Shared Flashcard Set

Details

Pharm CH 36
NSAIDs, Antirheumatic, Nonopioid Analgesics, & Gout Drugs
14
Pharmacology
Professional
05/31/2012

Additional Pharmacology Flashcards

 


 

Cards

Term
Aspirin
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

 

Anti-inflammatory effects:

↓ Platelet aggregation, interferes with kallikrein system, ↓Granulocyte adherence to    damaged vasculature, ↓Chemotaxis of PMNs & macrophages

 

Anti-platelet: ↓ COX-1 & COX-2

Analgesic effects

Antipyretic effects: ↓ COX & IL-1

Gastric upset, gastric/duodenal ulcers, hepatotoxicity, asthmatic attacks, rashes, renal toxicity

 

High doses: salicylism (vomiting, tinnitus, ↓ hearing, vertigo)

 

 

Used for anti-platelet effect:

↓ incidence of ischemic attacks, unstable angina, coronary artery thrombosis with MI, thrombosis after coronary bypass surgery

 

Term
Celecoxib
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

 

Selectively inhibits COX-2

Renal toxicity

↑ risk of thrombotic events

GI upset, peptic ulcers

Fewer GI effects and doesn’t affect platelet aggregation; no cardioprotective effects

 

Term
Ibuprofin
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

 

Reversibly inhibits both

COX-1 & COX-2

Less fluid retention & GI

ulcers

GI upset, peptic ulcers

Close the patent ductus arteriosus, analgesia

Anti-inflammatory and anti-platelet action ↓ when used with aspirin

 

Term
Indomethacin
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

 

Nonselective COX inhibitor

Inhibit phospholipase A & C

Reduce neutrophil migration

↓ T cell & B cell proliferation

 

Pancreatitis, headache (25%), psychosis (rarely), thrombocytopenia, aplastic anemia, renal papillary necrosis

GI upset, peptic ulcers

Close the patent ductus arteriosus, gout

 

Term
Methotrexate
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

 

Inhibits AICAR* transformylase & thymidate synthase

 

Affects PMN chemotaxis, DHF

reductase, ↓ proinflammatory cytokines

Nausea, mucosal ulcers, hepatotoxicity

 

CI in pregnancy

Rheumatoid arthritis (1st choice)

 

Juvenile chronic arthritis, psoriasis, ankylosing spondylitis, polymyositis, Wegener’s granulomatosis, lupus, vasculitis

 

Term
Cyclosporine
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

 

Inhibits interleukin-1 and 2 receptor production => inhibits macrophage-T-cell interaction and T-cell responsiveness

Nephrotoxicity

Hyptension, hyperkalemia, hepatotoxicity, gingival hyperplasia, hirsutisim

rheumatoid arthritis (↓ new bony erosions)

 

Term
Leflunomide
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

 

Inhibits dihydroorotate dehydrogenase leading to ↓ ribonucleotide synthesis and arrest of cells in G1 phase =>  ↓ T-cell proliferation and production of autoantibodies by B cells

 

↑ IL-10 receptor mRNA, ↓ IL-8 receptor type A mRNA, ↓ TNF-α-dependent NF-κB

Diarrhea (25%), ↑ liver enzymes

Mild alopecia, weight gain, ↑BP

 

CI in pregnancy

Rheumatoid arthritis (inhibit bony damage)

 

Term
Mycophenolate mofetil
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

 

Inhibits CMP dehydrogenase => ↓T-cell proliferation

 

Interferes w/ WBC adhesion via E&P selectins and ICAM-1

Nausea/vomiting,

hypertension, reversible neutropenia

Renal disease, vasculitis,

Wegner's granulomatosis, Lupus

 

Term
Hydroxychloroquine
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

 

↓ T-cell response to mitogens

↓ leukocyte chemotaxis

↓ DNA/RNA synthesis

Trap free radicals

Ocular toxicity
dyspepsia, nausea, vomiting, abdominal pain, rashes, nightmares

Malaria, rheumatic disease

 

Term
Gold salts
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

 

Inhibit immune response

Pigmentation changes (anti-rheumatic gold containing compounds)

No longer used due to toxicity &

questionable efficacy

 

Term
Adalimumab
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

TNF-α Inhibitors

 

Human IgG1 anti-TNF antibody that complexes with TNF-α and prevents its interaction with p55 and p75 cell surface receptors => ↓macrophage and T-cell

↑risk of bacterial and macrophage-dependent infection (including TB and other opportunistic infections)

Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile idiopathic arthritis, plaque psoriasis, Crohn’s disease

Term
Infliximab
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

TNF-α Inhibitors

 

Chimeric IgG1 antibody that binds to soluble and bound TNF-α => ↓macrophage and T-cell function

↑incidence of bacterial infections (including upper respiratory), activation of latent TB

Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, Crohn’s disease

Term
Etanercept
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

TNF-α Inhibitors

 

Fusion protein made of 2 soluble TNF p75 receptor moieties linked to Fc of human IgG1; binds TNF-α and inhibits lymphotoxin-α

↑bacterial infections, especially soft tissue infections and septic arthritis, may activate latent TB

Rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, juvenile chronic arthritis, psoriasis

Term
Acetaminophen
Definition

CH 36 NSAIDs, Antirheumatic Drugs, Nonopioid Analgesics, & Drugs Used in Gout

 

Weak COX 1 and 2 inhibitor in peripheral tissue

Antipyretic and analgesic, but NO anti-inflammatory or platelet aggregation inhibition

↑ hepatic enzymes

 

Overdose: Hepatotoxicity with centrilobular necrosis, acute

renal tubular necrosis

Treat moderate pain without anti-inflammatory effect

Preferred over aspirin for children with viral infections hemophiliacs, ulcer-prone patients, gout

 

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