Anti-inflammatory 1
Updated:
2013-09-11 17:36:20
Tags:
Pharm
Folders:

Description:
Anti-inflammatory
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user Neda317 on FreezingBlue Flashcards. What would you like to do?


  1. Name different Prostoglandins (PGs)
    • PGE1
    • PGE2
    • PGF2-alpha 
    • PGI2 (prostacyclin)
  2. Rx of NSAIDS ulcers
    Protective on GI mucous
    Misoprostol
  3. drug that Maintains PDA
    Alprostadil
  4. example of PGE1 drugs
    • Misoprostol
    • Alprostadil
  5. Contraindication for PGE1
    Abortificient
  6. Example for PGE2
    Dinoprostone
  7. Dinoprostone
    Cervical ripening
  8. PGF2-alpha action
    • Uterine and
    • bronchiolar muscle contraction
  9. example of PGF2-alpha
    • Dinoprost
    • Carboprost (Abortificient)
    • Latanoprost (Rx of glaucoma)
  10. What is elevated in dysmenorrhea?
    PGE2 & PGF2-alpha
  11. PGI2 (Prostacyclin) action
    • inhibits platelet aggregation 
    • vasodilator
  12. Example of PGI2 and use of it
    • Epoprostenol:
    • Used in pulmonary HTN
  13. Mechanism of action of Aspirin
    Inhibits thromboxanes
  14.  thromboxanes (TXA2) action
    • Oppose the effects of PGI2
    • Promotes platelets aggregation
    • Bronchoconstriction
    • vasoconstriction
  15. Effects
    of PGI2 on Platelets
    PGI2 activates cAMP--> inc. internal Ca++ pump--> dec. free Ca++ --> platelet stabilization
  16. Effects
    of  TXA2 on Platelets
    TXA2 activates Phospholipase C -->inc. IP3--> mobilization of bound Ca++ --> inc. free Ca++ --> Platelets aggregation
  17. Name all Leukotrienes (LTs)
    • LTB4
    • LTA4
    • LTC4
    • LTD4
  18. LTB4 action
    Mediates inflammation --> Chemotaxis --> inc. free radical --> cell injury
  19. action of LTA4 - LTC4 - LTD4
    • -Release of slow-reacting substance of anaphylaxis
    • -Bronchoconstriction
    • -Vasoconstriction
  20. what drugs affects Leukotrienes pathway and their action
    • 1.Corticosteroids: Inhibits Phospholipase A2 enzyme
    • 2.Lipoxygenase inhibitors
    • 3.Leukotrienes Inhibitors
  21. Zileuton action
    Lipoxygenase inhibitors
  22. Zafirlukast - Montelukast
    Leukotrienes Inhibitors
  23. Block cyclooxygenase
    Antiinflammatory effects
  24. Block lipoxygenase:
    Immunosuppressant effects
  25. MOA: NSAIDs
    Block cyclooxygenase pathways COX1 & COX2 --> dec. PGs and TXA2
  26. Only NSAIDs that irreversibly inhibits both COX1 & COX2 and is dose dependent
    Aspirin (Acetyl Salicylic Acid)
  27. 5 Pharmacological Effects of Aspirin
    • 1. Analgesic
    • 2. Antipyretic 
    • 3. Anti-inflammatory effect
    • 4. Antiplatelets aggregation
    • 5. Uricosuric effect
  28. MOA: Aspirin 
    Analgesic effect
    Inhibition of PGs --> inhib. of sensitization of pain receptors by pain mediators as bradykinin and histamine
  29. MOA: Aspirin
    Antipyretic
    • presence of pyrogens --> inc. production of
    • IL-1 --> inc. PGE2 production --> inc. the "set point" of temp. to a higher level
  30. MOA: Aspirin
    Anti-inflammatory
    • Through inhibition of COX2
    • Aspirin
    • affects signal transduction proteins
    • interfers with cell surface selectins and
    • integrins --> dec. neutrophil adhesion
  31. MOA: Aspirin

    Antiplatelets
    aggregation
    • Through
    • inhibition of TXA2
  32. MOA: Aspirin

    Uricosuric
    effects ???
    low dose 
    high dose
    low dose: Hyperuricemia by dec. tubular secretion 

    high dose: Uricosuric by dec. tubular reabsorption
  33. action of aspirin on Hyperthermia
    Aspirin resets the "set point" back to normal
  34. action of aspirin on Hypothermia
    Aspirin resets the "set point" even lower
  35. action of aspirin on Euthermia
    no effect
  36. Aspirin Dosage for:
    a-Headache
    b-inflammatory conditions 
    c-decrease MI by 44%
    • a- 1-2 tablets (325mg/pill)
    • b- 3-5 g/day (9-15 pills/day)
    • c- 1 tablet every other day or 1 baby aspirin 81mg/day
  37. Aspirin high dose effect
    • 1- respiratory alkalosis
    • 2- metabolic acidosis 
    • 3- gastritis
    • 4-inc. bleeding time 
    • 5- inc. prothrombin time
    • 6-uricosuric
    • 7- salycylism
  38. with Aspirin high dose
    Gastritis due to:
    inhibition of PGE2
  39. with Aspirin high dose 
    inc. bleeding time due to
    dec. platelets aggregation
  40. with Aspirin high dose
    inc. prothrombin time due to
    inhibition of synthesis of vit K factor
  41. in Chronic dosing of Aspirin 

    Salycylism:
    what r the signs and symptoms
    Tinnitus, vertigo, and decrease hearing
  42. Acute Aspirin Toxicity
    • 1. Respiratory alkalosis then Respiratory acidosis
    • 2. Hypokalemia
    • 3. Metabolic acidosis
    • 4. Fever
  43. Aspirin
    Hypersensitivity:
    • Triad
    • of : Asthma, nasal polyps, and atrophic rhinitis
  44. Aspirin + Viral infection
    Reye's Syndrome:
  45. Aspirin drug interaction

    Ethanol:
    Increase GI bleeding
  46. Aspirin drug interaction

    Uricosurics
    Aspirin blocks their activity
  47. Aspirin blocks their activity

    Oral hypoglycemics
    Aspirin increases their activity
  48. Aspirin drug interaction

    Warfarin:
    Aspirin increase warfarin toxicity
  49. what dose will give severe toxicity
    Adult 
    kids
    Adult: 30 tablets (high dose)

    Kids: 4-6 tablets (high dose)
  50. Emergency Management for Aspirin toxicity
    • 1.Gastric lavage
    • 2.Activated charcoal 
    • 3.Alkalinization of the urine
  51. example of distinct analgesic and fever reducing drug that is not an anti-inflammatory
    Acetaminophen
  52. Acetaminophen over dose
    Depletion of GSH stores lead to accumulation of reactive metabolite which reacts with the hepatocytes
  53. MOA acetaminophen
    • A reactive metabolite                                    (N-acetylbenzoquinoneimine)
    • produced in the liver by P450 and is conjugated with reduced glutathione (GSH)
  54. action of Acetaminophen
    • Inhibits only centrally found cycloxygenase
    • (CNS)
    • Has no effects on peripheral cyccloxygenases
  55. Acetaminophen toxicity
    Hepatotoxicity
  56. Acetaminophen
    Antidote:
    • Acetylcysteine
    • Supply-SH groups that inactivate the metabolite
  57. Reversible
    inhibitors of COX1 & COX2
    (9)
    • 1-Ibuprofen
    • 2-Naproxen
    • 3-Etodolac
    • 4-indomethacin
    • 5-Ketorolac
    • 6-Nabumetone
    • 7-Sulindac
    • 8-Tolmetin
    • 9-Diclofenac
  58. #1 pain relief and why
    • Ibuprofen
    • Doesn't
    • affect activity of warfarin or hypoglycemic
  59. use in gout
    Naproxen
  60. Indomethacin side effect
    • Thrombocytopenia,
    • agranulocytosis
  61. Sulindac side effect
    Pancreatitis
  62. Diclofenac side effect
    Hepatotoxicity
  63. Cox inhibitors that has no effect on hypoglycemic drugs
    • Ibuprofen
    • Tolmetin
  64. NSAIDs action 
    • 1. All have analgesic, antipyretic and antiinflammatory activity 
    • 2. Cross sensitivity with aspirin may exist
    • 3. At antiinflammatory doses aspirin is less well tolerated than other NSAIDs
  65. Side effects of NSAIDs
    • 1. GI: Dyspepsia
    • 2. Renal: Interstitial nephritis
  66. NSAIDs-Drugs
    Interactions:
    decrease clearance --> increase activity 
    OF:
    • Hypoglycemic
    • Methotrexate
    • Lithium
  67. NSAIDs-Drugs
    Decrease activity:
     
    OF:
    • Hypertensive drugs:
    • ACE inhibitors
    • Loop diuretics
    • Beta Blockers
  68. name some 
    Selective COX2 Inhibitors
    • Rofecoxib
    • Celecoxib
    • Valdecoxib
  69. COX1
    receptors found in
    • Blood vessels causing platelets aggregation and 
    • Stomach and are protective against ulcer
  70. COX2
    Receptors are activated by
    inflammation
  71. Rofecoxib
    (Vioxx) 
    what family?
    indication
    • Selective COX2 inhibitors But COX1 receptors are activated
    • Good
    • for inflammation (Arthritis)
  72. Rofecoxib (Vioxx)
    what is the advantage and disadvantage of having COX1 receptors are active?
    • Good for the stomach because it is protected
    • Bad for the heart because of platelet aggregation 
    • leading to blood clot and myocardial infarction
  73. Celecoxib Cross allergy with
    sulfonamides
  74. Drugs
    used for Migraine
    • 1.drugs ending in "Triptan": 
    • Sumatriptan, Zolmitriptan, Frovatriptan

    • 2.Ergotamine and Methysergide
    • 3.Analgesics: ASA, acetaminophen, Oral or IM opioid-analgesics,Butorphanol (Spray)
  75. MOA
    drugs ending in "Triptan"
    Agonist at 5HT1D (serotonin) receptors in cerebral BV
  76. adverse effect
    drugs ending in "Triptan"
    Possible asthenia, throat pressure
  77. MOA
    Ergotamine and Methysergide
    • Partial agonist at alpha1 and 5HT2 in BV
    • Vasoconstriction lead to decrease pulsation
  78. Ergotamine and Methysergide
    indication
    • in
    • acute attack of migraine
  79. Migraine
    Prophylaxis:
    6
    • 1.Beta blockers
    • 2.Tricyclic antidepressant
    • 3.Calcium channel blockers
    • 4.Carbamazepine
    • 5.Gabapentin
    • 6.Valproic acid
  80. Mechanism
    of action of triptan
    Serotonin Agonist

What would you like to do?

Home > Flashcards > Print Preview