Inflammation

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Author:
GordyG
ID:
246071
Filename:
Inflammation
Updated:
2013-11-10 00:48:53
Tags:
Pharmacology
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Description:
Pharmacology
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  1. First generation H1 antagonists
    • Antihistamines
    • Diphenhydramine
  2. Diphenhydramine side effects
    Reduces flushing, edema, mucous secretion, itching and pain

    highly sedating, seizures, pupil dilation, tachycardia
  3. What are the effects of histamine?
    • Vasodilation
    • increased capillary permeability
    • bronchoconstriction (increased secretions)
    • CNS effects
  4. Second generation antihistamines
    Claritin

    • blocks histamine receptors
    • less side effects
    • long acting
  5. Second generation antihistamine nasal spray
    Azelastine (Astelin)

    Causes a little bit of drowziness
  6. What is the difference between ASA and first line NSAIDs?
    • ASA is irreversible
    • NSAIDs are reversible
  7. Nonselective irreversible COX inhibitor
    ASA
  8. Physiologic difference between ASA and NSAIDs
    ASA decreases platelet aggregation

    NSAIDs have an increase in thrombotic events
  9. When are NSAIDs used first line?
    Osteoarthritis and RA
  10. Side effects of NSAIDs
    • Bleeding
    • GI
    • Renal impairment
  11. COX inhibitors will usually result in what as an adverse effect?
    Renal impairment
  12. What is a first generation NSAID?
    • Ibuprofen
    • Naproxen
  13. What is an NSAID given IV/IM?
    Ketorolak (Toradol)
  14. What is the difference between first and second generation NSAIDs?
    1st generation - COX I and II inhibitors

    2nd generation - COX II inhibitor
  15. Second generation NSAID
    Celebrex
  16. Action of Celebrex
    • Reduces pain
    • Reduces fever
    • Reduces inflammation
  17. What is the action of Acetaminophen?
    Inhibits prostaglandin production (CNS only)
  18. What are the effects of Acetaminophen?
    • Anti-pyretic
    • Analgesic
  19. What does Acetaminophen inhibit the metabolism of?
    Warfarin
  20. What is the antidote for Acetaminophen?
    Mucomyst
  21. What class is Celebrex?
    Second generation NSAID

    COX II inhibitor
  22. Don't take alcohol with Acetaminophen
    Causes toxic metabolism of acetaminophen in liver via P450 system
  23. Common glucocorticoids
    • Cortisone
    • Prednisone
  24. What class is Cortisol?
    Glucocorticoid
  25. What class is Prednisone?
    Glucocorticoid
  26. What basic effect do glucocorticoids have?
    Anti-inflammatory
  27. What physiologic effects are glucocorticoids going to be similar to?
    Cortisol
  28. What two major actions does Cortisone have?
    • Anti-inflammatory
    • Immunosuppressive
  29. What can Cortisone be used to treat?
    • RA
    • SLE
    • IBD
    • Organ rejection
  30. Receiving Glucocorticoids will have a negative feedback effect, so it will cause what?
    Adrenal insufficiency
  31. How do you avoid adrenal insufficiency in a patient taking long term therapy glucocorticoids?
    Taper
  32. How do you avoid adrenal insufficiency?
    • do not stop taking cortisol abruptly
    • carry an extra supply
    • Seek tx for illness/stress
    • Wear an ID bracelet
  33. What is the first line of drugs used to treat RA?
    NSAIDs
  34. What type of NSAIDs are best for tx of RA?
    COX II inhibitors
  35. Why are COX II inhibitors the best NSAID for tx of RA?
    Less side effects
  36. Could someone with RA start tx using Celbrex?
    Yes

    Second Generation NSAID
  37. Why would someone getting tx for RA not get Celebrex?
    They are already at risk for MI or thrombotic events
  38. What is an option for someone with limited affected joints RA?
    Glucocorticoid injections
  39. What is the advantage of Glucocorticoid injections?
    No systemic effects
  40. What is the next step in therapy for RA if NSAIDs are ineffective?
    Glucocorticoids PO
  41. Name four nonbiologic DMARDs
    Methotrexate/Rheumatrex/Trexall

    Hydroquloriquine/Plaquenil

    Azulfadine

    Arava
  42. Two biologic DMARDs
    Enbrel

    Orecenia
  43. If nonbiologic DMARDs are ineffective for RA, switch to what?
    Biologic DMARDs
  44. What is the strange biologic DMARD?
    Gold Salts
  45. What is the short term relief tx of Gout?
    NSAIDs

    Gucocorticoids
  46. What is the more dangerous short term tx for gout?
    Colchicine

    • Toxicities
    • n/v/d
    • abdominal pain
  47. What is the long term tx of Gout?
    Zyloprim and Uloric

    Probenicid
  48. What is Colchicine used to treat?
    Gout
  49. How and when is Probenicid given?
    Once gout is under control using Zyloprim and Uloric

    Then Probenicid is used to prevent Gout

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