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Antiinflammatory Drugs

  1. Aspirin - 1o MOA
    Reversible competitive (-) of COX-1/COX-2 --> (-) PGE syn
  2. Another name for Acetylsalicylic acid?
    Aspirin
  3. Aspirin trade name:
    Bayer
  4. Trade name: Azulfidine
    Sulfasalazine
  5. Sulfasalazine - MOA:
    • "Sulfa..." = hypersensitivity rxn
    • (-) COX & LOX
    • (-) IL-1 & TNF-a








  6. What is the main benefit of using Sulfasalazine instead of other NSAIDs?
    No GI toxicity
  7. Aspirin
    Dose     Affect
    Low:
    Med:
    High:
    • Dose Affect
    • Low: Anti-platelet
    • Med: Analgesi/Antipyretic
    • High: Anti-Inflammatory
  8. Why do you NOT give Aspirin to kids?
    Reye Syndrome
  9. Clinical manifestation of Reye Syndrome:
    • 1) Respiratory infection
    • 2) 4 days later - nausea, vomitting, chg in mental status
    • **Liver damage & cerebral edema**
  10. Toxic Dose of Aspirin S/S:
    • Uncompensated respiratory/metabolic acidosis
    • Decrease RR
  11. What are the Salicylates?
    • Aspirin (acetylsalicylic acid)
    • Sulfasalazine (Azulfidine)
  12. What are the non-Salicylates?
    • Propionic acid derivatives
    • Acetic acid derivatives
    • Oxicams
    • Coxibs
  13. Propionic acid derivatives:
    • Ibuprophen
    • Naproxen
  14. Acetic acid derivatives:
    • Diclofenac
    • Ketorolac
  15. Oxicams:
    Piroxicam
  16. Coxib:
    Celecoxib
  17. Diclofenac MOA:
    • (-) COX-1/2
    • @ low levels can (-) LOX
  18. Ketorolac MOA:
    • 1o use as analgesic --> can decrease amt of morphine needed
    • Weak anti-inflammatory
    • High renal toxicity
  19. Diclofenac A/E:
    • GI ulcers
    • Alleviated by combined use with Misopristol
  20. Indomethacin MOA:
    • (-) COX-1/2, Phospholipases, Neutrophil migration --> (-) A.A. pathway
    • Decrease T/B cell proliferation
  21. Indomethacin uses:
    • Gout
    • Closure of PDA
    • Ankylosing Spondyliti
  22. Indomethacin C/I:
    • use with Probenecid --> Probenecid increases Indomethacin's t1/2
    • 3rd Trimester b/c it will prematurely close PDA
  23. Piroxicam MOA:
    • (-) Leukocyte migration
    • Decrease production of radicals
  24. Piroxicam C/I:
    • Pts with gastric ulcers
    • **Most GI TOXIC**
  25. Celecoxib - MOA:
    • Selectively (-) COX-2
    • weak anti-platelet
    • **BLACK BOX in MI pts**
  26. What is Acetaminophen?
    • Tylenol
    • Non-NSAID
  27. Acetaminophen - MOA:
    • (-) COX-1/2 in CNS
    • Antipyrogenic & Analgesic
    • Normal:
    • Acetaminophen -p450-> NAPQI -Glutathione-> Excretion

    • Toxic dose or w/EtOH:
    • Acetaminophen -p450-> NAPQI -glutathione-> increased cyp2EI = liver cell death b/c of increased -SH groups
  28. How do glucocorticoids work?
    • MOA - affect gene expression at DNA level
    • MOA - Fx as transcription factors --> (-) phospholipases --> (-) COX path --> (-) PGE syn.
  29. Glucocorticoid - Uses:
    • Antiinflammatory
    • Immunomodulatory
    • Stimulate surfactant syn
  30. Glucocorticoid
    Short-to-Medium Acting
    • Cortisone
    • Hydrocortisone
  31. Glucocorticoid
    Intermediate-Acting
    • Methylprednisolone
    • Prednisolone
    • Prednisone
    • Triamcinolone
  32. Glucocorticoid
    Long-Acting
    • Betamethasone
    • Dexamethasone
  33. What is the Dexamethasone Suppression Test?
    Diagnostic test for differential diagnosis of "Non-iatrogenic Cushing's Syndrome"
  34. How does the Dexamethasone Suppression Test work?
    • Dexamethasone dosages & affects:
    • NORMAL = low dose --> decreases cortisol levels
    • Cushing's Dz = high dose --> resets (-) feedback loop decreasing cortisol levels
    • Cushing's Syndrome = low/high dose --> NO Chg
Author
Anonymous
ID
136114
Card Set
Antiinflammatory Drugs
Description
Antiinflammatory Drugs
Updated

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