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226 Cards in this Set
- Front
- Back
|
examples of asthma drugs
Glucocorticoids |
BECLOMETHASONE
fluticasone PREDNISONE |
|
|
examples of asthma drugs
Mast Cell Stablizers |
CROMOLYN SODIUM
|
|
|
examples of asthma drugs
CROMOLYN SODIUM |
Mast Cell Stablizers
|
|
|
examples of asthma drugs
Leukotriene Inhibitors |
MONTELUKAST (SINGULAIR)
ZILEUTON Zarkulast |
|
|
examples of asthma drugs
Selective beta2-Adrenergic Receptor Agonists |
ALBUTEROL
EPINEPHRINE terbuteline salmeterol |
|
|
examples of asthma drugs
"Other" Bronchodilators |
IPRATROPIUM
THEOPHYLLINE |
|
|
examples of asthma drugs
Immunoglobulin Antagonist |
OMALIZUMAB (XOLAIR)
|
|
|
examples of asthma drugs
Antitussives |
CODEINE
dextromethorphan |
|
|
examples of asthma drugs
Expectorants |
GUAIFENESIN
IODINE water |
|
|
examples of asthma drugs
Antihistamines |
FEXOFENADINE
DIPHENHYDRAMINE |
|
|
General class of drug
BECLOMETHASONE |
Anti-inflammatory Drugs
Glucocorticoids |
|
|
General class of drug
CROMOLYN SODIUM |
Anti-inflammatory Drugs
Mast Cell Stablizers |
|
|
General class of drug
MONTELUKAST |
Anti-inflammatory Drugs
Leukotriene Inhibitors |
|
|
General class of drug
ZILEUTON |
Anti-inflammatory Drugs
Leukotriene Inhibitors |
|
|
General class of drug
fluticasone |
Anti-inflammatory Drugs
Glucocorticoids |
|
|
General class of drug
PREDNISONE |
Anti-inflammatory Drugs
Glucocorticoids |
|
|
General class of drug
ALBUTEROL |
Bronchodilators
Selective beta2-Adrenergic Receptor Agonists |
|
|
General class of drug
terbuteline |
Bronchodilators
Selective beta2-Adrenergic Receptor Agonists |
|
|
General class of drug
salmeterol |
Bronchodilators
Selective beta2-Adrenergic Receptor Agonists |
|
|
General class of drug
IPRATROPIUM |
Bronchodilators
Anticholinergic drugs |
|
|
General class of drug
THEOPHYLLINE |
Bronchodilators
Non-Selective PDE Inhibitor |
|
|
General class of drug
OMALIZUMAB (XOLAIR) |
Immunoglobulin Antagonist
|
|
|
General class of drug
CODEINE |
Antitussives
|
|
|
General class of drug
dextromethorphan |
Antitussives
|
|
|
General class of drug
GUAIFENESIN |
Expectorants
|
|
|
General class of drug
IODINE |
Expectorants
|
|
|
General class of drug
FEXOFENADINE |
Antihistamines
|
|
|
General class of drug
DIPHENHYDRAMINE |
Antihistamines
|
|
|
Broncodilators mechs
|
-beta 2 agonists increases CAMP
-Theophyline increases CAMP to 5'AMP -IPRATROPIUM blocks Ach via M3 receptor stimulation leading to decrease in cytosolic Ca |
|
|
besides smooth muscle relaxation what else do beta 2 agonists do for asthma patients
|
-stimulation of mucociliary
decreae muscle hypertrophy and hyperplasia -inhibit inflammatory cells -increase in NO |
|
|
What mediates the helpful effects of the beta 2 agonists
|
cAMP
|
|
|
what is the long acting beta2 agonist? Time?
|
Salmeterol
12 Hours |
|
|
Selective β2 adrenergic agonists
Major side effects |
tremor
|
|
|
Bronchodilators
what are the anticholinergics used for |
usually COPD, not asthma
|
|
|
Theophylline
prototype of wwhat drug class |
Methylxanthine
Non-selective PDE inhibitor |
|
|
Adverse effects may be related to PDE3 inhibition
|
Theophylline: and all other Methylxanthines
|
|
|
why do you need to monitor blood levels of Theophylline
|
-Drug and food interactions
-Wide blood level variation (i.e., elderly, smokers) |
|
|
Theophylline
toxicity effects in order as dose increases |
-GI Upset and
-nervousness -Arrthythmias -Convulsions |
|
|
Factors affecting theophylline clearance
|
clearance increased by: young, cigarrete smoking, pregnancy, OCP
Decreased by :old age, Liver disease, Alcoholism, Fever, Viral, infection, drugs, CHF, obesity |
|
|
Factors affecting theophylline clearance
specific Drugs |
ALL DECREASE CLEARANCE
Cimetidine Allopurinol Propranolol Macrolide antibotics |
|
|
Cromolyn Sodium
MOA |
-affects delayed chloride channels in cell membranes
-inhibits Ca++ influx |
|
|
Cromolyn Sodium
cellular effects |
airway nerves → ↓inhibit cough
↓inflammatory mediators ↓ eosinophil infiltration |
|
|
Zafirlukast
moa |
-Inhibition of leukotrienes
-↓ both early and late inflammatory phases |
|
|
Zafirlukast
adverse effects |
headache
nausea & diarrhea infection |
|
|
zileuton
moa |
-Inhibition of leukotrienes
-selective 5 - lipoxygenase inhibitor |
|
|
zileuton
adverse effects |
hepatic toxicity
headache dyspepsia |
|
|
Omalizumab
moa |
antibody blocks only the specific region of IgE that binds to mast cells
|
|
|
Omalizumab
how administered |
Not orally active – requires SC administration every 2-4 weeks
|
|
|
Omalizumab
adverse effects |
-headache
-viral infection -thrombocytopenia? -allergic reactions |
|
|
No other expectorant is superior
|
water
|
|
|
Oral mucokinetic agents
|
-potassium iodide
-guaifenesin (glyceryl guaiacolate) |
|
|
dornase alpha
class |
Expectorants
|
|
|
dornase alpha
moa |
recombinant human deoxyribonuclease (rhDNase)
Mechanism of action dornase decrease sputrum viscosity by cleaving extracellular DNA into smaller fragments |
|
|
dornase alpha
Therapeutic use |
-cystic fibrosis
-chronic bronchitis |
|
|
dornase alpha
Adverse effects |
-coughing and wheezing
-hemoptysis -pharyngitis |
|
|
antibodies to ?????? have not been detected
drug for CF |
dornase alpha
|
|
|
Autacoids and Antihistamines
Name the H1 receptor antagonists |
DIPHENHYDRAMINE
CHLORPHENIRAMINE FEXOFENADINE |
|
|
Autacoids and Antihistamines
Name the H2 receptor antagonists |
CIMETADINE and others
|
|
|
Autacoids and Antihistamines
Name the 5-HT agonists |
BUSPIRONE
sumatriptan tegaserod |
|
|
Autacoids and Antihistamines
Name the 5-HT antagonists |
clozapine
cyproheptadine ONDANSETRON METHYSERGIDE |
|
|
General class of drug
DIPHENHYDRAMINE |
Autacoids and Antihistamines
H1 receptor antagonists |
|
|
Autacoids and Antihistamines
Name the Endothelin-1 Antagonists |
BOSENTAN
|
|
|
Autacoids and Antihistamines
Name the Prostaglandins |
ALPROSTADIL
CARBOPROST MISOPROSTAL DINOPROSTONE EPOPROSTANOL latanoprost |
|
|
General class of drug
CHLORPHENIRAMINE |
Autacoids and Antihistamines
H1 receptor antagonists |
|
|
General class of drug
FEXOFENADINE |
Autacoids and Antihistamines
H1 receptor antagonists |
|
|
General class of drug
CIMETADINE |
Autacoids and Antihistamines
H2 receptor antagonists |
|
|
General class of drug
BUSPIRONE |
Autacoids and Antihistamines
5-HT agonists |
|
|
General class of drug
ONDANSETRON |
Autacoids and Antihistamines
5-HT antagonists |
|
|
General class of drug
METHYSERGIDE |
Autacoids and Antihistamines
5-HT antagonists |
|
|
General class of drug
ALPROSTADIL |
Autacoids and Antihistamines
Prostaglandins |
|
|
General class of drug
CARBOPROST |
Autacoids and Antihistamines
Prostaglandins |
|
|
General class of drug
MISOPROSTAL |
Autacoids and Antihistamines
Prostaglandins |
|
|
General class of drug DINOPROSTONE
|
Autacoids and Antihistamines
Prostaglandins |
|
|
General class of drug EPOPROSTANOL
|
Autacoids and Antihistamines
Prostaglandins |
|
|
General class of drug
BOSENTAN |
Autacoids and Antihistamines
Endothelin-1 Antagonists |
|
|
Physiologic role
H1 receptors |
-Allergy
-inflammation -Tissue growth, wound healing, keloid and scar formation -Urticaria -Cough reflex |
|
|
Physiologic role
H2 receptors |
-Allergy
-inflammation -Gastric acid secretion |
|
|
Physiologic role
H3 receptors |
↑ presynaptic receptors to ↓ neurotransmitter release
|
|
|
different H receptors are coupled to
|
-H1 receptors are coupled to inositol triphosphate (IP3) and diacylglycerol (DAC).
-H2 receptors activate G-proteins to increase adenyl cylase activity -H3 receptors are primarily presynaptic and coupled to G-proteins |
|
|
Antihistamines
Mechanism of Action Unrelated to H1-receptor blockade |
-Blockade of cholinergic muscarinic receptors (dose-dependent)
-Local anesthesia -Cardiac effects (membrane stabilizing) -Alpha-adrenergic receptor blockade promethazine |
|
|
Antihistamines
Adverse Effects |
-CNS
-GI tract -atropine-like effects -allergy: usually from topical application -teratogenesis: piperazines |
|
|
Antihistamines
drug interaction |
with erythromycin and ketoconazole causes torsade de pointe
|
|
|
Antihistamines
acute poisoning |
ANTICHOLINERGIC effects (hot as a here ...)
kids go up then down adults just go down |
|
|
Antihistamines
acute poisoning Tx |
-Generally supportive
-Physostigmine to counter the central anti-cholinergic actions |
|
|
Antihistamines
some lesser known uses |
-Parkinsonism
-petit mal seizures -local anesthesia |
|
|
Antagonists of H2-receptors
clinical uses |
primarily duodenal ulcer
|
|
|
Eicosanoids
Therapeutic Uses |
OB
Vascular disease CABG Broncospasm ED ... |
|
|
Bosentan
moa |
Endothelin-1 Antagonists
ETA and ETB antagonist |
|
|
Bosentan
Therapeutic use |
-pulmonary hypertension
-coronary reperfusion |
|
|
Drug for
pulmonary hypertension coronary reperfusion |
Bosentan
|
|
|
Bosentan
Adverse effects |
-hepatotoxic
-birth defects |
|
|
Drugs for Migraine Headaches
classes that abort |
-5-HT1D/1B agonists
-MISC |
|
|
5-Hydroxytryptamine (5-HT)
aka |
serotonin
|
|
|
serotonin
aka |
5-Hydroxytryptamine (5-HT)
|
|
|
5-Hydroxytryptamine (5-HT)
function |
5-HT1 receptors:presynaptic effects, vasoconstriction
5-HT2 receptors: vasoconstriction, antiplatelet effects |
|
|
methysergide
|
nonselective inhibition of vasoconstrictor and pressor actions of 5-HT. It also is a partial agonist
|
|
|
nonselective inhibition of vasoconstrictor and pressor actions of 5-HT. It also is a partial agonist
|
methysergide
|
|
|
cyproheptadine
|
nonselective antagonizism of the effects of 5-HT on smooth muscle. Also blocks H1 and muscarinic receptors
|
|
|
nonselective antagonizism of the effects of 5-HT on smooth muscle. Also blocks H1 and muscarinic receptors
|
cyproheptadine
|
|
|
Ergot Alkaloids
Pharmacokinetics |
-Poorly and irregularly absorbed from the GI tract due to high molecular weight
-Probably metabolized in the liver |
|
|
Ergot Alkaloids
uses wrt preg |
-uterus at term is very sensitive
-long sustained contractions are not suitable for induction of labor -ergonovine and methylergonovine are used to control post partum hemorrhage |
|
|
Adverse effects of ergotamine
|
-GI
-arteriospastic effects -muscle weakness -hypersensitivity – localized edema and itching |
|
|
Triptans
name |
Sumatriptan
|
|
|
Short DOA → rebound headaches
|
Sumatriptan
|
|
|
name the
5-HT1D/1B agonists and there uses |
Buspirone – antidepressant
SSRIs Sumatriptan – migraine Ergot alkaloids - migraine and post partum bleeding Tegaserod –IBS |
|
|
name the 5-HT Drugs
Antagonists and there uses |
-Clozapine – antipsychotic
-Cyproheptadine – also H1 antagonist -Methysergide – migraine -Ondansetron – antiemetic -ketanserin - HTN |
|
|
Migraine
DOC for acute attacks |
ergotamine
|
|
|
ergotamine is effective in terminating migranes because
|
-Vasoconstriction (partial agonist activity)
-Presynaptic effects ↓ release of inflammatory and pain peptides |
|
|
-prazole
|
Proton pump inhibitors
|
|
|
PPI
name them |
omeprazole, lansoprazole, rabeprazole, esomeprazole and pantoprazole
|
|
|
name the
H2-receptor antagonists |
cimetidine,
.... -tidine |
|
|
cimetidine,
.... -tidine |
H2-receptor antagonists
|
|
|
name the M1-muscarinic receptor antagonists
|
-antheline
and -ZEPINE |
|
|
name the
Laxatives: |
castor oil,
emodin alkaloids phenolphthalein, bisacodyl Bulk forming laxatives |
|
|
name the Stool softeners
|
docusate,
glycerin suppositories, mineral oil |
|
|
name the Opioids Antidiarrheals
|
diphenoxylate,
loperamide, difenoxin, paregoric |
|
|
name the Absorbants Antidiarrheals
|
bismuth subsalicylate,
kaolin, pectin |
|
|
name the Emetics:
|
ipecac, apomorphine
|
|
|
name the Antiemetics:
|
scopolamine, dimenhydrinate, meclizine, cyclizine, dronabinol, ondansetron, granisetron
|
|
|
name the Gastrointestinal reflux disease drugs (not PPI H2 blocker or ntacid)
|
metoclopramide, cisapride
|
|
|
name the Inflammatory Bowel Disease drugs
|
5-aminosalicylic preparations: sulfasalazine, olsalazine, mesalamine (several formulations).
Corticosteroids: hydrocortisone, prednisone. |
|
|
name the Anticholelithics
|
ursodiol, chenodiol, monoctanoin
|
|
|
name the IBS drugs
|
tegaserod,
alosetron |
|
|
Gastric acid secretion by the parietal cell is under the control of 3 agonists:
|
histamine
Ach gastrin |
|
|
PPI MOA
|
oxidizes - SH groups in the pump after it is converted to the sulfenamide derivative. It inhibits acid secretion elicited by every stimulus, irreversible.
|
|
|
Drug of choice for Zollinger-Ellison syndrome
|
Omeprazole
|
|
|
Most effective drugs for treating gastroesophageal reflux disease
|
PPI
|
|
|
-tidine
side effects |
reduce male sexual function
gynecomastia menstrual disorders |
|
|
Misoprostol
moa |
Agents that Increase Resistance of Mucosa to Acid-Peptic Digestion
-prostaglandin E1 analog |
|
|
Sucralfate
moa |
Agents that Increase Resistance of Mucosa to Acid-Peptic
-residual compound becomes negative and polymerizes to form a viscous paste |
|
|
Colloidal Bismuth subsalicylate
moa |
bismuth subsalicylate reacts with hydrochloric acid to form bismuth oxychloride and salicylic acid
|
|
|
Triple-drug therapy treatment recommended for H. pylori infection
drugs |
1.Bismuth subsalicylate (Pepto-Bismol)
2. Metronidazole (Flagyl) 3. Tetracycline or amoxicillin (Amoxil, Wymox) |
|
|
Helidac -
|
three tablets (Triple-drug therapy treatment recommended for H. pylori )
|
|
|
Systemic Antacids
|
Sodium bicarbonate, sodium citrate
|
|
|
Systemic Antacids
adverse effects |
-alkalosis
-urinary tract infection by altering urinary pH. |
|
|
Calcium Carbonate
Adverse effects |
hypercalcemia
|
|
|
Magnesium hydroxide
Adverse effects |
diarrhea
|
|
|
Aluminum hydroxide
uses |
antacid
|
|
|
Aluminum hydroxide
Adverse effects |
constipation
|
|
|
Milk-Alkali Syndrome
|
Systemic antacids and large amounts of milk produce headache, weakness, nausea, and vomiting. Hypercalcemia, mild alkalosis stone formation in kidney, calcification-renal failure.
|
|
|
Bisacodyl
uses |
laxatives
|
|
|
Irritant or stimulant laxatives
|
Emodin
Danthron Cascara sagrada Senna Aloe Rhubarb |
|
|
Objectionable taste; strong cathartic effect; metabolized like other fatty acids.
|
Castor Oil
|
|
|
Active component is ricinoleic acid an anionic surfactant. It is present as a triglyceride that is hydrolyzed by pancreatic lipase to yield ricinoleic acid. Action in small bowel action within 2 hours.
|
Castor Oil
|
|
|
laxative that When given orally active after deacetylation by bacteria.
|
Bisacodyl
|
|
|
Isosmotic solution of polyethylene glycol, used as a colonic lavage solution in preparation for radiologic and endoscopic procedures.
|
Polyethylene glycol
|
|
|
Polyethylene glycol
uses |
used as a colonic lavage solution in preparation for radiologic and endoscopic procedures.
|
|
|
Absorbs liquid in intestines and swells to form soft bulky stool. Bulky mass stimulates intestinal muscles speeding stool transit through colon. Need fluid intake to work.
|
Polycarbophil
|
|
|
Side Effects of Laxatives
|
1.Cathartic colon syndrome
2. Addiction 3. hypokalemia 4. malabsorbtion 5. liver probs |
|
|
Diarrhea Tx
|
1.replace fluid and electrolytes
2.reduce water in stools and increase absorption 3.drugs |
|
|
liquid and solid preparation, effective against "traveler's diarrhea" - absorbs enterotoxins from E. coli. Antimicrobial action against E. coli inhibits PG production and cAMP levels
|
Pepto-Bismol, bismuth subsalicylate
|
|
|
kaolin/pectin
moa |
Antidiarrheal effect of opiates related to effects on smooth muscle and mucosa increasing electrolyte transport.
|
|
|
Opiates anti diarrheal
moa |
Nerve plexuses within bowel wall inhibiting release of acetylcholine. Enkephalin receptors found in CNS and gastrointestinal tract - µ receptors
|
|
|
major metabolite of diphenoxylate, 5 times more potent, action on CNS side effect
|
Difenoxin
|
|
|
(Lomotil combined with atropine) analog of meperidine (Demerol) similar actions to morphine. No analgesic activity in therapeutic range.
|
Diphenoxylate
|
|
|
opiate analog, effects on gastrointestinal motility similar to those of morphine. Acts on opiate receptors (naloxone blocks)
|
Loperamide
|
|
|
Loperamide wrt adiction
|
-no analgesic activity
-no CNS effect -used chronically (1 year) no tolerance or dependence; only minor side effects |
|
|
Ipecac
moa |
chemoreceptor trigger zone (CTZ) in the fourth ventricle of the brain,
|
|
|
Ipecac timing
|
it has a delayed onset of action.
Vomiting in 85% of patients within 20 min. |
|
|
Apomorphine
uses |
Emetics
|
|
|
Apomorphine
moa |
It also acts on the CTZ but since it is given by injection
|
|
|
Apomorphine
timing |
It also acts on the CTZ but since it is given by injection (subcutaneously) it has an onset of action of a few minutes
|
|
|
Apomorphine
other use |
Dopamine analog, also used to treat Parkinson's disease.
|
|
|
Scopolamine:
moa |
An anticholinergic agent
|
|
|
are usually employed to treat postoperative nausea and vomiting, as well as that induced by radiation therapy. Oral also rectal and IV.
|
Phenothiazines e.g., chlorpromazine (Thorazine)
|
|
|
Treating anorexia associated with weight loss in AIDS patients. Acts on vomiting center, mechanism unknown.
|
Cannabinoids
|
|
|
Ondansetron (ZOFRAN), granisetron (KYTRIL).
moa |
antiemitic
5-HT3 antagonists |
|
|
Given orally or IV before cancer chemotherapy, well tolerated. Metabolized in liver. Selectively blocks 5-HT3 receptors in the periphery and the brain (chemoreceptor trigger zone).
|
5-HT3 antagonists. Ondansetron (ZOFRAN), granisetron (KYTRIL).
|
|
|
Metoclopramide
moa |
GERD
Increase tone of esophageal sphincter |
|
|
Metoclopramide
adverse effects |
-Increase sensitivity of intestinal smooth muscle to acetylcholine;
-can cause diarrhea. |
|
|
Cisapride
moa |
GERD
Increases contractility of intestinal musculature, gastric and lower esophageal sphincter tone and esophageal motility |
|
|
themes in therapy of Chronic Inflammatory Bowel Disease (ulcerative colitis, Chron’s disease).
|
Treatment involves use of salicylate derivatives, corticosteroids and immunosuppressive agents.
|
|
|
Inhibit prostaglandin and leukotriene formation. High doses cause upper gastrointestinal tract irritation. Several preparations available.
|
Mesalamine
|
|
|
Salicylates
|
Mesalamine preparatins (Asacol
Pentasa Rowasa) |
|
|
Mesalamine aka
|
5-ASA
|
|
|
Mesalamine
uses of |
XIII.Chronic Inflammatory Bowel Disease (ulcerative colitis, Chron’s disease).
Treatment involves use of salicylate derivatives, |
|
|
Mesalamine
adverse effects |
watery diarrhea,
some nephrotoxicity and pancreatitis. |
|
|
After oral administration about one-third is absorbed from the small intestine. The remaining two-thirds pass to the colon where the azo bond in the compound is split by intestinal bacteria into 5-ASA and sulfapyridine.
|
Sulfasalazine
|
|
|
Sulfasalazine
adverse effects |
Most of the sulfapyridine is absorbed and about one-third of the 5-ASA is absorbed, the remainder ends up in feces. Sulfapyridine can cause significant toxicity:
-bone marrow suppression, -liver failure, -impair male fertility. |
|
|
links two 5-ASA molecules via an azo bond that is broken down by bacteria in the colon to release 5-ASA
|
Olsalazine
|
|
|
Olsalazine absorbtion
|
After oral administration only 2% of olsalazine enters the circulation, the remainder reaches the colon.
|
|
|
Infliximab
moa |
Chimeric IgG monoclonal antibody for the treatment of Crohn’s disease. Neutralizes the biological activity of TNF-.
|
|
|
Infliximab
adverse reactions |
- infusion reactions
-infections. |
|
|
Drugs for dissolution of gallstones (anticholelithics).
|
Chenodiol, chenodeoxycholic acid (Chenix) and ursodiol, ursodeoxycholic acid the 7-epimer of chenodiol (Actigall) are effective at dissolving stones in some patients. Oral.
|
|
|
Chenodiol
moa |
inhibits 3-hydroxy-3-methylglutaryl-CoA reductase, rate limiting enzyme in the synthesis of cholesterol in the liver
|
|
|
Chenodiol
adverse effects |
Requires long term treatment (2 years). Adverse side effect is diarrhea in 30% of patients.
|
|
|
Ursodiol
moa |
inhibits intestinal absorption of dietary and biliary cholesterol. Also promotes mobilization of cholesterol from gallstones.
|
|
|
Ursodiol
adverse effects |
Less diarrhea than chenodiol.
|
|
|
infused (24 hours) into common bile duct to dissolve retained bile duct stones. The remaining 20% is other fatty acid esters and glycerol
|
Monoctanoin
|
|
|
Monoctanoin
adverse effects |
. Fatigue,
abdominal pain, nausea, vomiting, diarrhea pruritus. |
|
|
is for the short-term treatment of women who have IBS with constipation
|
Tegaserod maleate
|
|
|
Tegaserod maleate
uses |
women who have IBS with constipation
|
|
|
Alosetron
uses |
Irritable bowel syndrome (IBS) with diarrhea
|
|
|
drug for Irritable bowel syndrome (IBS) with diarrhea
|
Alosetron
|
|
|
Name the Nonsteroidal Anti-inflammatory Drugs
nonselective |
Aspirin
Ibuprofin Naproxen Ketolac |
|
|
Name the COX-2
|
Celecoxib
|
|
|
Name the COX-3
|
Acetomenophin
|
|
|
Name the DMARDS
|
Methotrexate
Hydroxychloroquine Etanercept Infliximab sulfasalazine |
|
|
Name the drugs to prevent gout attacks
|
probenacid
sulinpyrazole allopuranol |
|
|
Name the to Tx gout attacks
|
colchicine
NSAIDs (indomethicin) |
|
|
NSAIDs
Other Adverse Effects |
dyspepsia
Analgesic or urate nephropathy Inhibition of renal PG’s Asthma Skin rashTinnitus Headache, drowsiness, dizziness, fatigue Reye’s syndrome |
|
|
Aspirin:
Treatment of Overdose |
Induce vomiting/gavage
NaHCO3 IV Counteract metabolic acidosis |
|
|
Acetaminophen
interactions |
acetaminophen/warfarin
acetaminophen/alcohol |
|
|
acetaminophen/alcohol
effects |
intermediate metabolite NAPQI bulds up bc increased P450 action and decreased amount of glutathione
|
|
|
Single most effective DMARD
|
Methotrexate
|
|
|
Methotrexate
moa |
↓ folate reductase
↓ lymphocyte proliferation ↓ cytokines and rheumatoid factor production ↓ leucocyte chemotaxis ↓ production of free radicals and other cytotoxins |
|
|
Methotrexate
adverse effects |
Hepatoxicity, bone marrow suppression, teratogenic
|
|
|
Methotrexate
class of drug |
DMARDS
-Antineoplastic and immunomodulatory |
|
|
etanercept
moa |
DMARD
Immunomodulators – human TNF receptor + Fc fragments of IgG Bind to and ↓ TNF |
|
|
infliximab
moa |
DMARD
Immunomodulators monoclonal Ab for TNF Bind to and ↓ TNF |
|
|
adalimumab
moa |
DMARD
Immunomodulators monoclonal Ab for TNF Bind to and ↓ TNF |
|
|
Least toxic DMARD but slow onset > 6 mo
|
Hydroxychloroquine
|
|
|
↓ lymphocytes, PMN’s, superoxide radicals
G6PD deficiency → hemolytic anemia Retinal damage in elderly |
Hydroxychloroquine
|
|
|
DMARDS
?MOA |
Sulfasalazine
|
|
|
MOA ???
Nausea, rash, G6PD deficiency → hemolytic anemia Leukopenia, hepatitis |
Sulfasalazine
|
|
|
Gold Salts
adverse effects |
Hematologic
Dermatologic GI renal |
|
|
Reduce uric acid synthesis
|
Allopurinol
-Purine (uric acid) analog inhibits xanthine oxidase |
|
|
Allopurinol
adverse effects |
Nausea,
vomiting, hypersensitivity hepatitis, skin rash |
|
|
inhibit reabsorption of uric acid by renal tubules
|
probenecid,and sulfinpyrazone
|
|
|
probenecid
moa |
inhibit reabsorption of uric acid by renal tubules
|
|
|
sulfinpyrazone
moa |
inhibit reabsorption of uric acid by renal tubules
|
|
|
colchicine
moa |
decrease tubulin synthesis → decrease leucocyte mobility
|
|
|
decrease tubulin synthesis → decrease leucocyte mobility
|
colchicine
|
|
|
colchicine
adverse effects |
nausea,
vomiting, diarrhea, cramps |
|
|
NSAID for Gout
|
Indomethacin
|
|
|
Indomethacin
uses |
NSAID for Gout
|
