Shared Flashcard Set

Details

Ophtho/Derm/Rheum-Pharm
Gout and Rheumatoid Arthritis Drugs
20
Pharmacology
Graduate
12/08/2010

Additional Pharmacology Flashcards

 


 

Cards

Term
What are the drugs used in an acute gouty attack and what is their mechanism of action
Definition

Indomethacin:NSAID

Corticosteroids

ACTH

Colchincine: Prevents microtubule polimerazation inhibiting leukocyte Migration and phagocytosis, also decreases LTB4

Term
What is the mechanism of action of Probenecid and its adverse effects?
Definition

Decreases Uric Acid secretion but decreases Reabsorption more

Adverse: Kidney Stones

Acute Exascerbation

Alters drug clearance:

Hypoglycemics, Zidovudine, Methotrexate

 

Term
What are the contraindications to Probenecid use
Definition

Low GFR

High Uric Acid secretion prior to Admin

Methotrexate, Hypoglycemic Drugs, Zidovudine

Term
What is the mechanism of Allopurinol and what are the adverse effects
Definition

Hypoxanthine Isomer converted to alloxanthin(active metabolite) blocking Xanthine Oxidase

Adverse: Acute Exacerbation of gout (Tissue->Plasma)increase dose slowly

Monitor Liver and Kidney Function

Interaction with XO drugs(Azathioprine, Mercatopurine)

Term
When can allopurinol be used where Probenecid cannot
Definition

Renal dysfunction

High Urate levels and Secondary hyperuracemia

 

Term
What is the mechanism of Methotrexate and what are the adverse effects
Definition

DH Folate Reductase Inhibitor

Increases Adenosine(Anti-Inflammatory)

Adverse: Mucosal Ulcers(Give Leucovorin, Folic Acid)

Liver Disease especially in Alcoholics

Marrow Suppression
Term
What are the pharmokinetics of Methotrexate
Definition

Liver metabolism to 7-hydroxymethotrexate(active)

Long half life bc Polyglutamated

Term
What is the mechanism of action of Hydroxychloroquine and its adverse effects and when is it typically used
Definition

Lysosomal accummulation altering pH which blocks spingomyelinase preventing TNF transduction

Adverse: Retinal(Basal eye exam)

Peripheral Neuropathy

Leukopenia

Use: Pt not responding to NSAIDS

Term
What is the mechanism and adverse effects of etanercept
Definition

2/3 Human, 1/3 mouse, bind TNF-Alpha

Adverse: TB

URT Infections

Demyelinating disease: Not to MS patients

Term
What is the MOA, and adverse effects of sulfasalazine
Definition

MOA: Unknown, but has sulfapyradine active moiety

Adverse: Neutropenia, Hepatotoxic

Term
What is the mechanism and Adverse effects of Adalimumab
Definition

Human Anti-TNF-Alpha

Adverse: TB

Term
What is the mechanism and Adverse effects of Anakinra
Definition

IL-1 Receptor Antagonist

Adverse: Lymphoma,

Serious Infections

Not with TNF blockers

 

Term
What is the mechanism and adverse effects of Leflunomide
Definition

Dihydroorotate Dehydrogenase Inhibitor-> decrease in UMP-> GI Arrest (mostly B-cells)

Adverse: Cholestryamine blocks the enterohepatic circulation

Increase Ibuprofen/NSAID's through p450's

Reversible Allopecia

Increased Liver Enzymes

 

Term
What is the Mechanism and adverse effects of Abatacept
Definition

Block T-costimulation by binding CD80 blocking CD28 binging

Adverse: Serious Infections

Not to COPD

Not with TNF blockers

Term
What is the Mechanism and Adverse effects of Rituximab
Definition

Binds CD20 on B-cells(prevents activation->lysis)

Adverse: Myelosuppression in long term

Term
What rheumatoid drugs should not be given to a pregnant women
Definition

Methotrexate

Infliximab

Leflunomide

Term
Which TNF-aplha blocker is given IV
Definition
Infliximab
Term
What is the mechanism of Uricase and Febuxostat
Definition

Uricase: Produces Allantoin from uric acid which least toxic

Feboxostat: Non-purine Selective Inhibitor of Xanthine Oxidase

Term
What are the advantages of Febuxostat
Definition

Hepatically eliminated: good for renal insufficiency

Unaffected by Allopurinol allergies

 

Term
When is colchicine used for gout and when do you stop increasing the dose
Definition

NSAIDs Contraindicated

Intolerable diarrhea

Supporting users have an ad free experience!