1. cyclooxygenase inhibitors - therapeutic effects?
    • 1 - decreased inflammation
    • 2 - decreased pain
    • 3 - reduced fever
  2. MSA-4 protects against what?
    stroke and MI
  3. when cyclooxygenase is inhibited, it decreases amount of what?
  4. COX @ site of tissue injury?
    decreased pain and inflammation
  5. COX @ stomach
    protects gastric mucosa
  6. COX @ blood vessels
  7. COX @ brain
    regulates fever
  8. COX @ uterus
  9. COX @ platelets
  10. COX @ uterus?
    promotes contractions
  11. 2 forms of COX?
    • COX 1 - found in all tissues
    • COX 2 - produced at site of tissue inflammation/injury
  12. inhibition of COX-1
    gastric erosion, bleeding, renal impairment.  protects against MI and stroke
  13. COX-1 normal effects?
    found in all tissues, protects gastic mucosa, supports renal fx, promotes platelets
  14. COX-2 normal effects?
    produced at sites of tissue injury.  mediates inflammation and sensitizes to painful stimuli. in the brain - mediates fever and contributes to pain perception
  15. inhibition of COX-2?
    suppresses inflammation, alleviates pain, reduces fever.  increased risk of MI and stroke
  16. difference between NSAIDs and acetaminophen?
    • NSAIDS - have anti-inflamm properties
    • acetaminophen lack anti-inflamm properties
  17. aspirin (first generation NSAIDs)
    inhibits COX-1 and COX-2.  treats inflamm disorders
  18. adverse effects of aspirin?
    • GI upset
    • bleeding
    • renal impairment
    • salicylism (s/s headache, tinnitus, sweating, dizziness)
    • Reye's syndrome (in children - do not give < 2 years)
  19. methotrexate - type of drug & therapeutic use?
    • DMARD (disease modifying antirheumatic)
    • used for rheumatoid arthritis
  20. methotrexate - given how many times?
    once a week via IM
  21. sulfasalazine (Azulfidine)- therapeutic uses?
    rheumatoid arthritis, IBD
  22. Hydroxychloroquine (Plaquenil)- onset?
    3-6 months
  23. Hydroxychloroquine (Plaquenil)- significant side fx?
    • retinal damage
    • need frequent eye exams
  24. sulfasalazine (Azulfidine)- action?
    • slows progression of joint deterioration
    • anti-inflammatory
  25. Enteracept (Enbrel)- therapeutic use?
    • mild to moderate RA
    • delays progression of joint damage
  26. Enteracept (Enbrel)- administration? side fx?
    • given subQ
    • may have local site reaction
    • ^ risk of infection
  27. Enteracept (Enbrel)
    Infliximab (Remicade)
    adalimumab (Humira)
    - what type of medication?
    Tumor necrosis factor (TNF) blocker
  28. mech of action of TNF blockers?
    inhibits TNF (tumor necrosis factor), thus reducing inflammation, as in RA
  29. disease of altered purine metabolism.  associated with hyperuricemia
  30. goals of therapy for gout?
    • block inflamm process
    • increase excretion & decrease production of uric acid
  31. usual meds given for an acute gout attack?
    NSAIDS & glucocorticoids
  32. colchicine - therapeutic use?
    acute gout attacks
  33. allopurinol - therapeutic use?
    • chronic gout
    • inhibits uric acid production
  34. probenecid - therapeutic use/ action?
    • chronic gout symptoms
    • decreases reabsorption of uric acid; thereby promoting excretion
  35. probenecid - long term side fx?
    GI effects, renal fx
  36. first gen NSAIDs inhibit what?
    COX-1 and COX-2
  37. second gen NSAIDs inhibit what?
    selectively COX-2
  38. causes effects in stomach, kidneys, platelets.
  39. effects on inflammation, pain, fever
  40. difference between inhibition of COX-1 and COX-2?
    • COX 1: bleeding, renal impairment, stomach erosion (acts systemically)
    • COX 2: reduces inflammation, pain, fever. (acts on CNS and @ sites of tissue injury)
  41. benefits of ASA?
    suppression of pain, fever, inflammation.  also protects against MI/stroke.
  42. first line treatment/ drug of choice for arthritis?
  43. which drug decreases ASA's protection against MI/stroke?
    ibuprofen.  (reduces ASA's side effect of blood thinning)
  44. ASA is contraindicated for which children?
    <2 years of age, with the flu, with chickenpox
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