First Aid: Msk Pharm

Front 1

Lipoxygenase

Back 1

Converts arachidonic acid to leukotrienes

Front 2

LTB4

Back 2

Neutrophil chemotactic agent

Front 3

LTC4, LTD4, LTE4

Back 3

Bronchoconstriction

Vasoconstriction
Contraction of smooth muscle
Increased vascular permeability

Front 4

PGI2

Back 4

Prostacyclin

Inhibits aggregation of platelets
Decreases uterine tone
Vasodilates

"Platelet Gathering Inhibitor"

Front 5

Phospholipase A2

Back 5

Converts membrane lipids to arachidonic acid

Front 6

COX-1, COX-2

Back 6

Convert arachidonic acid to TxA2, prostacyclin (PGI2) and prostaglandin (PGE2)

Front 7

PGE2

Back 7

Prostaglandin

Increases: pain, temp, uterine tone
Vasodilates

Front 8

TxA2

Back 8

Platelet aggregation
Vasoconstriction

Front 9

Zileuton

Back 9

Lipoxygenase inhibitor. Prevents formation of Leukotrienes.

Front 10

Montelukast/Zafirlukast

Back 10

Leukotriene receptor inhibitor

Front 11

COX-1 acts mainly on

Back 11

gastric mucosa

Front 12

COX-2 acts mainly on

Back 12

inflammatory cells

Front 13

Corticosteroid: mechanism for anti-inflammatory action

Back 13

Inhibit Phospholipase A2
Inhibit protein synthesis required for COX-1, COX-2 production

Front 14

NSAIDs
Acetaminophen
Aspirin

MOA

Back 14

Inhibit COX-1, COX-2 formation of prostaglandins (PGE2)

Front 15

Aspirin

1. MOA

2. Use and dosage

3. Toxicity

Back 15

1. Irreversibly and covalently binds COX, decreasing synthesis of both PGE2 and TxA2

2. Low dose: anti-platelet
Intermediate dose: anti-pyretic and analgesic
High-dose: anti-inflammatory

3. Gastric upset. Renal failure, interstitial nephritis, upper GI bleed.
Reye's syndrome in kids after viral illness.

Front 16

Reye's syndrome

Back 16

Fatty liver and extreme encephalopathy, among other symptoms.

Caused by aspirin use in children post viral illness.

Front 17

NSAIDs

1. MOA
2. Use
3. Toxicity

Back 17

Ibuprofen, naproxen, indomethacin, ketorolac

1. Reversibly inhibits COX-1, COX-2, blocking PGE2 synthesis.

2. Anti-pyretic, analgesic, anti-inflammatory

3. Renal damage, aplastic anemia, GI distress, ulcers

Front 18

COX-2 inhibitors

1. aka ____
2. MOA
3. Use
4. Toxicity

Back 18

1. Celecoxib

2. Reversibly inhibits COX-2, found on inflammatory cells, vascular endothelium, mediating inflammation and pain.
Helps maintain gastric mucosa, no corrosive effects.

3. RA and OA

4. Increased risk of thrombosis.
Sulfa drug allergy.

Less toxicity to GI mucosa

Front 19

Acetamenophen

1. MOA
2. Use
3. Toxicity

Back 19

1. Reversibly inhibits COX in CNS. Inactivated peripherally.

2. Anti-pyretic, analgesic. NO ANTI-INFLAMMATORY properties. Used instead of aspirin in kids to avoid Reye's syndrome.

3. Hepatic necrosis after overdose.

Front 20

Bisphosphonates

1. MOA
2. Use
3. Toxicity

Back 20

1. Inhibit osteoclastic activity.

2. Malignancy-associated hypercalcemia, Paget Disease of the bone, post-menopausal osteoporosis.

3. Corrosive esophagitis, nausea, diarrhea

Front 21

What is used to Tx:

Acute gout?
Chronic gout?

Back 21

1. Colchicine

2. Probenecid and/or Allopurinol

Front 22

Colchicine

1. MOA
2. Use
3. Toxicity

Back 22

1. Stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation.

2. Acute gout

3. GI toxicity

Front 23

Probenecid

1. MOA
2. Use
3. Toxicity

Back 23

1. Inhibit reabsorption of uric acid in PCT

2. Chronic Gout

3. inhibits secretion of penicillin

Front 24

Allopurinol

1. MOA
2. Use
3. Toxicity

Back 24

1. Inhibits Xanthine Oxidase, preventing conversion of xanthine to uric acid.

2. Chronic gout, lymphoma and leukemia to prevent tumor-lysis associated urate nephropathy.

3. Increases concentrations of azothioprine and 6-MP (metabolized by XO)

Front 25

What drug should not be given in a patient with gout?

Back 25

Salicylates and certain diuretics.

Salicylates decrease uric acid clearance.

Front 26

TNF-a inhibitors (3)

Back 26

Etanercept
Infliximab
Adalimumab

Front 27

Etanercept

1. MOA
2. Use

Back 27

1. TNF-a receptor decoy --> inhibits TNF-a

2. RA, psoriasis, ankylosing spondylitis

Front 28

Infliximab

1. MOA
2. Use
3. Toxicity

Back 28

1. anti-TNF-a Ab

2. Chron's, RA, ankylosing spondylitis

3. Predisposes to infxns (i.e. reactivation of latent TB)

Front 29

Adalimumab

1. MOA
2. Use

Back 29

1. anti-TNF-a Ab

2. RA, psoriasis, ankylosing spondylitis