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pharmacology 13
| Term | Definition |
|---|---|
| Hyperuricemia | Urate levels build up in the blood serum happens if too much uric acid stays in your body |
| Urates | Product of metabolism of purines salts or esters of uric acid |
| Medical Conditions Associated with Hyperuricemia | ⬤ Gout ⬤ Cardiovascular disease ⬤ Chronic kidney disease ⬤ Hyperlipidemia ⬤ Insulin resistance ⬤ Obesity |
| Gout | Urate crystals deposited in joints Crystals produce inflammation and pain produced by foods high in purine Resolves in 7 to 10 days |
| Tophi | hard, chalky deposits of uric acid crystals that form under the skin and in the soft tissues around joints, |
| Drugs Used to Treat Gout | Analgesics ⬤ Antiinflammatories ⬤ Uricosurics ⬤ Inhibitors of uric acid synthesis |
| Colchicine | an oral prescription medication used to treat and prevent gout attacks works by interfering with inflammatory processes ( Inhibits histamine release) |
| Indomethacin | NSAID with anti-inflammatory, antipyretic, and analgesic properties, used to treat rheumatoid arthritis and gout. |
| Glucocorticosteroids | Oral prednisone + injections Inhibit synthesis of proinflammatory substances and antibodies responsible for attacking healthy cells Decrease leukocytes and T cells corticosteroids That Reduce flare-ups, treat the pain and inflammation |
| Uricosurics | drugs that increase the excretion of uric acid through the kidneys, which lowers the concentration of uric acid in the blood. Promote elimination of urates |
| Probenecid | a prescription medication used primarily to treat and prevent chronic gout by lowering uric acid levels in the blood |
| Xanthine oxidase inhibitors | a substance that blocks the action of the enzyme xanthine oxidase, which is responsible for producing uric acid in the body |
| Allopurinol | drug that inhibits uric acid formation in the body and is used to treat gout and related conditions.(Xanthine oxidase inhibitors) Absorbed and eliminated easily |
| Febuxostat | a prescription medication used to lower high blood uric acid levels (hyperuricemia) in adults with CHRONIC gout when allopurinol has not worked well/cannot be used |
| Recombinant urate oxidase enzymes | genetically engineered enzymes used to treat high uric acid levels (hyperuricemia) |
| pegloticase | A Recombinant urate oxidase enzyme USED TO TREAT CHRONIC GOUT |
| Rasburicase | a medication used to treat high uric acid levels (hyperuricemia) caused by certain cancer treatments, A Recombinant urate oxidase enzyme |
| Nonpharmacological Therapy TO REDUCE GOUT | A diet low in purines + Weight loss |
| Warning Labels Uricosurics | Take with food Take with lots of water Avoid aspirin |
| Osteoarthritis | Inflammation of the fluid that surrounds the joint (synovial fluid) contributes to pain, Joint pain Stiffness Swelling, Crepitus (creaking joints). Pain after activity or at rest. |
| Osteoarthritis risk factors | Previous joint injury or surgery, obesity, increasing age, muscle weakness, occupations that involve excessive joint use. |
| drugs used to help Osteoarthritis pain | Acetaminophen Aspirin Nonsteroidal anti-inflammatory drugs (NSAIDs) |
| Rheumatoid Arthritis | a chronic autoimmune disease that causes inflammation, pain, stiffness, and swelling in the joints Elevated levels of rheumatoid factor |
| Rheumatoid Arthritis phase 1 | Synovial membrane inflamed Swelling, pain, stiffness |
| Synovial membrane | a specialized connective tissue that lines the inside of freely movable joints, such as the knee, and is responsible for producing synovial fluid |
| Rheumatoid Arthritis phase 2 | Rapid cell growth causes synovium to thicken |
| Rheumatoid Arthritis phase 3 | Inflamed cells in synovium release enzymes Enzymes digest bone and cartilage |
| Glucocorticosteroids NSAIDs Salicylates | drugs used to Suppress inflammation and reduce swelling and pain in Rheumatoid Arthritis |
| Salicylates | most common is acetylsalicylic acid (Aspirin), which is used to relieve pain, reduce fever, and lower inflammation. |
| DMARDs/Disease-Modifying Antirheumatic Drugs | treat rheumatoid arthritis by suppressing the immune system to slow down or stop disease progression and prevent joint damage |
| Biological response modifiers | ⬤ Inhibit release of cells that body believes are harmful ⬤ Inhibit release of substances that produce inflammation ⬤ Interfere with the activity of immune system mediators/ cytokines, leukocytes, B cells, T cells |
| Tumor Necrosis Factor-α Inhibitors | a class of Genetically engineered drugs that block the action of tumor necrosis factor-alpha, a protein that causes inflammation Prevent cell lysis |
| etanercept | a biologic medication used to treat autoimmune diseases like rheumatoid arthritis, by blocking tumor necrosis factor (TNF) and reducing inflammation |
| Tumor Necrosis Factor-α Inhibitors adverse reactions | ⬤ Can produce allergic reaction and anaphylactic shock ⬤ Opportunistic infections: tuberculosis and fungal infections ⬤ Can cause onset of MS ⬤ Associated with development of secondary cancer |
| Adverse reactions glucocorticosteroids | CNS: insomnia and euphoria Cardiovascular: edema and hypertension Endocrine system: hyperglycemia, leading to diabetes GI: increased risk of infection and ulceration ⬤ nausea, weight gain, osteoporosis, acne, cataracts, and poor wound healing |
| Nonsteroidal Antiinflammatory Drugs | ⬤ Inhibit synthesis and release of prostaglandin ⬤ Block activity of the enzyme cyclooxygenase (COX-1 and COX-2) warning: Cardiovascular toxicity Gastrointestinal ulceration |
| Azathioprine | immunosuppressant medication used to treat rheumatoid arthritis. Blocks purine synthesis and causes DNA damage Suppresses immune system responses mediated by T cells |
| Cyclophosphamide | immunosuppressant medication used to treat rheumatoid arthritis. Blocks DNA synthesis/cell replication Reduces B-cell antibody production/T-cell activity Decreases cytokine and immunoglobulin production Inhibits antigen-driven T-cell responses |
| Cyclosporine | immunosuppressant medication Selectively interferes with T-cell proliferation and interleukin production |
| Methotrexate | immunosuppressant medication Inhibits formation of folates needed for purine synthesis Decreases cytokine and immunoglobulin production and COX-2 activity |
| Mitoxantrone | Interferes with DNA repair and RNA synthesis immunosuppressant medication |
| Antimalarials | medications used to reduce inflammation, swelling, stiffness, and joint pain, and can help prevent long-term joint damage. ex Hydroxychloroquine |
| Penicillamine, Gold compounds,Leflunomide | DMARD's inhibits T-cell function, decrease release of antibodies and inhibit action of collagenase, blocks replication of lymphocytes |
| Sulfasalazine | DMARD that slows progression of rheumatoid arthritis |
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