Pharmacology - Prostaglandins And Aspirin

Front 1

common precursor for prostaglandin and leukotriene synthesis

Back 1

phospholipid membrane FA cleaved by PLA2 to form AA

Front 2

Where does the PG/LT pathway diverge

Back 2

catabolism of arachidonic acid by either PGH Synthase or lipooxegenase

Front 3

What steps of the PG/LGT are most sensitive to drug intervention?

Back 3

COX1 and COX2

Front 4

cell that does not synthesize eicosanoid

Back 4

erythrocytes

Front 5

properties of eicosanoids

Back 5

locally-acting, G-protein mediated, degraded quickly

Front 6

Action of PGI2

Back 6

1) vasodilation (BF maintainance)
2) reversal of platelet aggregation

Front 7

PGI2 agonists

Back 7

Epoprostenol

Front 8

Action of PGE1

Back 8

1) vasodilation
2) GI protectant
3) bronchodilation
4) blocks platelet aggregation

Front 9

PGE1 agonists

Back 9

Misoprostol, Alprostadil, also PGE1 directly used for platelet harvesting and aggregation (MAP)

Front 10

Action of PGE2

Back 10

1) vasodilation
2) bronchodilation
3) GI protectant

Front 11

Epoprostenol

Back 11

PGI2
rapid reversal of pulmonary hypertenstion (vasodilation)

Front 12

PGE2 agonists

Back 12

dinoprostone

Front 13

Dinoprostone

Back 13

induce labor, 2nd trimester abortion

Front 14

Misoprostol

Back 14

used to decrease gastric ulceration

Front 15

Alprostadil

Back 15

inproves BF, platelet anti-aggregant, can maintain patent ductus arteriosus, used for mel impotence but pain directly at site of injection

Front 16

Drug that can maintain a patent ductus arteriosus

Back 16

Alprostadil

Front 17

Action of PGF2

Back 17

1) vasoconstrictor
2) bronchoconstrictor

Front 18

PGF2 agonists

Back 18

Latanoprost

Front 19

Latanoprost

Back 19

used to treat glaucoma but only used topically because it will cause bronchoconstriction

Front 20

Action of TXA2

Back 20

1) platelet aggregant
2) vasoconstriction
3) bronchoconstrictor

Front 21

action of COX

Back 21

converstion of AA to PGG2

Front 22

action of peroxidase

Back 22

conversion of PGG2 to PGH2

Front 23

COX blockers (general categories)

Back 23

NSAIDS or COX-2 selective blockers

Front 24

Effects of COX blockers

Back 24

1) analgesic (inhibition of PG)
2) antipyretic (reset set point of PGE2)
3) Anti-inflammatory by reducing leukocyte activation/interaction with endothelial cells

Front 25

Respiratory effects of Aspirin

Back 25

increased respiration which causes respiratory alkalosis

Front 26

GI effects of Aspirin

Back 26

cramping, nausea, vomiting, gastric ulceration

Front 27

How does Aspirin cause increased respiration and how does this affect the kidneys?

Back 27

it uncouples oxidative phosphorylation and causes increased CO2 which sitmulates the respiratory center; kidneys excrete bicarb to compensate for respiratory alkalosis

Front 28

used to close a patent ductus arteriosus

Back 28

indomethacin

Front 29

Mechanisms of aspirin on COX

Back 29

1) irreversible acetylation
2) metabolism in to salicylic acid which reversibly inhibits COX

Front 30

Ulceration of what can occur with aspirin?

Back 30

Gastric but not duodenal

Front 31

Effects of aspirin in pegnancy?

Back 31

When used in the last trimester, aspirin cuases prolonged gesation, labor, and increased maternal blood loss.

Front 32

effects of Salicylism toxicity?

Back 32

tinnitus, hearing loss, vertigo

Front 33

effects of salicylate poisoning?

Back 33

inhibition of respiratory center due to uncompensated respiratory acidosis and DEATH

Front 34

How is metabolic acidosis caused in salicylate poisoning?

Back 34

Krebs cycle inhibition which causes acidic byproduct buildup

Front 35

Patients with this triad have a higher incidence of hypersensitivity of aspirin

Back 35

Chronic rhinitis
Asthma
Polyp

Front 36

Absorption and metabolizm of aspirin.

Back 36

Upper SI, metabolized in liver.

Front 37

Drugs enhanced by aspirin

Back 37

anticoagulants and oral hypoglycemics

Front 38

Drugs inhibited by aspirin

Back 38

probenecid and sulfinpyrazone

Front 39

Treatment of acetominaphen toxicity

Back 39

N-acetylcysteine

Front 40

Amount of acetaminophen considered toxic to liver

Back 40

<10g or >10g with alohol

Front 41

What are DMARDS?

Back 41

disease modifying anti rheumatic drugs

Front 42

What are the anti TNFs?

Back 42

infliximab, adalimumab, and etanercept

Front 43

How are COX2 selective blockers cardiotoxic?

Back 43

they block COX2 production of PGI2 which is antithrombotic without blocking COX1 production of thromboxane

Front 44

Why are non-aspirin nsaids not cardioprotective?

Back 44

their effects are reversible

Front 45

How does aspirin enhance resolution phase mediation?

Back 45

blockage of PG synthesis allows AA to be used for lipoxin and resolvin synthesis instead.

Front 46

What enzyme is responsible for making resolution phase mediators?

Back 46

COX-2, therefore selective inhibition of this may be :(

Front 47

NSAID associated with acute renal failure

Back 47

indomethacin

Front 48

What drugs can be used to minimize NSAID GI ulceration?

Back 48

misoprostol or omeprazole

Front 49

arthrotec

Back 49

combo drug with diclofenac and mistoprostol

Front 50

What are the side effects of aspirin?

Back 50

inhibition of platelets, inhibition of uterine motility,
hypersensitivity reaction

Front 51

What renal problems may NSAIDS cause?

Back 51

in norm ppl, nothing. In those with CHF, liver cirrhosis, and renal disease, the vasoconstriction caused by PGE1/2 inhibition will cause decreased RPF and precipitate acute renal failure

Front 52

Indomethacin

Back 52

acetic acid NSAID associated with acute renal failure

Front 53

Classifications of NSAIDS:

Back 53

Carboxylic acid
Propionic Acid
Acetic Acid

Front 54

What are the 4 criteria that need to be met for classification of rhematoid arthritis?

Back 54

-Rheumatic Factor > 95th percentile
-Stiffness in morning > 1 hr for at least 6 weeks
- Hand arthritis
- Joint erosion
- Symmetrical arthritis
- Subcutaneous nodules
- Swelling of >14 joints

Front 55

What is OA and its most common treatment?

Back 55

sequence of disorters that affect weight bearing joints treated with acetaminophen

Front 56

Ultrasonography is used to:

Back 56

detect erosions in early rheumatoid arthritis and is 6x more sensitive than conventional readiographs

Front 57

What is the step down combination therapy for RA?

Back 57

" Slowly Make Progress "

Sulfasalazine (2g/day)
Methotrexate (7.5 mg/ week for 40 weeks)
Prednisone (60 mg/day for 28 weeks)

Front 58

Two treatments that ensure long term prognosis for RA?

Back 58

1) step down combo therapy
2) biological agents

Front 59

What biological agents are used for RA?

Back 59

Anti-TNF drugs, Anti IL-1 drugs