| Question |
Answer |
| which leukotriene is a neutrophil attractant? |
LTB4 |
| which LT --> bronchoconstriction |
LTC4, D4, E4 |
| what reaction does phospholipase A2 catalyze |
phospholipids --> arachidonic acid |
| what rxn does COX catalyze? |
arachidonic acid --> PGG, PGH (endoperoxides) |
| what rxn does lipoxygenase catalyze? |
arachidonic acid --> HPETEs (hydroperoxides) |
| what drug blocks lipoxygenase |
zileuton |
| what drug blocks COX |
NSAIDS acetominophen cox-2 inhibitors |
| what drugs block the effects of leukotrienes? |
zafirleukast montelukast |
| actions of PGE? |
increased uterine tone decreased bronchial tone decreased vascular tone |
| examples of nsaids |
ibuprofen naproxen indomethacin ketorolac |
| mech of nsaids |
reversibly inhibits cox 1 and 2, blocking PG synth |
| uses for nsaids |
antipyretic analgesic anti-inflammatory |
| what drug is used to close PDA |
indomethacin |
| toxicity of nsaids |
renal damage aplastic anemia GI distress ulcers |
| MOA cox2 inhibitors |
reversibly inhibits cox2, maintaining gastric mucosa (cox2 is found only in inflammatory cels that mediate inflamm and pain) |
| risks associated with cox 2 inibitors |
thrombosis less gi risk |
| MOA actaminophen |
reversibly inhibits cox (mostly in cns) inactivated peripherally |
| uses of acetaminophen |
antipyretic analgesic NOT AN ANTI INFLAMMATORY!!!!!!! |
| toxicity of acetaminophen how? |
hepatic necrosis a metabolite of acetaminophen depletes glutathione and forms toxic tissue adducts in liver |
| how is toxic hepatic damage from acetaminophen treated moa? |
n-acetylcysteine - it regenerates glutathione |
| drugs that treat gout |
colchicine allopurinol probenecid indomethacin |
| NSAIDS |
And said: "I be napping in Keto" ibuprofin naproxen indomethacin ketorolac |
| which gout drugs are used to treat chronic gout? |
allopurinol probenecid |
| which gout drugs are ued to treat acute gout |
colchicine indomethacin |
| MOA colchicine |
depolymerizes MT, impairing WBC chemotaxis and degranuation |
| side effects of colchicine |
gi |
| what drug is a good alternative to colchicine? |
indomethacin (less toxic, more commonly used) |
| MOA probenecid |
inhibits resorption of uric acid |
| MOA allopurinal |
inhibits xanthine oxidase, so less formation of uric acid |
| aside from gout, what else can allopurinal be used to treat? |
can help with sx of tumor lysis syndrome, seen in lymphoma/leukemia following chemo |
| what is the original source of uric acid |
purines from diet and broken down nucleic acids |
| fxn of xanthine oxidase |
hypoxanthine --> xanthine --> uric acid (blocked by allopurinol) |
| describe interference of probenecid and penicillin |
inhibits secretion of penecillin |
| what promotes tubular secretion of uric acid |
diuretics and low dose salicylates |
| MOA etanercept |
recombinant form of TNF receptor that binds TNF-alpha |
| uses for etanercept |
RA psoriasis ankylosing spondylitis |
| MOA infliximab |
TNF-alpha AB |
| uses for infliximab |
crohns dz RA ankylosing spondylitis |
| toxicity of infliximab |
predisposes to infection (reactivates latent TB) |
| MOA cyclosporine |
binds to cyclophilins, blocking differentiation and activiation of t cells by inhibiting calcineruin (prevents the production of IL2 and receptor) |
| fxn of calcineurin |
phosphatase that activates IL2 |
| use for cyclosporine |
suppress organ transplants treats some autoimmune d/o |
| toxicity of cyclosporine |
predisp to viral infx and lymphoma NEPHROTOXIC (prevent w mannitol diuresis) |
| MOA tacrolimus |
binds FK-binding protein, inhibiting the secretion of IL2 and other cytokines |
| uses of tacrolimus |
immunosuppression following organ transplant |
| toxicity of tacrolimus |
nephrotoxic peripheral neuropathy HTN pleural effusion hyperglycemia |
| moa azathioprine |
interferes with metabolism and synth of nucleic acids toxic to prolif wbc |
| uses of azathioprine |
kidney transplant autoimmune d/o glomerulonephritis hemolytic anemia |
| toxicity of azathioprine |
bone marrow suppression |
| what is the active metabolite of azathioprine how is it metabolized implication |
mercaptopurine xanthine oxidase toxic effects may be increased by allopurinol |
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