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21 Cards in this Set

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Major inflamation mediator due to both COX enzymes?
generation of Prostaglanding E2
What's a COX2 selective drug currently in use?
celecoxib (celebrix)
DMARDs: Methotrexate (MTX)
anti-inflammatory drug, most widely used DMARD, immunosupression may lead to infection, lymphomas.

Combo of MTX with cyclosporine or infliximab better than MTX alone
DMARDs: Gold preparation
retard bone progression, and articular destruction.
DMARDs: Gold sodium thiomalate
i.m. gold accumulates in macrophages, depress macrophage activity, migration and immune response.

adv: dermatitis, thrombocytopenia, aplastic anemia, proteinuria.
DMARDs: drugs often given together with MTX
Leflunamide, Etanercept, infliximab, abatercept, rituximab, Anakinra
Etanercept
TNF-alpha antagonist, prevents TNF-r stimulation
Infliximab
ab to TNF-alpha
abatacept
mimics CTLA-4, works upstream of infliximab and etanercept
rituximab
CD20 ab (spec B lymphocytes)
Anakinra
IL-1-r antagonist, natural, DON'T USE WITH TNF-ALPHA BLOCKERS
DMARDs side effects
serious infections, TB reactiviation, allergic rxn, malignancies
Aspirin
IRREVERSIBLE, nonselective cox inhibitor, through aceylation.
older NSAIDS: ibuprofen, naproxen
REVERSIBLE, non selective

gastric ulcerations, bleeding, impaired kideny function
Salicylate
weak Cox inhibitor, NF-kB inhibition more important.

NF-kB normally induces IL-1, IL-6, IFN beta etc.
Celecoxib
COX-2 selective, suppose to reduce gastric damage,
Acetaminophen (Tylenol)
not part of the NSAID group. good analgesic and antipyretic. LESS EFFECTIVE AS anti-inflammatory agent.

Weak COX inhibitor. Exact mechanism might include COX-2 inhibition in the brain.
Use of IRRVERSIBLE COX inhibiotor: Aspirin
prophylactic for myocardial infarction in men and ischemic stroke in women.

Bartter's Syndrome: hyperplasia of renal JGA, increase renin, aldosterone, hypokalemia, normal BP. NSAIDS reverse these sx.

Paten Ductus arteriosus: allows duct to close without suregery.
Aspirin metabolism
dose dependant, deacylated to salicylate. Dose dependance due to saturation of conjugation pathway, glycine conjugation. >>> zero order elimination.
NSAIDS with short half life
aspirin, ibuprofen, indomethacin
NSAIDS with long half life
naproxen, phenylbutazone, salicylate.