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67 Cards in this Set
- Front
- Back
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4 Properties of NSAIDS
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Analgesia
Anti-Platelet Anti-Pyresis Anti-Inflammatory |
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MOA for NSAIDS
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Inhibits cyclooxygenase (COX), resulting in inhibition of PG synthesis
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COX 1
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Constitutive
Protective/Maintenance Function PG's in: GI, Kidney, Platelet |
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COX 2
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Inducible
Proinflammatory/mitogenic PG in inflammatory sites (Synoviocytes/Macrophages) |
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Aspirin
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Salicylate
MOA- non-selective COX inhibitor, irreversible Prolongs bleeding time--> TxA2 (low dose) Aggravate gout control |
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Diflunisal (Dolobid)
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Fluorinated Salicylate
Non-selective COX Inhibitor NO ANTIPYRETIC Less SE than Aspirin |
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Gout
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Hyperuricema, Acute Arthritis, typically metatarsophalangeal joint of big toe
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Indomethacin
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NSAID,
quicker onset than Colchicine GI & CNS Side effects significant |
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Phenylbutazone
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NSAID
Acute gout relief Metabolized to active metabolite Hematological Side Effects |
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Colchicine
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Prevents Intracellular tubulin polymerization
Breaks Inflammatory Cycle Not analgesic/uricosuric Cimetidine/Erythromycin inhibit metab. Narrow TI |
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Allopurinol (Xyloprim)
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Xanthine Oxidase Comp. Inhib
Cleared by kidneys/ Dose according to GFR |
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Febuxostat (Uloric)
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Xanthine Oxidase Inhibitor
Better for pt. w/ Renal Insufficiency |
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Probenecid
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Uricosuric
Don't use if Urine > 600mg/day Low CrCl <50ml/min contraindication Inhibits Renal secretion of Indomethacin |
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Sulfinpyrazone (Anturane)
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UricoSuric
GI irritation > Probenacid |
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NSAID MOA
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Inhibit Cyclooxygenase enzymes
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Sx of Mild Salicylism
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Uncoupling of Ox Phos--> increased respiration-->
Decreased pCO2--> Resp. Alkalosis--> compensated resp. Alkalosis |
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Sx of Severe Aspirin Intox
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Inhibit Respiratory Center-->
increased pCO2--> Resp Acidosis (decreased pH and bicarb, normalization pCO2) --> Uncoupled Ox Phos--> Met. Acidosis, Hyperthermia, hypokalemia |
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Ibuprofen (Motrin)
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NSAID
Low cost/Toxicity 4x/day dosing Cannot take w/ aspirin |
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Naproxen (Naprosyn)
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NSAID
2x/day dosing |
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Nabumetone (Relafen)
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Only NON-ACID NSAID
Prodrug--> Ketone Kidney Elimination, so GFR dependent Expensive |
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Ketorolac (Toradol)
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NSAID
Analgesic, NOT ANTI-INFLAMM Parental Use |
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Celecoxib (Celebrex)
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COX2 Inhibitor
Risk of MI Cancer Treatment? |
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Meloxicam (Mobic)
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COX2 Preferred Inhibitor
Risk of MI Cancer Treatment? |
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Misoprostol
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PGE1 analog
Reduces GI irritation |
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Acetaminophen
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Not an NSAID
Inhibits COX2 mostly in CNS Analgesic/Antipyretic |
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Methotrexate (MTX)
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Gold Standard DMARD
Dihydrofolate Reductase Inhibitor |
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Hydroxychloroquine
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Anti-Malarial
Mechanism for RA Unknown SE of Retinopathy |
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Gold Salts (Aurothiomalate)
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Inhibition of Macrophage Function
Mechanism Uncertain No antipyretic/analgesia Several months for effect |
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Pencillamine (Cuprimine)
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Chelating Agent for Copper
Mechanism Unknown Decreases bone destruction |
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Leflunomide (Arave)
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Inhibits pyrimidine synthesis
Option for those pt. sensitive to MTX |
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Etanercept (Enbrel)
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Recombinant TNFa Receptor
Activation of latent TB Opportunistic Infection SQ injection 2x/week |
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Infliximab (Remicade)
Adalimumab (Humira) Golimumab (Simponi) |
Monoclonal Antibody to TNFa
Risk of infection and PML Possible CHF |
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Abatacept (Orencia)
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Inhibits T-cell activation thus production of TNFa
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Anakinra (Kineret)
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IL-1 Receptor Antagonist
Blocks inflammatory/immunologic rxn in RA |
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Capsacin
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Stimulates Substance P release
Deplete stores to decrease pain |
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Cortisone
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Short-Acting Glucocorticoid
Anti-Inflamm = Salt-Retaining |
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Prednisone
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Short-Acting Glucocorticoid
4: 0.3 Anti-Inflamm: Salt-Retaining |
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Prednisolone
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Short Acting Glucocorticoid
5:0.3 Anti-Inflamm: Salt-Retaining |
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Triamcinalone
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Intermed. Acting Glucocorticoid
5:0 Anti-Inflamm: Salt-Retaining |
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Dexamethasone
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Long-Acting Glucocorticoid
30:0 Anti-Inflamm: Salt-Retaining |
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Fludrocortisone
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Mineralcorticoid
10:250 Anti-Inflamm: Salt-Retaining |
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Median Nerve
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Flexors of Forearm, Thenar Eminence and 1st 2 lumbricals
Anterior Digits 1-4.5 Sensory |
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Ulnar Nerve
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Intrinsic Muscles of Hand
Digits 4.5-5 Sensory |
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Musculocutaneous Nerve
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Anterior Compartment of Arm
Flex Elbow Sensory to Lateral Forearm |
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Axillary Nerve
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Deltoid/Teres Minor Muscle
Flex/Extend/Abduct Shoulder |
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Radial Nerve
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Posterior Compartment of Arm/Forearm
Extends Elbow, Wrist, Hand & Digits, Supinates Forearm |
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Superior Gluteal Nerve
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Gluteus Medius/Minimus, Tensor Fascia Lata
Abducts leg/ Resists Pelvic Tilt |
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Inferior Gluteal Nerve
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Gluteus Maximus
Powerful Hip Extensor |
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Femoral Nerve
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Anterior Thigh Muscles
Flex hip/Extend Knee Sensory: Medial Thigh/leg/heel, via saphenous |
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Obturator Nerve
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Abductor Muscles of Thigh
Medial Thigh Directly above Knee |
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Sciatic Nerve
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Tibial and Common Fibular Nerve Bunndled
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Common Fibular Nerve
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Knee Flexion (Biceps Femoris Short Head)
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Tibial Nerve
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Posterior Leg Compartment
Plantar Flexion/Inversion Gives Rise to Medial/Lateral Plantar Nerve |
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Superficial Fibular Nerve
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Lateral Compartment of Leg
Eversion/Sensory to dorsum of Foot |
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Deep Fibular Nerve
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Anterior Leg Compartment
Dorsiflexion/Extend Toes |
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Type I (Red) Muscle
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Slow-Twitch
Oxidative Metabolism Fatigue Resistant Slower myosin ATPase |
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Type II B (White) Muscle Fibers
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Fast Twitch
Glycolytic Easily Fatigued Precise Movement (Ocular) |
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Muscle Spindle
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Gamma Motor
Type Ia- Velocity/ Absolute Stretch Type II- Absolute Stretch |
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Golgi Tendon Organ
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Type Ib
Prevent Tearing Decrease Agonist/Increase Antagonist Tone |
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Erb-Duchenne Palsy
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Injury to Superior Trunk
C5-6 Affected Subclavius, Suprascapular, Axillary, Musculocutaneous Nerves Affected Waiters Tip Sign |
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Klumpke Paralysis
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Injury to Inferior Trunk
Ulnar Nerve/ Medial Cutaneous Nerve of Arm/Forearm |
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Trendelenburg Gait
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Superior Gluteal Nerve Injury
Contralateral Pelvis Drop/ Trunk Shift to affected side |
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C5
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Elbow Flexors
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C6
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Wrist Extensors
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C7
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Elbow Extensors
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C8
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Finger Flexors
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T1
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Finger Abductors
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