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21 Cards in this Set
- Front
- Back
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Aspirin
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-mech: irreversibly inhibits cyclooxygenase by covalent binding, which decreases synthesis of both thromboxane and prostaglandins
-use: low doses decrease platelet aggregation. intermediate doses are antipyretic and analgesic. High doses are anti-inflammatory -ae: gastric upset. chronic use can lead to acute renal failure, interstition nephritis, upper GI bleeding. Reyes syndrome in kids with viral infection |
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NSAIDs
(ibuprofen, naproxen, indomethacin, ketorolac) |
-mech: reversibly inhibit cyclooxygenase, blocks prostaglandin synthesis
-use: antipyretic, analgesic, anti-inflammatory. Indomethacin closes PDA -ae: renal damage, fluid retension, aplastic anemia, GI distress, ulcers |
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Celecoxib
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-mech: reversibly inhibits COX-2, which is found in inflammatory cells and vascular endothelium and mediates inflammation and pain. Spares COX-1, which helps maintain the gastric mucosa
-use: rheumatoid and osteoarthritis, pts with gastritis or ulcers -ae: increased risk of thrombosis, sulf allergy |
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Acetaminophen
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-mech: reversibly inhibits cyclooxygenase, mostly in CNS. Inactivated peripherally
-use: antipyretic, analgesic, but lacking anti-inflammatory properties -ae: OD produces hepatic necrosis bc metabolite depletes glutathione and forms toxic tissue adducts in liver. N-acetylcysteine is antidote bc it regenerates glutathione |
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Etidronate
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bisphosphanate
-mech: inhibits osteoclastic activity, reduces both formation and resportion of hydroxyapatite -use: malignancy-associate hypercalcemia, Paget's disease of bone, postmenopausal osteoporosis -ae: corrosive esophagitis, nausea, diarrhea, osteonecrosis of jaw |
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pamidronate
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bisphosphanate
-mech: inhibits osteoclastic activity, reduces both formation and resportion of hydroxyapatite -use: malignancy-associate hypercalcemia, Paget's disease of bone, postmenopausal osteoporosis -ae: corrosive esophagitis, nausea, diarrhea, osteonecrosis of jaw |
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alendronate
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bisphosphanate
-mech: inhibits osteoclastic activity, reduces both formation and resportion of hydroxyapatite -use: malignancy-associate hypercalcemia, Paget's disease of bone, postmenopausal osteoporosis -ae: corrosive esophagitis, nausea, diarrhea, osteonecrosis of jaw |
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risedronate
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bisphosphanate
-mech: inhibits osteoclastic activity, reduces both formation and resportion of hydroxyapatite -use: malignancy-associate hypercalcemia, Paget's disease of bone, postmenopausal osteoporosis -ae: corrosive esophagitis, nausea, diarrhea, osteonecrosis of jaw |
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zoledronate
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bisphosphanate - given IV
-mech: inhibits osteoclastic activity, reduces both formation and resportion of hydroxyapatite, no corrosive esophagitis -use: malignancy-associate hypercalcemia, Paget's disease of bone, postmenopausal osteoporosis -ae: nausea, diarrhea, osteonecrosis of jaw |
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colchicine
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-mech: binds and stabilizes tubulin to inhibit polymerization, impairing leukocyte chemotaxis and degranulation
-use: acute gout (with NSAIDs) -ae: GI side effects (nausea, abdominal pain, diarrhea), especially if given orally (IMPORTANT) -indomethacin is an alternative that is less toxic |
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probinecid
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-mech: inhibits reabsorption of uric acid in PCT (also inhibits secretion of penicillin)
-use: chronic gout (PRObinicid, PROximal tubule) |
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allopurinol
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-mech: inhibits xanthine oxidase (hypoxanthine to xanthine in purine metabolism), decreasing conversion of xanthine to uric acid
-use: chronic gout, lymphoma and leukemia (to prevent tumor lysis-associated urate nephropathy -ae: increased concentrations of azathioprine and 6-MP |
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salicylates effects on uric acid
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depress uric acid clearance, make gout worse
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Etanercept
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-mech: recombinant form of human TNF receptor that binds TNF, inhibiting TNF-alpha
-use: rheumatoid arthritis, psoriasis, ankylosing spondylitis -ae: none etanerCEPT is a TNF decoy reCEPTor |
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Adalimumab
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-mech: anti-TNF antibody, inhibits TNF-alpha
-use: rheumatoid arthritis, psoriasis, ankylosing spoldylitis (keeps TNF-alpha MUM) ae: none |
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Tx of osteogenesis imperfecta
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Bisphosphanates to increase bone mineralization
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Cause of osteomyelitis in sickle cell disease, how to treat
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Salmonella typhi
tx with ciprofloxacin |
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secondary causes of osteoporosis
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increased cortisol
heparin hypogonadism malnutrition |
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why does smoking put you at risk for osteoporosis
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inhibits osteoblasts
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Treats septic arthritis
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ceftriaxone
(tx N. gonnorhea) |
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Methotrexate
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-mech: inhibits dihydrofolate reductase (makes tetrahydrofolate - THF - which is a methyl shuttle needed for purine synthesis)
-use: moderate to severe RA -ae: teratogenic, mouth ulcers (can be minimized if give folate supplement), hepatotoxic, myelosuppression |
