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clinical Neuro
NSAIDs
73
Biology
Graduate
01/16/2008

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Term
What are the mediators of acute inflammation
Definition

1. Histamine

2. 5-HT

3. Bradykinin

4. PG

5. LKT

Term
Which of the acute inflammatory mediators are the best vasodilators
Definition
Bradykinin and PGs
Term
Which of the acute inflammation mediators is the best at preventing vacular permeability
Definition
Histamine and LKTs
Term
This acute inflammatory mediator causes pain
Definition
Bradykinin
Term
What's the effect of IL-1, 2, 3
Definition
Lymphocyte activation & PGE production
Term
What are the mediators of chronic inflammation
Definition
IL-1, 2, 3
GM-CSF
TNF-a
Interferons
PDGF
Term
GM-CSF activates
Definition
Macrophages and grunlocytes
Term
TNF-a increase the production of
Definition
PGE
Term
This chronic inflammatory mediator is a fibroblastic chemotaxis
Definition
PDGF
Term
What's the MOA of NSAIDs
Definition
1. Inhibit COX
2. Prevent formation of PG, TXA & Prostacyclin
Term
What's the rate limiting step in the formation of AA
Definition
Phopholipase A2
Term
Are NSAID pain mediators?
Definition
Yes, at the site of pain
Term
How are NSAIDs anti-inflammatory
Definition
Decrease vasodilator PG and this decreases edema
Term
How are NSAID a analgesic?
Definition
Decreases PG desensitizing nerve endings to bradykinin and 5-HT
Term
How do NSAID act as a Antipyretic
Definition
the cytokines cannot inflict a PG response
Term
How do NSAID work as an Antiplatelet
Definition
Induces reseresible inhibition of thromboxane synthesis
Term
What is the most common adverse reaction of NSAID
Definition
GI ulceration and renal injury
Term
How is Acetylsalicyclic acid eliminated?
Definition
excreted by the kidney
Term
How is Acetylsalicylic acid metabolized?
Definition
Cytochrome P450
Term
What is the MOA of aspirin
Definition
Binds irreversibly to COX
Term
Name the uses of Acetysalicylic acid
Definition
Analgesia: Mild to moderate pain
Antipyretic
Anti-inflammatory
Prevent ischemic attacks, unstable angina
Term
What are the adverse effect of asprin
Definition
Upper GI bleeding
Salicylism: vomiting, tinnitus, decrease hearing
Reyes syndrome
Term
This NSAID is used in gout
Definition
Indomethacin
Term
What's the adverse reaction of Indomethacin
Definition
It's more toxic than aspirin
Term
What advantage does Ibuprofen have over aspirin?
Definition
Less side effects
Term
Name the 2 NSAIDs w/ Long half lives
Definition
Naproxen and Prioxicam
Term
What advantage does Diclofenac have as an NSAID
Definition
it's well tolerated
Term
Which NSAID is used for Ocular
Definition
Flurbiprofen
Term
Which NSAID is used for acute attacks and flare ups
Definition
Sluindac
Term
Name the Aniline derivative
Definition
Acetaminophen
Term
Does Acetaminophen have anti-inflammatory effects
Definition
NO
Term
How is acetaminophen metabolized?
Definition
microsomal liver enzymes
Term
What's the MOA of acetoaminophen
Definition
Might be due to the inhibition of CNS type of COX
Term
What are the uses for Acetaminophen
Definition
Analgesic and antipyretic
Term
What are the adverse reactions of acetaminophen
Definition
Skin rash
Liver necrosis due to N-acetyl-p-benzoquinone
Term
What's the antidote for over dosing on acetaminophen
Definition
N-acetylcysteine
Term
Which COX is the enzyme that produces prostanoid mediator of inflammation
Definition
COX-2
Term
_____ is a potent COX-2 inhibitor that is used in Osteoarhritis & rheumatoid arthritis
Definition
Celecoxib
Term
What's an adverse effect of Celecoxib
Definition
MI
Term
How do Golden salts treat rheumatoid arthritis
Definition
Might inhibit macrophage function
Term
when would you not use golden salts
Definition
Pregnancy
Gold allergy
Impaired renal or liver
Term
What are some adverse reactions of golden salts
Definition
Pruritic skin rash
Hematological ab.
Proteinuria
Peripheral neuropathy
Term
Golden salts are used when?
Definition
Rheumatoid arthritis
Sjogren syndrome
Term
Name the 3 golden salts
Definition
Aurothiomalate
Aurothioglucose
Auranofin
Term
Which golden salt do you give PO
Definition
Auranofin
Term
Aurothiomalate and aurothioglucose are given how?
Definition
IM
Term
What would you give w/ hydroxychloroquine for rheumatoid arthritis
Definition
NSAIDs
Term
What are the adverse effects of Hydrooxychloroquine
Definition
1. Ocular toxicity (irreversible)
2. Dyspepsia, nausea, ab pain
Term
How does hydroxychloroquine work for rheumatoid arthritis
Definition
Might act as a non-specific leukocyte function inhibitor
Term
Penicilliamine is a ______ of penicillin
Definition
Metabolite
Term
What's the MOA of Penicillamine?
Definition
Unclear
Term
What are the major side effects of Penicillamine
Definition
Decreases B6
Bone marrow depression
Term
When would you use Penicillamine for RA
Definition
When it's not contorlled
Term
Name the two Immunosuppressive
Definition
Mehotrexate
Azathioprine
Term
What's the MOA of Mehotrexate
Definition
Potent immunosuppressive drug at anti-cancer doses
Dihydrofolase reductase inhibitor
Term
What are the adverse effects of Mehotrexate
Definition
Nausea, vomitting, rash, urticaria, renal damage
Term
What's the MOA of Azathioprine? When is it used?
Definition
Inhibits DNA synthesis
Used in renal transplants
Term
What drugs are used for Anklosing Spondylitis
Definition
Etanercept
Infliximab
Adalimumba
Abatacept
Term
Ethanercept is a recombinate protein made of what?
Definition
TNF linked to Fc of IgH
Term
When does Ethanercept peak?
Definition
72hrs
Term
What's the MOA of Etanercept
Definition
Inhibits TNF
Term
What are the adverse effects of Etanercept
Definition
Erythemia, local pain at the site of injection
Term
What kind of antibody is infliximab?
Definition
monoclonal
Term
Can you use Infliximab for RH
Definition
Yes, for those that do not respond to Infliximab
Term
What's the MOA of infliximab
Definition
Inhibits TNFa
Term
What's the adverse effect of Infliximab
Definition
URI
Term
Adalimumba is what kind of antibody
Definition
monoclonal
full IgG anti-TNF
Term
The clearance of Adalimumba is decreased by this drug
Definition
Methotrexate
Term
Adalimumba is used for
Definition
RA
Ankylosing spondylitis
Psoriati arthritis
Term
What are the adverse effects of Adalimumba
Definition
Opportunistic infections
Rare luekopenia
Rare vasculitis
Term
What's the MOA of Abatacept
Definition
1. Binds to CD80 & CD86
2. Inhibits activation of T cells by blocking B7-1 & B7-2 interaction w/ CD28
Term
What condition is Abatacept used for?
Definition
RA
Term
What's the adverse reactions of Abatacept
Definition
Increase risk of URT
Anti-abaticpet antibodiy
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