Term
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Definition
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Term
| in what cells can cox2 be induced? |
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Definition
| macro, mono, synovio, chondro, fibro, osteoblasts, endothelials |
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Term
| where is cox2 expressed constituitively? |
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Definition
| brain, kid, bone, ovary, uterus, si |
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Term
| where in the cell is cox found? |
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Definition
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Term
| what Pgs mediate vasodilation? |
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Definition
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Term
|
Definition
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Term
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Definition
| 1. lowers act threshold of 1ary neurons, 2. enhance depol of DH 2ary neurons, 3. inc. leuks --> more proinflammatory mediators |
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Term
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Definition
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Term
|
Definition
| inc. resorption (osteoclasts) |
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Term
|
Definition
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Term
| what do pge2 and pgi2 do in the gut? |
|
Definition
| dec acid, inc bicarb, inc mucous, inc blood flow |
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Term
| what cox do platelets express? |
|
Definition
|
|
Term
| why do endothelial cells not produce txa2? |
|
Definition
| they lack the requisite synthase |
|
|
Term
| what cox do endothelials express? |
|
Definition
|
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Term
|
Definition
| vasodilation, inc blood flow, inc GFR, inc Na/H2o excretion |
|
|
Term
| what role do pgs have in angiogenesis? |
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Definition
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|
Term
| describe a postualted role for the use of NSAIDS in cancer... |
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Definition
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|
Term
| effects of pgs on female GU |
|
Definition
| stim uterine contract, nsaids may delay labor, pgs maintain a PDA |
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Term
|
Definition
|
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Term
|
Definition
| indomethacin (diclofenac, sulindac, ketoralac, tolmentin) |
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Term
|
Definition
| irreversible cox1i, also inhibits cox2, inhibits nf-kb at hi dose |
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Term
| why is salicylate not as potent as aspirin? |
|
Definition
| it in a competitive antag rather than an irreversible one |
|
|
Term
| why does low-dose aspirin inhibit txa2 but not pge2? |
|
Definition
| txa2 is made by platelets that can't resynth cox1, endothelial cells can resynth cox1 |
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|
Term
| why is anti-platelet activity of aspirin diminished at higher doses? |
|
Definition
| inc inhibition of pge2 in endothelium |
|
|
Term
| key points with diflunisal |
|
Definition
| not anti-pyretic, fewer gi se |
|
|
Term
| when would you think about another salicylate over aspirin? |
|
Definition
| inc GI risk or bleeding tendency |
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Term
|
Definition
|
|
Term
| elimination kinetics of low dose aspirin (anti-platelet)? |
|
Definition
|
|
Term
| elimination kinetics of hi dose aspirin (anti-inf)? |
|
Definition
|
|
Term
| effects of aspirin dose on uric acid excretion? |
|
Definition
| low decreases, high increases |
|
|
Term
| therapeutics for salicylate tox? |
|
Definition
|
|
Term
|
Definition
| GI (distress, n/v, bleed, ulcer), dec renal blood flow/fxn, prolonged bleeding, resp depression (tox), hyperthermia (tox), hypersensitivity, reve's syndrome |
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|
Term
| gastric damage of aspirin - 2 moa |
|
Definition
| direct damage (ion trapping), inhibit pg |
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|
Term
| 2 options to limit gi tox of ASA |
|
Definition
| misprotol (pg analog), ppi |
|
|
Term
| talk about the ASA hypersensitivity rxn... |
|
Definition
| though to result from lots of leukotrienes due to buidup of AA |
|
|
Term
|
Definition
| aspirin given during febrile viral infection in kids can result in fatal liver disease with encephalopahty, don't give ASA to kids |
|
|
Term
| key features of traditional NSAIDs... |
|
Definition
| reversible inhibitors of cox, anti-inf, anti-pyretic, analgesic |
|
|
Term
| advantages of propionic acids over ASA? |
|
Definition
|
|
Term
|
Definition
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|
Term
|
Definition
|
|
Term
|
Definition
| very long hl, mildly uricosuric |
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|
Term
|
Definition
|
|
Term
| most effective anti-pyretic NSAID? |
|
Definition
|
|
Term
| what limits use of indomethacin? |
|
Definition
|
|
Term
|
Definition
| GI, HTN, Allergy, CNS, photosens, liver |
|
|
Term
| why do cox2s show inc cardiac risk? |
|
Definition
| inhibition of Cox2 decreases endothelial pgi2 and is pro-thrombotic |
|
|
Term
| contraindications for NSAIDs? |
|
Definition
| ulcer, bleeding disorder, renal disease, ASA hypersensitivity, pregnancy, elderly |
|
|
Term
| which NSAID does not work on gout? |
|
Definition
|
|
Term
| drugs interacting w/ NSAIDs? |
|
Definition
| oral anti-coags, anti-HTN, diuretics, uricosurics, oral hypoglycemics, Li, methotrexate, aminoglycosides |
|
|
Term
| when might you give Cox2i? |
|
Definition
|
|
Term
| drug of choice for OA pain? |
|
Definition
|
|
Term
| topical analgesic for OA pain? |
|
Definition
| capsaicin (depletes SubsP) |
|
|
Term
|
Definition
|
|
Term
|
Definition
| weak inhibition of cox1/2, inhibit cox3 (cns) |
|
|
Term
|
Definition
| anti-pyretic, analgesic (not anti-inf, not anti-plate) |
|
|
Term
| serious interaction for Acetaminophen? |
|
Definition
|
|
Term
| does acetaminophen contribute to gout? |
|
Definition
|
|
Term
| rx for acetaminophen tox? |
|
Definition
| n-acetyl cysteine (replace glutathione) |
|
|
Term
|
Definition
|
|
Term
| gen classes of meds for RA? |
|
Definition
| NSAIDs, analgesics, corticosteroids, DMARDS, BRM |
|
|
Term
| why is use of low-dose corticosteroids for RA controversial? |
|
Definition
| can lead to osteoporosis, weight gain, fluid retention, hypergly, HTN, infection |
|
|
Term
| when does one use DMARDs? |
|
Definition
| when NSAIDs/corticosteroids have not prevented sx |
|
|
Term
|
Definition
| methotrexate, hydroxychloroquine, salfasalazine, leflunomide |
|
|
Term
|
Definition
|
|
Term
|
Definition
| pregnancy -- teratogens except for sulfasalazine |
|
|
Term
|
Definition
|
|
Term
| how long does it take the effects of hydroxychloroquinone to appear? |
|
Definition
|
|
Term
| how long does it take the effects of methotrexate to appear? |
|
Definition
|
|
Term
| info points on sulfasalazine |
|
Definition
| safe for pregancy, more toxic than HCQ |
|
|
Term
| bad combo of DMARDs for the liver? |
|
Definition
| leflunomide, methotrexate |
|
|
Term
|
Definition
|
|
Term
|
Definition
| etanercept, infliximab, adlimumab |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| another drug that is good to use with TNFai? |
|
Definition
| methotrexate (dec antibodies and clearance) |
|
|
Term
| typical DMARD combo for mild RA? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| prevents tubulin polymerization --> blocks leuk mig/phag |
|
|
Term
|
Definition
|
|
Term
|
Definition
| porbenecid, sulfinpyrazone |
|
|
Term
|
Definition
| dec reabsorption of uric acid |
|
|
Term
|
Definition
| kidney stones due to inc. excretion, don't give to pts that are naturally uricosuric |
|
|
Term
|
Definition
| xanthine oxidase inhibitor |
|
|
Term
|
Definition
| acute gouty attack (can worsen) |
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