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47 Cards in this Set
- Front
- Back
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What drug inhibits the formation of LTs by inhibiting 5-lipoxygenase?
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Zileuton
tx of COPD and asthma |
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What drug acts by blocking LT receptors?
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Zafirlukast
tx of COPD and asthma |
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What drugs have the most potent anti-inflammatory properties?
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Corticosteroids
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In the chronic proliferative phase of inflammation, tissue degeneration and fibrosis occurs why?
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Because of the lysosomal and proteosomal enzymes
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List the COX inhibitors by increasing affinity for COX2 affinity.
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Indomethacin
Aspirin Piroxicam The following are typically considered more specific: Ibuprofen Diclofenac Meloxicam Celecoxib IN ASPen, PIRates PROvide (ibuPROfen) DICed MELOns & CELEry |
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T/F
Low doses of aspirin bind covalently and reversibly inhibit COX and platelet aggregation for the life of the platelet (8-11 days). |
False!
Low doses of aspirin bind covalently and IRreversibly inhibit COX and platelet aggregation for the life of the platelet (8-11 days). |
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What is the 1st line prevention of NSAID-induced GI injury?
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Use a COX-2 specific inhibitor!
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What is the #1 drug if there is already NSAID-induced GI injury and you want to promote healing?
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PPI
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To prevent NSAID-induced GI injury, avoid concomitant use of what drug(s)?
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Anticoagulate or corticosteroid use
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How are NSAIDs used in RA?
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As an adjunct only, never 1st line. They do NOT reduce progression of joint disease in RA
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Why are NSAIDs contraindicated in pregnancy?
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CI in the 3rd trimester d/t risk of post-partum hemorrhage and delayed labor
*Decrease in PGF2alpha and causes premature PDA closure!! |
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How does chronic use of NSAIDs relate to HTN?
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Causes Na+ retention, so it may decrease the efficacy of anti-HTN diuretics.
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Why are patients with renal dysfx susceptible to nephrotoxicity with NSAIDs?
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Because decreased PG synthesis leads to decreased renal perfusion
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What NSAID is an alternate to opiods (narcotics) in post-op analgesia?
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Ketorolac
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Ketorolac should never be taken more than 5 days. Why?
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Can cause severe GI bleeding!
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Half-lifes of which NSAIDs allow for once daily dosing?
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Naproxen (14 hrs)
Piroxicam (57 hrs) Sulindac (14 hrs) Meloxicam (20 hrs) Celecoxib (11 hrs) |
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Aspirin (acetylsalicylic acid) is primarily used for its _______ effects.
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Anti-platelet
(avoid use for analgesic/anti-inflam due to GI effects) |
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In what patients is aspirin (acetylsalicylic acid) contraindicated?
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COPD/asthma (bronchoconst d/t increased LTs)
children w/ viral infections! (can cause Reye's syndrome, fatal) |
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What drug is indicated for closure of the PDA?
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Indomethacin
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Indomethacin is highly indicated in what instances?
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RA
acute gouty attack OA |
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Indomethacin has prominent __________, ____________ and __________ activity.
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Anti-inflammatory, anti-pyretic, and analgesic
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T/F
With indomethacin, you need high doses daily. |
False!
You can use low doses (25 mg) daily. |
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Piroxicam and Meloxicam are indicated in what?
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Long-term tx of:
RA OA Acute gout |
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Sulindac is indicated in what?
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Acute AND long-term tx of:
OA RA (adjunct) Bursitis Acute gouty arthritis |
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Which drug is known for its 2 active components with an extended duration of action?
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Sulindac
It is a pro-drug (t1/2 = 7 hrs) that is transformed in the liver to its sulfide metabolite (t1/2 = 18 hrs) |
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Which drug is known for concentrating in the synovial fluid?
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Diclofenac
Therefore, it is indicated in long-term tx of: OA Ankylosing spondylitis short-term tx of: Acute MSK and post-op pain considered in acute gout attacks |
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This analgesic drug is 4x more potent than Aspirin, but it has LESS efficacy. What is it?
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Diflusinal
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What drug would you give to someone who needs a chronic NSAID, but has underlying GI distress?
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Celecoxib
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NSAIDs are contraindicated in ANY underlying _________ pathology.
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Cardiac
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What is the DOC for anti-pyresis in children?
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Acetaminophen (paracetamol)
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T/F
Acetaminophen has no anti-inflammatory and no antiplatelet activity. |
True!
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T/F
Acetaminophen is one of the safest NSAIDs. |
True!
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What is the 1st line tx of an acute gouty attack?
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Immobilize!
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What are the initial DOC's in an acute gout attack?
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Indomethacin or Ibuprofen
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What drugs may also be considered in an acute gout attack (not 1st line)?
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Naproxen or Diclofenac
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Which drug for gout should you only use if the patient is non-responsive to NSAIDs?
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Colchicine
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What drug inhibits mitotic spindles?
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Colchicine
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What are the side effects of colchicine?
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It causes severe diarrhea, vomiting, and nausea. Should be avoided, and if you use it, you should only give one dose!
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What drug is used to decrease plasma uric acid (NOT in an acute gout attack) or as prophylaxis prior to a vacation?
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Allopurinol
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What drug competitively inhibits xanthine oxidase?
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Allopurinol
Xanthine oxidase catalyzes the final steps of uric acid formation |
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T/F
Allopurinol is metabolized in the liver to its active metabolite, oxypurinol. |
True!
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For which drug did Dr. Krishna say you should "go low, go slow" and why?
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Probenicid
b/c if the dose is too high you can cause nephrolithiasis |
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What drug blocks proximal tubular reabsorption of uric acid?
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Probenicid
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What drug is used to increase uric acid excretion?
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Probenicid
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What drugs should be used in patients who are unresponsive to both NSAIDs and colchicine, or in patients with polyarticular involvement?
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Corticosteroids
(intra-articular Triamcinolone or oral Prednisone) |
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What is it called when gout begins to destroy the joint?
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Tophus
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Hyperuricemia/gout may be precipitated by what type of drugs?
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Diuretics
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