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Pharm - MSK/Derm

MSK/Derm Pharmacology from First Aid 2013

QuestionAnswer
What is the first step in the arachadonic acid pathway? What inhibits it? Phospholipase A2 turns phosphatidylinositol into arachadonic acid. Inhibited by corticosteroids.
What are the next two options in the AA pathway? What inhibits them? Lipooxygenase (LOX) - Zileuton Cyclooxygenase (COX-1, COX-2) - NSAIDS, et al.
What does the LOX pathway produce? What inhibits them? Leukotrienes: LTB4 - neutrophil chemotaxis, arrive B4 others LTC, LTD - inc bronchial tone (montelukast)
What does the COX pathway produce? Prostacyclin (PGI2) Prostaglandins (PGE2, PGF2) Thromboxane A2 (TXA2)
What does prostacyclin (PGI2) do? Where is it produced? Endothelial cells: vasodilation, decreased platelet aggregation, decreased bonchial tone, decreased uterine tone
What does prostaglandin (PGE2) do? Keeps the PDA open, decreased vascular tone, decreased bronchial tone, INCREASED uterine tone, protects the gastric mucosa, vasodilates the afferent artery of the kidney (reason why NSAIDs are nephrotoxic)
What does TXA2 do? Increase vascular tone, constrict bronchioles, increase platelet aggregation
Omega-3 fatty acid has what effect on platelets? Decreases platelet aggregation.
What does dipyrimadole inhibit? TXA2
NSAIDs: examples, MOA, Use Ibuprofen, naproxen, indomethacin MOA: reversible COX-1,2 inhibitors Use: antipyretic, anti-inflammatory analgesic Indomethacin maintains a PDA.
What are some NSAID toxicities? Gastric ulcer (PGE protects mucosa) Renal ischemia (PGE dilates aff. arteriole) Interstitial nephritis
Selective COX-2 inhibitor: name, MOA, Use, Tox Nom: Celecoxib MOA: COX2 found only in endothelium and inflammatory cells, spares COX1 in gastric mucosa Use: arthritis, patients with ulcers Tox: thrombosis
Acetaminophen: MOA, Use Reversible inhibit COX in CNS, less so peripherally (inactivated). Use: antipyretic and analgesic, NOT anti-inflammatory. Use in kids to avoid Reye's syndrome.
Acetaminophen toxicity mechanism and treatment? Why does alcohol or isoniazid make it worse? CYP2E1 metabolizes acetaminophen into NAPQI, which depletes the liver's supply of glutathione. --> free radicals Give N-acetylcysteine (mercaptan) to regenerate glutathione and activated charcoal to absorb the XS drugs.
Bisphosphonates: naming, MOA, Use, Tox Nom: Alendronate, "-dronate" MOA: bind HA in bone, inhibiting OC's Use: Osteoporosis, Pagets, hyperCa Tox: esophagitis, necrosis of jawbone
What are all of the effects of corticosteroids vis-a-vis inflammation? Inhibit PLA2 in AA pathway. Decrease adhesion molecules -> neutrophilia. Inhibit eosinophils. Induce lymphocyte apoptosis.
Name two chronic gout drugs that treat overproduction? What is its MOA? Uses? Allopurinol, febuxostat - xanthine oxidase inhibitors Gout and TLS.
What treats gout under-secretion? What other use does it have? Prohibits reabsorption of uric acid in PCT. Also increases half-life of penicillin.
What is colchicine's Use, MOA, Tox? Use: Acute gout! MOA: Inhibits neutrophil MT's. Tox: GI sfx.
How do you treat acute gout? NSAIDS, glucocorticoids, colchicine
Name two TNFa inhibitors? What conditions are they used for? Etanercept - TNF decoy receptor Infliximab - TNF antibody Psoriasis, ankylosing spondylitis, RA, Crohn's (infliximab)
Created by: wmwebb89
 

 



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