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24 Cards in this Set
- Front
- Back
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Aspirin mechanism
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Irreversible inhibits cycoloxygenase by covalent binding which decreases thromboxane and prostaglandin synthesis
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Aspirin mechanism
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Irreversible inhibits cycoloxygenase by covalent binding which decreases thromboxane and prostaglandin synthesis
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Clinical use of aspirin
Low dose Intermediate dose High dose |
Low dose (<300mg) used for decr platelet aggregation
Intermediate dose (300-2400mg): antipyretic and analgesic High dose (2400-4000mg): antiinflammatory |
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Toxicity of aspirin
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GI upset
Chronic use can lead to ARF, interstitial nephritis, upper GI bleeding Reye's syndrome in children w/viral infx |
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NSAIDs mechanism
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Ibuprofen, naproxen, indomethacin, ketorolac
Reversible inhibit cyrlocoxygenase (both COX1 and 2) Block prostaglandin synthesis |
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Clincal use of Nsaids
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Antipyretic
Analgesic Antiinflammatory |
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Toxicity of NSAIDs
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Renal damage
Aplastic anemia GI distress Ulcers |
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Celecoxib mechanism
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Reversibly inhibits COX2 found in inflammatory cells and vascular endothelium (mediates inflammation and pain); spares COX1 (which helps maintain gastric mucosa)
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Clinical use of celecoxib
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Rheumatoid and osteoarthritis
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Toxicity of celecoxib
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Incr risk of thrombosis
Sulfa allergy |
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Acetaminophen mechanism
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Reversibly inhibits cyclooxygenase mostly in the CNS; inactivate dperipherally
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Acetaminophen clinical use
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Antipyretic, analgesic
No antiinflammatory properties |
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Acetaminophen toxicity
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Overdose produces hepatic necrosis (metabolite depletes glutathione and forms toxic tissue adducts in liver)
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NSAID+antiplatelet activity
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Aspirin
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NSAID minus antiinflammatory activity
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Acetimenophen
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Bisphosphanates
(a) name (b) mechanism (c) clinical use (d) toxicity |
(a) etidronate, pamidronate, alendronate, risendronate
(b) inhibit osteoclastic activityl reduce both formation and resorption of hydroxyappetite (c) corrosive esophagitis, nausea, diarrhea |
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Colchicine
(a) clinical use (b) mechanism (c) toxicity |
(a) acute gout
(b) binds and stabilizes tubulin to inhibit polymerization of microtubules; impairs leukocyte chemotaxis and degranulation (c) Gi side effects esp orally |
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What other medication is used for acute gouty arthritis attacks?
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Indomethacin
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Probenecid
(a) clinical use (b) mechanism |
(a) chronic gout
(b) inhibits reabsorption of uric acid in PCT |
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Allopurinol
(a) clinical use (b) mechanism |
(a) chronic gout; also used in lymphoma and leukemia to prevent tumor lysis associated urate nephropathy
(b) inhibit xanthine oxidase to decrease conversion of xanthine to uric acid |
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What is the effect of allopurinol on azathioprine and 6-MP?
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Increase concentrations b/c both are normally metabolized by xanthine oxidase
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What medications should you not give to a gout patient?
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Salicylates
All but the highest doses depress uric acid clearance. |
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Etanercept
(a) mechanism (c) clinical use |
(a) recombinant form of TNF receptor that binds free TNF
(b) Rheumatoid arthritis, psoriasis, ankylosing spondylitis |
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Infliximab
(a) mechanism (b) clinical use |
(a) Anti TNF antibody
(b) chron's disease, RA, anklyosing spondylitis |
