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Pharm 0584 Fall 11 Final
Gout, Pain, Parkinson's, NSAIDs, Corticosteroids
52
Pharmacology
Graduate
11/07/2011

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Cards

Term
Indomethacin
Definition
NSAID prescription for treating gout
causes CNS side effects
Reversible cox1/2
prolongs gestation
NOT for juvenile RA
closes fetal ductus arteriosis
Term
Ketorolac
Definition
NSAID IM injection for acute gout/anxiety
reversibly inhibit cox1/2
Term
Colchicine
Definition
antiinflammatory specific for gout
prevents tubulin polymerization
EXTREME GI upset
removed from market except colcrys
Term
Allopurinol
Definition
inhibits xanthaine oxidase
reduces uric acid formation
*early increased gout (expose crystals)
hard on liver
^ half life of probenecid
Term
Febuxostat
Definition
new xanthine oxidase inhibitor
less GI upset/allergy
Term
Probenecid
Definition
A uricosuric agent (gout) that inhibits the anion exchange transporter. Increases uric acid excretion.
May cause kidney crystals
Not effective in acute attacks
Term
Rasburicase and Pegloticase
Definition
Gout: Recombinant urate-oxidase/uricase enzymes which convert uric acid to allantoin.
Term
Acetaminophen
Definition

inhibits prostaglandin synth in CNS but not periphery.

Mild inhibitor of COX1/2

para amino phenol derivative No antiinflammatory activity No GI irritation anti-diuretic LIVER TOXICITY

Term
Celocoxib
Definition
selective COX-2 inhibitor (celebrex)
not for patients with SULFONAMIDE allergy, aspirin triad or asthma
Term
Lidocaine (local anesthetics)
Definition
block sodium channels in nerve endings
Term
L-Dopa
Definition
dopamine precursor
parkinsons
Term
Selegiline/Deprenyl
Definition
inhibit metabolism of dopamine by MAO-B
parkinsons
Term
Entacopone
Definition
inhibits metabolism of dopamine by COMT
parkinsons
may minimize on/off phenomenon
Term
Bromocryptine
Definition

stimulates post-synaptic dopamine receptors ergot derivative parkinsons may affect on/off phenomenon

may help with on/off phenomenon

Term
Pramipexole, Ropinirole
Definition
Non-ergot dopaminergic agonists
parkinsons
restless leg syndrome
may minimize on/off phenomenon
Term
Amantidine
Definition
stimulates release of dopamine
parkinsons
first used as antiviral
Term
Benztropine, triheriphenidyl, diphenhydramine
Definition
centrally acting antimuscarinics
Parkinsons
CNS activity
remember Ach/DA balance
Term
Clozapine
Definition
antidepressant without parkinsonism side effects
manage side effects of L-Dopa
Term
Carbidopa
Definition
inhibits DOPA decarboxylase in periphery but not CNS
Parkinsons
Term
Rasalagine
Definition
MAO-B inhibitor
supplement to L-DOPA
Parkinsons
Term
Acetyl Salicylic Acid (aspirin)
Definition
Salicyclic acid derivative
COX-1/2 inhibitor
IRREVERSIBLY acetylate cox 1- blocks arachadonic acid->prostaglandins
prevents platelet aggregation by thromboxane A2 irreversibly 4-7 days
highly bound to albumin
excreted rapidly when alkaline urine
dissolution is rate-limiting
long-term large doses cause tinnitus
pulmonary edema
polyps in asthma patients
Term
Diflunisal
Definition

Salicyclic acid derivative

reversible COX-1/2 inhibitor

Long half life, similar to aspirin

Term
Etodolac
Definition

Acetic Acid derivative

reversible COX-1/2 inhibitor MORE COX 2

less severe GI than indomethacin

Term
Diclofenac
Definition

Acetic Acid derivative

reversible COX-1/2 inhibitor

CNS dizziness

Term
Tolmetin
Definition

Acetic Acid derivative

Reversable COX-1/2 inhibitor

Anaphylactoid reactions

Juvenile rheumatoid arthritis
Term
Naproxen
Definition

Propionic Acid derivative

reversible COX-1/2 inhibitor

Juvanile RA

do not use when nursing
Term
Ketoprofen
Definition

Propionic Acid derivative

reversible COX-1/2 inhibitor

GI in 30% patients

Term
Oxaprozin
Definition

Propionic Acid derivative

reversible COX-1/2 inhibitor

once daily

Term
Piroxicam
Definition
Enolic Acid Derivative
Oxicams
reversible COX-1/2 inhibitor
Term
Meloxicam
Definition
Enolic Acid Derivative
Oxicams
reversible COX-1/2 inhibitor
Term
Nabumetone
Definition
Non acidic compound
COX-1/2 inhibitor MORE cox2
activated by liver
Term
Hydrocortisone
Definition
short acting
corticosteroid for stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior
Term
Prednisone
Definition
intermediate acting
corticosteroid for stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior
Term
Methylprednisolone
Definition
short-med acting
corticosteroid for stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior
Term
Triamcinolone
Definition
intermediate acting
corticosteroid for stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior
Term
Dexamethasone
Definition
long acting
corticosteroid for stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior
Term
Fludrocortisone
Definition
mineralocorticoid agonist
corticosteroid for stress response, immune response and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior
Term
Methyrapone
Definition
glucocorticoid synth inhibitor
Term
Ketoconazole
Definition

glucocorticoid synth inhibitor

antifungal

Term
Spironolactone
Definition
Mineralocorticoid antagonist
Term
Cosyntropin
Definition
synthetic ACTH (corticotropin)
corticosteroid
Term
Ibuprofen
Definition
reversible cox 1/2
less GI toxicity than aspirin or indomethacin
ocular disturbances
avoid during pregnancy
close fetal ductus arteriosis
Term
Pergolide
Definition
DA receptor agonist
ergot derivative
may decrease on/off phenomenon
Term
Phenytoin
Definition
monotherapy
tonic-clonic and partial
prolongs Na channels
drugs (warfarin) metabolized by CYP2C9 affected
gingival hyperplasia
SJS
Term
Carbamazepine
Definition
monotherapy tonic-clonic and partial
prolongs Na channels
induces own metabolism
Acute side effects: stupor, coma, hyperirritability convulsions
Chronic side effects: drowsiness, vertigo, ataxia, blurred vision
Term
Oxcarbazepine
Definition
Monotherapy/adjunctive
partial seizures
prolongs Na channels
Prodrug
does not autoinduce
Dizziness, nasuea, somnolence, ataxia
Term
Ethosuximide
Definition
monotherapy
absence seizures
inhibits T-type Ca channels
not plasma bound-- few interactions
nausea, vomiting, anorexia, drowsiness, letahrgy, euphoria, SJS, aplastic anemia
Term
Valproic Acid
Definition
monotherapy
all types of seizures
T-type Ca channels, prolongs Na channels, increase GABA synth
GI nausea, anorexia, sedation, ataxia, tremor, increase hepatic enzymes
displaces phenytoin from plasma proteins
Term
Benzodiazepines
Definition
only for adjunctive treatment of absence
inhibit GABA receptor
drowsiness, lethargy, aggression, hyperactivity, irritability
withdrawl causes status epilepticus
Term
Gabapentin
Definition
suppress neuronal activity
treat neuropathic pain
not metabolized
fatigue, ataxia
Term
Lamotrigine
Definition
monotherapy and adjunctive
partial and tonic/clonic
prolong Na channels
dizziness, ataxia, blurred vision, nausea, rash and SJS when added to other AEDs
Term
Levetriacetam
Definition
Adjnctive for partial in adults
very save-- no interactions
somnolence, dizziness, asthenia
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