Anti-Inflammatory

Front 1

Name the 6 NSAID groups

Back 1

1. Salicylates
2. Pyrazolones
3. Indoleacetic Acids
4. Propionic Acids
5. Oxicams
6. Fenamates

Front 2

How is aspirin a unique NSAID?

Back 2

- acetylates cyclooxygenase irreversibly, NOT reversibly like the other NSAIDs.

Front 3

What are the 4 main uses of NSAIDs?

Back 3

1. anti-inflammatory
2. analgesic
3. antipyretic
4. antiplatelet

Front 4

Name 4 slow-acting anti-rheumatic drugs (SARDS).

Back 4

1. methotrexate
2. gold salts
3. penicillamine
4. hydroxychloroquine

Front 5

Acetominophen

Back 5

- OTC analgesic and antipyretic with weak anti-inflammatory properties
- blocks prostaglandin synthesis in CNS, less effect in peripheral tissues
- no effect on platelet function
- CAN be given to gout patients taking probenecid

Front 6

N-acetylcysteine (Mucomyst)

Back 6

Given to counteract acetominaphen hepatotoxicity.

Front 7

How are COX1 and COX2 different?

Back 7

COX1 is ubiquitous and constitutive, while COX2 is released in response to inflammatory stimuli.

Front 8

Diflunisal

Back 8

3-4x more potent than aspirin as an analgesic and anti-inflammatory agent, but no antipyretic properties

Front 9

Aspirin and other salicylates

Back 9

- anti-inflammatory, analgesic, antipyretic
- uncouples oxphos, so increases CO2 and increases respiration
- increases gastic acid, lowers protective mucus secretion
- inhibits thromboxane production in platelets, leads to poor platelet aggregation
- prostaglandins maintain renal blood flow, so aspirin can lead to interstitial nephritis, edema, hyperkalemia
- DOC in rhematoid arthritis
- facilitates closure of patent ductus arteriosus

Front 10

What is Reye's syndrome?

Back 10

Fatal, fulminating hepatitis with cerebral edema. Caused by giving aspirin to kids who are susceptible.

Front 11

What is salicylism?

Back 11

- Salicylate toxicity leading to nausea, vomiting, hyperventilation, headache, mental confusion, dizziness, tinnitus
- increasing urinary pH helps eliminate salicylate

Front 12

Proprionic acid and derivatives

Back 12

- ibuprofen, naproxen, fenoprofen, ketoprofen, flurbiprofen, oxaprozin
- anti-inflammatory, analgesic, antipyretic effects, used in the chronic treatment of rheumatoid and osteoarthritis due to lighter GI effects
- reversible COX inhibitors
- almost totally bound to serum albumin

Front 13

Indoleacetic acids

Back 13

- indomethacin, sulindac, etodolac
- generally not used to lower fever

Front 14

Indomethacin

Back 14

- potent anti-inflammatory, but not well-tolerated by rheumatoid arthritis pts
- used in acute gouty arthritis, ankylosing spondylitis and to close a patent ductus arteriosus

Front 15

Piroxicam

Back 15

- an oxicam derivative, mxn unknown
- used to treat rheumatoid arthritis, ankylosing spondylitis, osteoarthritis

Front 16

Phenylbutazone

Back 16

- powerful anti-inflammatory with high associated toxicities
- used in short-term treatment of acute gout and acute rheumatoid arthritis
- causes agranulocytosis and aplastic anemia

Front 17

What is gout?

Back 17

Associated with high blood levels of uric acid. Characterized by attacks of arthritis and urinary calculi, which are caused by deposits of sodium urate crystals in joints, cartilage and kidneys. Uric acid is the end product of purine metabolism.

Front 18

How do you treat acute gout vs. chronic gout?

Back 18

"PIC PACS"
Acute:
Phenylbutazone (NSAID)
Indomethacin (NSAID)
Colchicine (inhibits neutrophil migration)

Chronic:
Probenecid (renal proc of uric acid)
Allopurinol (blocks steps in uric acid synthesis)
Colchicine (inhibits neutrophil migration)
Sulfinpyrazone (renal proc of uric acid)