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23 Cards in this Set
- Front
- Back
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COX-1 synthesizes what from what?
COX-2? |
COX-1 arachidonic acid -> homeostatic prostaglandins
COX-2 arachidonic acid to inflammatory prostaglandins |
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NSAIDS inhibit which pathway?
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both COX1 and COX 2
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fxn of COX 1 products?
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constitutively active
protection of gastic mucosa, regulation of platelet aggregation, peripheral vascular resistance, Na excretion |
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fxn of COX 2 products?
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inducible
proinflammatory: prostanoids in fibroblasts, macrophages, and other cells |
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fxn of PGE2, PGI 2 (prostacyclin)?
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proinflammatory: vasodilatation, vascular permeability, osteoclastic bone resorption
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fxn of thromboxane?
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vasoconstriction
platelet aggregation bronchoconstriction |
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what step in the prostaglandin pathway do corticosteroids inhibit?
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it induces lipocortin which blocks phospholipase A (makes arachidonic acid from membrane phospholipids)
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examples of short acting steroids?
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cortisone, cortisol
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examples of intermediate acting steroids?
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prednisone, prednisolone, methylprednisolone
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examples of long acting steroids?
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dexamethasone
betamethasone |
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corticosteroid + steroid receptor suppresses which gene?
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NFkB
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anti inflammatory actions of steroids?
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enhance: lipocortin synthesis, blocking phospholipase
suppress: proinflammatory cytokines/enzymes, neutrophil migration, lymphocyte fxn |
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side effects of steroids?
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hyperglycemia
na/fluid retention, hypertension hyperlipoproteinemia secondary adrenal insufficiency impaired growth in children redistribution of body fat (cushingoid habitus) osteoporosis myopathy impaiired wound healing avascular necrosis of bone gonadal suppression infection cataract peptic ulcer w/ NSAID altered mood acne |
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fxn of NSAIDs
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anti inflammatory (higher dose)
anti pyretic analgesic (lower dose) inhibition of COX ** acetaminophen is not anti inflammatory |
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NSAID cleared via?
protein bound or not? |
both kidney/liver
highly protein bound |
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NSAID side effect
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acute reversible renal dysfxn
interstitial nephritis GI complication - ulcer ** H pylori is not a risk factor |
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how do NSAIDs cause ulcer?
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inhibit mucous layer, bicarb secretion, cell membrane integrity, mucosal blood flow
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NSAID vs pylori ulcer
site? Sx? histo? |
NSAID vs pylori
site? gastric - duodenal Sx? aSx - pain/dyspepdia histo? no inflammation - inflammation |
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NSAID CNS side effect?
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headache, aseptic meningitis
confusion,lethargy tinnitus |
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NSAID hemat adverse effect
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impaired platelet aggregation (reversible. irreversible w/ aspirin)
anemia (GI blood loss) thrombocytopenia, neutropenia |
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NSAID hypersensitivity rxn?
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urticaria, asthma, anaphalaxis
fam Hx important happen to all NSAID |
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refecoxib (vioxx) (cox-2 inhibitor) compared to naproxen (NSAID) what was different?
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less upper GI events, but higher myocardial infarction
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celecoxib (cox-2 inhibitor) vs NSAID?
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celecoxib had fewer GI Sx.
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