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20 Cards in this Set
- Front
- Back
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NSAIDs
-name them(4)) -mech -special use for indomethacin -toxicity |
-ibuprofen, naproxen, indomethacin, ketorolac
-reversibly inhibit COX 1/2, block prostaglandin synth -indomethacin closes PDA tox: renal damage, aplastic anemia, GI distress, ulcers |
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COX-2 inhibitors
-name them (2) -mech -clin use |
-celecoxib, valdecoxib
-reversibly inhibit COX2 (in inflamm cells); spares COX1 (maintains gastric mucosa) -for rheumatoid and osteoarthritis |
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COX-2 inhibitor toxicity
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-increased risk of thrombosis
-less toxicity to GI mucosa |
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Acetaminophen
-mech -clin use -tox? antidote? |
-reversibly inhibits COX, mostly in CNS*
-inactivated peripherally *antipyretic, analgesic, but LACKS ANTI-INFLAMM properties -tox: overdose -hepatic necrosis (metabolite depletes tlutathione and forms toxic tissue adducts in liver) -antidote - N-acetylcysteine (regenerates glutothione) |
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Gout Drugs
name them (3) |
-Colchicine
-Probenecid -Allpurinol |
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colchicine
-clin use -mech -tox |
-for ACUTE gout
-depolymerizes MTs, impairing luekocyte chemotaxis and degranulation -tox: GI, esp if PO *indomethacin is more commonly used b/c less toxic |
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Probenecid
-clin use -mech -relation to penicillin? |
for CHRONIC gout
-inhibits reabsorption of uric acid (also inhibitos secretion of PENICILLIN) *action same in HIGH dose salicylates |
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Allopurinol
-mech -clin uses (2) |
for CHRONIC gout
-inhibits XANTHINE OXIDASE (decrease conversion of xanthine to uric acid) -also used in lymphoma nad leukemia (prevent TUMOR LYSIS-AssOCIATED URATE NEPHROPATHY) |
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Etanercept
-mech -clin use |
-recombinant form of human TNF receptor that binds TNF-alpha
-for rheumatoid arthritis, psoriasis, anklosing spondylitis |
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Infliximab
-mech -clin use -tox |
-TNF-alpha antibody
for Crohn's dz, RA, anklyosing spondylitis -tox: predisposes to infections *REACTIVATION OF LATENT TB |
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Cyclosporine
-mech (hint: involve Calcineurin) |
-binds to cyclophilins
-complex blocks differentiation and activation of T cells by inhibiting CALCINEURIN - preventing production of IL-2 and its receptor |
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Cyclosporine
-clin use |
-supporesses organ rejection s/p transplantation
-selected autoimmune d/o |
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Cyclosporine
-toxicity? prevention? |
- predisposes to viral infxns and Lymphoma
- NEPHROTOXIC (prevent with MANNITOL diuresis) |
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Tacrolimus (FK506)
-mech -clin use |
- similar to cyclosporine 0 binds to FK-binding protein, inhibits secretion of IL-2 and other cytokines
-potent immunosuppressive used in organ transplant recipients |
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Tacrolimus (FK506)
-toxicity |
SIGNIFICANT
-NEPRHOTOXICITY -PERIPHERAL NEUROPATHY -HYPERTENSION -PLEURAL EFFUSION -HYPERGLYCEMIA |
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Azathioprine
-mech (derivative of what?) |
antimetabolie derivative of 6-MP (interferes with metabolism and synthesis of nucleic acids)
-toxic to proliferating lymphocytes |
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Azathioprine
-clin use |
Kidney transplant
Autoimmune d/o (including glomerulonephritis and hemolytic anemia) |
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Azathioprine
-toxicity |
-BONE MARROW SUPPRESSION
-active metabolite marcaptopurine is metabolized by XANTHINE OXIDASE (toxic effects may be increased by allopurinol) |
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Recombinant Cytokines (1/3) - clinical uses?
1. Alesleukin (interleukin-2) 2. Erythropoietin 3. Filgrastim (granulocyte colony stim factor) 4. Sargramostim (granulocyte-macrophage colony stim factor) |
1. RCC, metastatic melanoma
2. Anemias (esp renal failure) 3. Recover of bone marrow 4. Recovery of bone marrow |
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Recombinant cytokins - clinical use? (2/2)
5. alpha-interferon 6. beta-interferon 7. gamma-interferon 8. Oprelvekin (IL-1) 9. Thrombopoietin |
5. Hep B, Hep C, Kaposi's sarcoma, leukemias, malignant melanoma
6. Multiple sclerosis 7. chronic granulomatous dz 8. thrombocytopenia 9. thrombocytopenia |
