3. Abdominal pain, diarrhea, dyspepsia, HA, Allergy (sulfonamides), BLACK BOX- increases risk of MI, CV disease, and stroke because when COX-2 pathway is inhibited COX-1 pathway increases (increases platelet).
5. When to Use a COX-2 Inhibitor- Pts with multiple medical problems; >75, Pts on corticosteroids, Prior GI bleeds. *Better idea to use an NSAID with less COX-1 inhibition for pts with GI problems rather than a COX-2 inhibitor.
1. Biological Response Modifiers (BRM are like DMARDs)
2. Treats RA (strong antiinflammatory effect)
3. Injection site Reaction (erythema, itching, pain, swelling), positive antinuclear bodies, increased infection risk. FDA warning- Risk of fungal infection can lead to death in immunosuppressed individuals.
5. Very expensive and only available injectable, used only when other RA treatment doesn't work. Prep-powder mixed with bacteriostatic H20- gently swirled to avoid foaming. [Acts as a Tumor necrosis factor (TNF) receptor and TNF is main cytokine responsible for inflammation in RA]
2. Treats gout by increasing renal excretion of uric acid (inhibits reabsorption)
3. kidney stones, N/V, anorexia, hematuria, HA.
4. Many- Aspirin, diuretics
5. Need to increase fluid intake and alkalinize the urine. Not for use in impaired kidney function.
Uric acid metabolism disorder causing crystals to form in joints.
Obesity, Males, Alcoholism, Heredity, Middle Age
2. Clinical Uses
3. Adverse Effects
4. Drug-Drug Interactions
5. Special Notes: Differences between the different penicillin preparations (G,V, etc)
1. Antibiotic (Penicillins)
2. Mostly Gram + bacteria
3. Allergic reaction (most common drug allergy), contact dermatitis, GI distress.
5. G- original, oral only, must be taken on empty stomach; V(K)- oral not affected by food, no need to be on empty stomach; G(parenteral)- combined with sodium or potassium salts so monitor electrolyte levels.
Not effective against penicillinase (beta-lactamase) producing organisms.
5. Can be oral or injectable. Both require special preparation.
6. Oral- acid sensitive so special salt forms used so monitor electrolytes. Injectable- lactobionate is pH sensitive so must be mixed with Sterile H20 without preservative and infused with NS or Buffer d5W
5. Must take peak-to find therapeutic blood levels, and troughs- to make sure there is no build up (toxicity). Hearing damage to fetus. Infuse slowly 30-60 min to avoid neuromuscular blockade. Dose must be adjusted for kidney dysfunction.