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91 Cards in this Set
- Front
- Back
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Prostacyclins
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PGE2
PGI2 |
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Cream used to treat Osteoarthritis
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Capsaicin cream
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Mechanism of action of capsaicin cream
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Desensitizes receptors
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Aggressive therapy for Rheumatoid Arthritis
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Methotrexate
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Treatment of gout
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Colchicine
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2 Drugs to prevent gout
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Allopurinol
Probenecid |
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Enzyme metabolizing Phospholipids to arachidonic acid
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Phopholipase A2
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Cyclooxygenases produce what two products?
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1. Prostaglandins
2. Thromboxanes |
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PGE and PGI2 effect on blood pressure
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Decrease BP
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TXA2 effect on blood pressure
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Increase BP
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PGE and PGI2 effect on coronary vessels
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Dilate coronary vessels
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TXA2 effect on coronary vessels
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Constricts coronary vessels
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TXA2 effect on platelet aggregation
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Stimulates platelet aggregation
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PGI2 (prostacyclin) effect on platelet aggregation
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Inhibits platelet aggregation
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Drug used to maintain patency of patent ductus arteriosus
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Alprostadil (PGE1)
To maintain maternal/fetal blood flow |
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PGE and PGI2 effects on renal vessels
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Renal vasodilation
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PGE and PGI2 effects on renin
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Increase renin release
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PGE and PGI2 effects on bronchioles
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Dilation of bronchioles
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TXA2 and PGF2alpha effects on bronchioles
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Constricts bronchioles
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PGE2 and PGI2 effect on gastric acid secretion
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Inhibits gastric acid secretion
Protective of gut |
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PGE and PGI2 effect on mucous secretions in gut
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Increased mucous secretions in gut
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Misoprostol
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PGE1 analog
Promote ulcer healing Gastric protection |
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PGE2 effects on non pregnant uterus
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Relax non-pregnant uterus
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PGE2 effect on pregnant uterus
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Contract pregnant uterus
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PGF2alpha effect on nonpregnant uterus
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Contracts non-pregnant uterus
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PGF2alpha effect on pregnant uterus
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Contracts pregnant uterus
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PGF2alpha effect on corpus luteum
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Lysis of corpus luteum
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PGE2 and PGF2alpha main use in childbirth:
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Control post-partum hemorrhage
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Carboprost tromethamine
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Drug for parturition
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Dinoprostone
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Induce labor by promoting ripening and dilation of cervix
PGE2 |
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Central administration of PGs into hypothalamus induces what?
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Fever
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Improve harvesting and storage of platelets
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PGG
PGI2 |
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Epoprostenol
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PGI2
Dilate pulmonary vessels |
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Alprostadil
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Maintenance of PDA
PGE2 |
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Zafirlukast
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LTC4 and LTD4 actions blocked at cys-LT1 receptor
LT receptor antagonist Treatment of asthma |
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Montelukast
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LTC4 and LTD4 actions blocked at cys-LT1 receptor
LT receptor antagonist Treatment of asthma |
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Activation of what receptor by Leukotrienes causes bronchoconstriction
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cys-LT1 receptor
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Which pathway of AA metabolism produces leukotrienes
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Lipoxygenase pathway
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Why no tolerance development with ASA?
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Binding enzyme activity
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NSAIDS block what enzymes?
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COX1 and COX2
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NSAIDS treat what part of the diseas?
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Only the symptoms, not the underlying cause of disease
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ASA is purified from what plant?
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Willow bark
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81 mg baby ASA administered for:
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MI prophylaxis by reducing platelet aggregation
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ASA must be avoided in which subset of women?
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Pregnant in 3rd trimester
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ASA can cause what disease in children/young adults?
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Reyes Syndrome
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Respiratory effect of toxic ASA
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True metabolic acidosis
Directly depresses respiration causes increase in CO2 Displacement of bicarbonate Decreased excretion of organic acids |
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Respiratory effect of therapeutic dose of ASA
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Respiratory alkalosis
Directly stimulates respiration causes increased O2 consumption and CO2 production Compensate with increased renal excretion of bicarbonate |
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APAP does/does not have anti-inflammatory actions
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Does not have anti-inflammatory actions
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APAP
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Analgesic and Antipyretic
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Overdose of APAP leads to
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Fatal hepatic necrosis
Liver toxicity |
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Liver toxicity with APAP can occur in what conditions of glutathione?
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Low glutathione
Produces free radical adduct that destroys hepatocytes |
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Treatment of APAP poisoning
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N-acetylcysteine
Recycles glutathione |
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Cox2 is constitutive or inducible?
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Inducible
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Cox1 is constitutivce or inducible?
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Constitutive
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2 functions of Cox1
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1. Electrolyte balance in kidney
2. Cytoprotection of gastric mucosa |
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Function of Cox2
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Induced inflammation
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Celecoxib
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COX2 inhibitor
Sulfa containing (CI in Sulfa sensitive patients) |
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Side effect of COX2 inhibitors
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Increased MI's
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COX2 produces what in endothelial cells?
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Prostacyclin (PGE2, PGI2)
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Effects of prostacyclin induced by COX2 (2 effects)
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1. Vasodilation
2. Block platelet aggregation |
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COX1 produces what in platelets
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Thromboxanes (TXA2)
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Effect of TXA2 induced by COX1 (2 effects)
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1. Vasoconstriction
2. Platelet aggregation |
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Disease Modifying Antirheumatic Drugs (DMARDS): List 4
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1. Azathioprine
2. Methotrexate 3. Leflunomide 4. Penicillamine |
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Mechanism of action of DMARDS
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Anti-cancer drugs therefore suppress cellular proliferation
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Serious side effect of DMARDS
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Infection secondary to immunosuppression
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DMARDS does/does not treat the underlying disease
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Yes
Attenuate both inflammation and destructive process |
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DMARDS can/cannot be used continuously?
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Must be stopped in 1-2 years (2-4 for MTX)
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NSAIDS can/cannot be used continuously?
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Can be used continuously b/c bind to enzymes
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Biological modifiers are/are not disease modifying drugs
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Yes they are disease modifying drugs
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Infiximab
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TNFalpha chimeric monoclonal antibody
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Etanercept
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Construct of TNFalpha receptor (False receptor)
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Adalimumab
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TNFalpha human monoclonal antibody
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Anakinra
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IL-1beta receptor antagonist
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Abatacept
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Costimulation modulator; fusion protein to CD4
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Rituximab
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Monoclonal antibody to CD20 on B cells
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Major side effect of biological modifiers and DMARDS
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Infection secondary to immunosuppression
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Gold compounds used in treatment of what disease?
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Rheumatoid arthritis
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Auranofin
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gold compound
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Aurothioglucose
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Gold compound
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Gold sodium thiomalate
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Gold compound
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2 causes of Hyperuricemia
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1. Increased Uric acid production
2. Decreased Uric acid excretion |
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Prostacyclins
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PGE2
PGI2 |
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Neurons in peripheral sensitization
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Small diameter sensory neurons
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Eicosanoids
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Oxygenated C20 fatty acids that are metabolites of arachidonic acid (5,8,11,14 eicosatretraenoic acid)
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Two major pathways in arachidonic acid breakdown
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1. Cyclooxygenase
2. Lipoxygenase |
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Metabolic products of cyclooxygenase
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Prostaglandins
Thromboxanes Prostacyclin |
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Metabolic products of lipoxygenases
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Leukotrienes
HPETEs HETEs Lipoxins |
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Phospholipid --> Arachidonic Acid (Enzyme?)
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Phospholipase A2
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ASA reversibly/irreversibly blocks COX enzyme?
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Irreversibly blocks
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Lipoxygenase found mostly where?
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Central Nervous System
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Eicosanoids are paracrine/autocrine/endocrine hormones?
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Paracrine/Autocrine
Are not stored, but synthesized on demand in response to hormones, drugs, or stressors |
