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Anti-inflammatory Rx
| Term | Definition |
|---|---|
| Pegloticase | recombinant uricase. Use for actively symptomatic gout. |
| Pegloticase | Used for severe gout where other rate-lowering treatments have failed |
| Pegloticase | Catalyzes the oxidation of uric acid into allantoin |
| Allopurinol | inhibits xanthine oxidase |
| Allopurinol | Treatment for chronic tophaceous gout. Especially with renal insufficiency |
| Febuxostat | Newer xanthine oxidase inhibitor. |
| Sulfinpryazone | effects transport sites in middle segment of proximal tubules responsible for reabsorption of uric acid |
| Sulfinpyrazone | can be used as an anti platelet drug |
| Probenecid | effects transport sites in middle segment of proximal tubules responsible for reabsorption of uric acid |
| Sulfinpryazone | more potent than probenecid |
| Probenecid | Results in increase in penicillin, cephalosporins, sulfoamides, and indomethacin |
| Probenecid | blocked by salicylates |
| Uricosurics | Increase excretion of uric acid. Ex: probenecid and sulfinpyrazone |
| Colchicine | given in first 12-36 hours of gout attack |
| Colchicine | antimitotic |
| Indomethacin | NSAID for acute treatment of gout |
| Acetaminophen | indicated for mild to moderate pain and fever. |
| Acetaminophen | Treat overdose with acetylcysteine |
| Acetaminophen | Weak inhibitor of cycloxygenases in peripheral tissue |
| TNF-α blocking agents | Adalimumab, certolizumab, etanercept, golimumab, infliximab |
| Multiple drug therapy for rheumatoid arthritis | Methotraxte with cyclosporine, chloroquine, hydrochloroquine, leflunomide, inflixmab, adalimumab, rituximab, or etanercept. |
| Sulfasalazine | metabolize to sulfapyridine |
| Sulfasalazine | indicated to rheumatoid arthritis |
| Rituximab | Targets CD20 B lymphocytes and depletes them. |
| Mycophenolate mofetil (MMF) | Inhibits T cell proliferation, inhibits E-selectins and P-selectins |
| Rituximab | indicated for arthritis |
| Mycophenolate mofetil (MMF) | Indicated for renal disease due to systemic lupus erthematosus |
| Methotrexate | Used in 50-70% patients with arthritis |
| Methotrexate | Inhibits neutrophil chemotaxis. |
| Leflunomide | Decrease in ribonucleotide synthesis and arrests cells in G1 |
| Leflunomide | Indicated for arthritis |
| Cyclosporine | inhibits IL-1 and IL-2 receptor. Inhibits macrophage-Tcell interaction and T cell responsiveness. |
| Cyclophosphamide | Suppress T and B cell function by 30-40 % |
| Choroquine and hydrochloroquine | Indicated for malaria |
| Azathioprine | Suppresses inosinic acid synthesis, T and B cell function, Ig production, and IL-2 secretion |
| Abatacept | inhibits activation of T cells |
| DMARDs | Abatacept, azathioprine, chloroquine, hydrochloroquine, cyclophosphamide, cyclosporine, leflunimide, methotrexate, mycophenolate mofetil, rituximab, sulfasalazine |
| Selective COX-2 inhibitor | Celecoxib |
| Naproxen | non-selective COX inhibitor |
| Ibuprofen | reversible COX inhibitor |
| Ibuprofen | less than 2400 mg/day for analgesic. More for anti-inflammatory |
| Aspirin | Low dose: decrease platelet aggregation. Med dose: analgesic and antipyretic. High dose: anti-inflammatory |
| Aspirin | non-selective irreversible COX inhibitor |
| Complications of NSAIDs | Na retention, hypertension, hyperkalemia, decreased renal blood flow, interstitial nephritis |
| Gastro/renoprotective role of PGE | enhance bicarbonate secretion, enhance renal blood flow, enhance blood flow to mucosal surfaces |
| Montelukast | leukotriene antagonist |
| Zafirlukast | Leukotriene antagonist |
| Zafirlukast | increases prothrombin time with warfarin |
| Zileuton | Leukotriene antagonist |
| Zileuton | increase propranolol and theophylline concentrations; increase PT with warfarin |
| Cortisol | Anti-inflammatory at supraphysiologiocal levels |