Pharm36 Nsaids,ra,gout

Front 1

MOA of NSAIDs

Back 1

Inhibit prostaglandin synthesis by inhibiting cyclooxygenase

Front 2

Four main actions of NSAIDs

Back 2

Antiinflammatory
Analgesia
Antipyretic
Antiplatelet

Front 3

Agent used for closure of patent ductus arteriosus

Back 3

Indomethacin

Front 4

Aspirin is contraindicated in children with viral infection

Back 4

Potential development of Reye's Syndrome

Front 5

SE of Salicyclates

Back 5

Tinnitus
GI Bleeding


hypersens from ↑LTs
↑bleeding
Metabolic Acidosis
UNCOUPLERS

Front 6

NSAID also available as an opthalmic preparation

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Diclofenac
Ketoralac

Front 7

NSAID available orally, IM, and opthalmically

Back 7

Ketoralac

Front 8

NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity

Back 8

Ketoralac

Front 9

Newer NSAID that selectively inhibits COX-2

Back 9

Celecoxib

Front 10

COX2 inhibitors may have reduced risk of

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Gastric Ulcers
GI Bleeds

Front 11

COX2 inhibitors should be used cautiously in patients with

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preexisting cardiac or renal disease

Front 12

Acetaminophen only has

Back 12

Antipyretic and analgesic activity

Front 13

SE of Acetaminophen

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Hepatotoxicity

Front 14

Antidote for acetaminophen toxicity

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N-acetylcysteine

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DMARDs are slow acting drugs for

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Rheumatic Disease

Front 16

Initial DMARD of choice for patients with RA

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Methotrexate

Front 17

Drug often used in combination with TNF-α inhibitors in RA

Back 17

Methotrexate

Front 18

Causes BMS

Back 18

Methotrexate

Front 19

SE of Penicillamine

Back 19

Aplastic anemia and renal toxicity

Front 20

Inferferes with activity of T lymphocytes

Back 20

Hydroxychloroquine

Front 21

Anti-malarial drug used in RA

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Hydroxychloroquine

Front 22

SE of Hydroxychloroquine

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Retinal destruction and dermatitis

Front 23

MOA of Leflunomide (newer DMARD)

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Inhibiting dihydroorotate dehydrogenase which leads to decreased pyrimidine synthesis, decreased T cell proliferation and decreased antibody production by B cells

Front 24

Proteins that prevent action of TNFα

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Adalimumab
*Infliximab
*Etanercept

Front 25

Anti-RA drug also used in Ulcerative Colitis

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Sulfasalazine

Front 26

Anti-RA agent also used in Chron's Disease

Back 26

Infliximab

Front 27

NSAID used in Gout

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Indomethacin

Front 28

NSAID contraindicated in Gout

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Aspirin

Front 29

MOA of Colchicine (used in Acute Gout)

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selective inhibitor of microtubule assembly (M phase)

Front 30

SE of Colchicine

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Kidney and Liver toxicity
Diarrhea

Front 31

Agent used to treat Chronic Gout by increasing Uric Acid secretion and excretion

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Probenecid
Sulfinpyrazone

Front 32

Allopurinol treats Chronic Gout by decreasing uric acid production by inhibiting

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Xanthine Oxidase

Front 33

Agent used to treat Chronic Gout by increasing Uric Acid secretion and excretion

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Probenecid
Sulfinpyrazone

Front 34

Allopurinol treats Chronic Gout by decreasing uric acid production by inhibiting

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Xanthine Oxidase

Front 35

What reaction do NSAIDs inhibit?

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Conversion of Arachidonic Acid to PGs/TxA2/Prostacyclin

Front 36

NSAID with greatest antiinflammatory effect

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Indomethacin

Front 37

NSAID used for analgesic effects during surgergy

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Ketorolac

Front 38

Only NSAID which can be administered parenterally

Back 38

Ketorolac

Front 39

Primary location of COX2 expression

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Inflammatory cells, CNS

Front 40

What is the reasoning behind aspirins strong antiplatelet effects

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irreversible inhibition leads to longer inhibition of platelets

with half-life of ~10 days, reasoning why aspirin is discontinued 10 days before surgergy

Front 41

Effects of aspirin at low dose (<300)

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Antiplatelet

Front 42

Effects of Aspirin at intermediate dose (>300-2400)

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Antipyretic
Analgesic

Front 43

Effects of Aspirin at high dose

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Anti-inflammatory

Front 44

DOC closure of PDA

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Indomethacin

Front 45

DOC maintaining PDA

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Alprostadil (Prostacyclin/PGI2 analog)

Front 46

PGI2(Prostacyclin) antidote to NSAID ulcer

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Misoprostol

Front 47

Elimination of aspirin at low dose

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2-5 hours, first order kinetics

Front 48

Elimination of aspirin at high dose

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15 hours, zero order kinetics

Front 49

Acidosis/Alkalosis progression of Aspirin in toxicity

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First causes Respiratory Alkalosis then leads to metabolic acidosis

Front 50

Contraindication to Celecoxib (COX2)

Why?

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thrombosis (MI, stroke risks)

greater inhibition of prostacyclin formation than on thromboxane

Front 51

Only OTC ANALGESIC commonly available in the US

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Acetaminophen

Front 52

Acetaminophen effects are similar to what aspirin dose

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Intermediate

antipyretic and analgesic

Front 53

Antidote to Acetaminophen toxicity

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N-acetylcysteine

Front 54

Onset of action of DMARDs

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6 weeks to 6 months

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#1 RA drug

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Methotrexate

Front 56

MOA infliximab

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binds to TNF, inhibiting its action

given by injection

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MOA Etanercept

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TNF receptor analog, TNF binding to etanercept decreases binding to TNF receptors of body

given by injection

Front 58

MOA Anakinra

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IL-1 receptor anatagonist

Front 59

MOA Hydroxychloroquine

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interference of T lymphocyte activity

Front 60

function of LTB4

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chemotaxis of neutrophils and macrophages

involved in acute inflammation

Front 61

function of LTC/D/E4

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SRSA (slow reacting substance of anaphylaxis)

alteration of permeability
bronchoconstriction
increased secretion
=asthma

Front 62

Where is Uric Acid normally reabsorbed

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In proximal tubules by a general weak acid reabsorption channel

Front 63

MOA of probenecid and sulfinpyrazone

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weak acids which competatively compete with uric acid for absoprtion

in early phase can cause increased in uric acid by competing for secretion

cause decreased secretion of many other weak acids

Front 64

Why is aspirin contraindicated in Gout

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as a weak acid competatively competes with uric acid for secretion, can lead to ↑serum concentration

Front 65

Drugs used in ACUTE Gout

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Colchicine (toxicity is severe diarrhea)
Indomethacin

Front 66

Drugs used in Chronic Gout

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Probenecid
Sulfinpyrazone
Allopurinol
Febuxostat

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MOA Allopurinol

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Suicide inhibitor of Xanthine Oxidase

Front 68

Allopurinol potentially causes increased serum levels of what anticancer drugs

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6-MP
Azathioprine

Front 69

cause of Reye's Syndrome in child with viral infection

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Aspirin

Front 70

Chronic toxicity of aspirin

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Acute Renal Failure
Interstitial Nephritis
Upper GI bleeds

Front 71

Clinical benefit of COX2 selectives (Celecoxib)

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Decreased risk of GI bleeds

Front 72

Mechanism of Acetaminophen toxicity?

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Depletion of Phase II reactants (Glutathione) leading to formation of toxic tissue adducts

Front 73

Anti-TNF ABs

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Infliximab
Adalimumab