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35 Cards in this Set

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Aspirin
NSAID

*irreversibly acetylates COX
Uses/Adverse: see tables
Diclofenac
NSAID (non-selective COX inhibitors)
Etodolac
NSAID (non-selective COX inhibitors)
Ibuprofen
NSAID (non-selective COX inhibitors)
Indomethacin
NSAID (non-selective COX inhibitors)
Ketoprofen
NSAID (non-selective COX inhibitors)
Ketorolac
NSAID (non-selective COX inhibitors)
Naprozen
NSAID (non-selective COX inhibitors)
Piroxicam
NSAID (non-selective COX inhibitors)
Tolmetin
NSAID (non-selective COX inhibitors)
Celecoxib
NSAID (COX-2 Selective Inhibitors)

Uses: anti-inflam, anti-pyretic, analgesis, BUT no effect on platelet aggregation
Adverse: LESS GI effect, renal toxicity, CV thrombotic events (Rofe/Valdecoxib)
Etoricoxib
NSAID (COX-2 Selective Inhibitors)

*highest selectivity for COX2

Uses: anti-inflam, anti-pyretic, analgesis, BUT no effect on platelet aggregation
Adverse: LESS GI effect, renal toxicity, CV thrombotic events (Rofe/Valdecoxib)
Meloxicam
NSAID (COX-2 Selective Inhibitors)

*prefers COX2 but not selective

Uses: anti-inflam, anti-pyretic, analgesis, BUT no effect on platelet aggregation
Adverse: LESS GI effect, renal toxicity, CV thrombotic events (Rofe/Valdecoxib)
Acetaminophen
NOT an NSAID

*weak COX1/2 inhibitor, no anti-inflamm or anti-platelet effect
**ANALGESIC VIA COX3

Uses: mild moderate pain when there is no inflammation; DOC for osteoarthritis but not for RA, prefered in hemophilia and peptic ulcer
Adverse: safe but OD -> decrease liver fxn which is helped w/ ACETYLCYSTEINE
Methotrexate
DMARDS (1st choice demand)

*inhibits AICAR

Uses: anti-inflammatory; cancer chemotherapy
Adverse: nausea, mucosal ulcers, pseudolymphomatous rxn; Antifolate actions (help w/ leucovorine); NOT IN DESIRED PREGNANCY
Cyclophoshamide
DMARDS (cytotoxic agents)

*phosphoramide cross links DNA -> decrease replication -> decrease T/B cells

Uses: also for SLE
Adverse: infertility, bone marrow suppression, hemorrhagic cystitis, Bladder CA- from acrolein metabolite
Azathioprine
DMARDS (cytotoxic agents)

*+allopurinol to prevent increase uric acid
**decrease Ig/IL2 from B/T cells

Adverse: bone marrow suppresion, GI disturbances, increase infections, skin rash, hepatic dysfxn
Leflunomide
DMARDS (cytotoxic agents)

*only affects autoimmune T/B cells

Adverse: diarrhea, increase liver enzymes
Mycophenolate mofetil
DMARDS (cytotoxic agents)

*inhibits IMP DHG type II lymphocytes -> decrease T/B cells
Chlorambucil
DMARDS (cytotoxic agents)

*phenylacetic acid mustard cross-links DNA

Adverse: dose-related bone marrow suppression and infertility, increase risk of leukemia
Cyclosporin
DMARDS (Immunophilin ligands)

*decrease activation of NFAT ->increase TGF-B-> decrease antigen triggered signal transduction

Adverse: nephrotoxicity, tremor, HTN, hyperglycemia, hyperlipidemia, osteoporosis, hirsutism, gum hyperplasia, DECREASED bone marrow toxicity
Hydroxychloroquine
DMARDS (antimalarial drugs)

Uses: pts who did not respond to NSAIDs/salicylates
Adverse: retinopathy (scotomas, blurred vision, night blindness)
Sulfazaline
DMARDS

*reduces bone erosion

Uses: ulcerative colitis, juvenile arthritis, ankylosing spondylitis
Adverse: rash, nausea, vomit, dizziness, headaches, leucopenia
Gold sodium thiomalate
DMARDS (Gold compounds) (IM)

*inhibition of maturation of T cells/macrophages

Uses: decrease pain/joint swelling, decrease rheumatoid factor
Adverse: gi disturb, dermatitis, hephrotoxicity, thrombocytopenia, leukopenia, pancytopenia, encephalitis, exfoliative dermatitis
Auranofin
DMARDS (Gold compounds) (oral)

*inhibition of maturation of T cells/macrophages

Uses: decrease pain/joint swelling, decrease rheumatoid factor
Adverse: gi disturb, dermatitis, hephrotoxicity, thrombocytopenia, leukopenia, pancytopenia, encephalitis, exfoliative dermatitis
Adalimumab
DMARDS (anticytokine drugs - ANTI-TNF)

Uses: RA, ankylosing spondylitis, chrohn's, psoriatic arthritis
Infliximab
DMARDS (anticytokine drugs - ANTI-TNF)

Uses: RA, ankylosing spondylitis, chrohn's, psoriatic arthritis
Adverse: URT infections, nausea, headaches, drug-induced Lupus
Etanercept
DMARDS (anticytokine drugs - ANTI-TNF)

Adverse: erythema, local pain, swelling, itching
Anakinra
DMARDS (anticytokine drugs - ANTI-IL1)

Uses: decreases immunologic responses
Glucocorticoids
DMARDS / GOUT

*inhibit PLA2 -> decrease arachidonic acid -> decrease COX-2 selectively

Uses: polyarticular gout, pts w/ renal insufficiency
Adverse: fractures, infections, cataracts, patatherosclerotic heart disease
Colchicine
Drugs for Acute Gout

*binds to intracellular tubulin -> decrease neutrophil activation

Uses: gouty attack, Mediterranean fever, amyloidosis, pseudogout, biliary cirrhosis
Adverse: nausea, vomit, abdominal pain, bloody diarrhea, myelosuppression, nephrotoxicity
Allopurinol
Drugs for Chronic Gout

*non-compet. inhibitor of Xanthine Oxidase

Uses: hyperurecemia, gouty arthritis, NOT GOUTY attack
Adverse: Maculopapular rash, decrease metab. of mercaptopurine and azathioprone -> icnrease risk of gout attack in early phase treatment
Probenecid
Drugs for Chronic Gout

*inhibits anion exchanger in proximal tubule
Uses: hyperuricemia, gouty arthritis NOT attack
Adverse: inhibits tubular secretion of many weak acids: penicillins, cephalosporins, methotrexate, sulfonylureas, indomethacin; uric acid stones
Sulfinpyrazone
Drugs for Chronic Gout

*inhibits anion exchanger in proximal tubule

Adverse: ineffective in pts w/ renal insuff. GI irritation, depression of hematopoiesis, not used w/ underlying blood dyscrasias
***inhibits warfarin metabolism -> serious bleeding can occur
Rasburicase
Drugs for Chronic Gout

*reduce plasma urate levels
Uses: initial manag. of pediatric pts w/ leukemia, lymphoma, solid tumor malig.