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12 Cards in this Set

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Opioids-morphine, fentanyl, codeine, heroin,methadone, meperidine
1)MOA
2)Uses
3)Toxicity
4)Overdose trt
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
NASAIDs- Ibuprofen, Naproxen, Indomethacin, Ketorolac
1)MOA
2)Uses
3)Toxicity
1) Reversibly inhibit COX1 & COX2 to prevent prostaglandin synthesis

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

3) renal damage, aplastic anemia, GI ulcers
COX2 Inhibitors (celecoxib, valdecoxib)
1)MOA
2)Uses
3)Toxicity
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
Acetaminophen
1)MOA
2)Uses
3)Toxicity
4)Antidote
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
Colchicine
1)MOA
2)Uses
3)Toxicity
1) Depolymerizes microtubules to impair leukocyte chemotaxis and degranulation --> blocks pain

2) Pain in acute gout attack

3) GI side effects
Probenecid
1)MOA
2)Uses
3)Toxicity
1) Blocks reabsorption of uric acid in the kidney and increases penicillin excretion
2)Chronic Gout
Allopurinol
1)MOA
2)Uses
3)Toxicity
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
Etanercept
1)MOA
2)Uses
1) Recombinant form of TNF that bind TNF-alpha

2) Rheumatoid Arthritis, Psoriasis, Ankylosing Spondylitis
Infliximab
1)MOA
2)Uses
1) Antibody to TNF-alpha

2) Crohn's disease, Rheumatoid Arthritis, Ankylosing Spondylitis
Cyclosporine
1)MOA
2)Uses
3)Toxicity
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
Tacrolimus
1)MOA
2)Uses
3)Toxicity
Similar to cyclosporine, it blocks IL-2 and other cytokine release

2) Potent immunosuppressant in transplant

3) Significant nephrotoxicity, peripheral neuropathy, HTN, pleural effusion
Azathioprine
1)MOA
2)Uses
3)Toxicity
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