Musculoskeletal Pharm

Front 1

Opioids-morphine, fentanyl, codeine, heroin,methadone, meperidine
1)MOA
2)Uses
3)Toxicity
4)Overdose trt

Back 1

1) Agonist at opioid receptor (mu= morphine, delta=enkephalins, kappa=dynorphin)

2) Pain, Cough Suppression (Dextromethorphan), diarrhea, Acute Pulmonary Edema, Trt of Addicts (methadone)

3) Respiratory Depression, Consitpation, Pinpoint Pupils, CNS depression

No tolerance to constipation and pinpoint pupils

4) Naloxone, Naltexone

Front 2

NASAIDs- Ibuprofen, Naproxen, Indomethacin, Ketorolac
1)MOA
2)Uses
3)Toxicity

Back 2

1) Reversibly inhibit COX1 & COX2 to prevent prostaglandin synthesis

2) Antipyretic, anaglesic, anti-inflammatory, closes PDA (indomethicin)

3) renal damage, aplastic anemia, GI ulcers

Front 3

COX2 Inhibitors (celecoxib, valdecoxib)
1)MOA
2)Uses
3)Toxicity

Back 3

1) Selective inhibition of COX2 which is found in inflammatory cells (COX1 is involved in GI mucosa) -->prevents pain, but no risk of ulcers

2) Rheumatoid and Osteoarthritis

3) Similar to NSAIDS but less GI problems

Front 4

Acetaminophen
1)MOA
2)Uses
3)Toxicity
4)Antidote

Back 4

1) Reversible COX inhibitor, mostly CNS --> inactivated peripherally

2) Antipyretic, Analgesic, no anti-inflammatory

3) Overdose causes hepatic necrosis via depletion of gluathione --> allows free radical damage in liver and in renal medulla (don't combine acetominophen with aspirin)
4) N-acteylcysteine regenerates glutathione

Front 5

Colchicine
1)MOA
2)Uses
3)Toxicity

Back 5

1) Depolymerizes microtubules to impair leukocyte chemotaxis and degranulation --> blocks pain

2) Pain in acute gout attack

3) GI side effects

Front 6

Probenecid
1)MOA
2)Uses
3)Toxicity

Back 6

1) Blocks reabsorption of uric acid in the kidney and increases penicillin excretion
2)Chronic Gout

Front 7

Allopurinol
1)MOA
2)Uses
3)Toxicity

Back 7

1) Blocks Xanthine Oxidase to decrease conversion of xanthine --> Uric Acid.

2)Chronic Gout,and Lymphoma/Leukemia where increased cell turnover leads to uricemia

3) Blocks 6-mercaptopurine excertion --> lower dose

Front 8

Etanercept
1)MOA
2)Uses

Back 8

1) Recombinant form of TNF that bind TNF-alpha

2) Rheumatoid Arthritis, Psoriasis, Ankylosing Spondylitis

Front 9

Infliximab
1)MOA
2)Uses

Back 9

1) Antibody to TNF-alpha

2) Crohn's disease, Rheumatoid Arthritis, Ankylosing Spondylitis

Front 10

Cyclosporine
1)MOA
2)Uses
3)Toxicity

Back 10

1) Binds to cyclophilines to prevent differentiation and activation of T-cells (no IL-2 production)

2) Suppression of organ rejection

3) Predisposed to viral infxn, lymphoma, and it is nephrotoxic

Front 11

Tacrolimus
1)MOA
2)Uses
3)Toxicity

Back 11

Similar to cyclosporine, it blocks IL-2 and other cytokine release

2) Potent immunosuppressant in transplant

3) Significant nephrotoxicity, peripheral neuropathy, HTN, pleural effusion

Front 12

Azathioprine
1)MOA
2)Uses
3)Toxicity

Back 12

1) derivative of 6-MP that inferferes with nucleic acid production, so it is toxic to proliferating Lymphocytes

2) Kindney transplants, autoimmune disorders

3) Bone marrow suppression, toxic effects are worsened by Allopurinol