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MSK exam 1 Pharma.
MSK exam 1 Pharmacology and pathophysiology
| Question | Answer |
|---|---|
| OA: Neuroinflammatory | local mediators |
| OA: pain type | Nociceptive: mechanical inflammatory |
| OA: Treatment | NSAIDs & analgesic |
| OA is a type of ___ | neuro inflammatory |
| OA is induced by | trauma, injury, stress, age, genetics, a persons life style |
| For OA what joints are affected | neck, spine (lower vertebrae), hips, knees, hands |
| in OA cartilage fibrillation happens because | of the degradation of cartilage |
| OA Lipoxygenase pathway | AA-> Leukotrienes |
| Aspirin/ NSAIDs sensitivity _____ | asthma |
| OA: COX -1 is | constitutive |
| OA: COX -1 Pathway is | AA-> Prostaglandins and thromboxane |
| OA: COX-2 is | inducible |
| OA: COX-2 Pathway is | AA-> Prostaglandins and prostacyclin |
| OA: COX-2 can get activated by | oxidative stress, injury, ischemia, seizures, neurodegenerative disease |
| acetaminophen MOA | COX inhibitor, Inhibits prostaglandin synthesis in the CNS |
| acetaminophen is used to | reduce pain and fever |
| Aspirin is used for | inflammation, pain, fever and anti-thrombotic |
| acetaminophen toxicities especially high doses are | nephron- and hepatotoxic |
| what is the alternative for acetaminophen | aspirin ( 20 y/o) |
| aspirin MOA | irreversible, non- selective COX inhibitor |
| aspirin side effects are | GI effects, hypersensitivity |
| aspirin should be used with caution if patient is | Hepatic/renal impairment |
| aspirin can cause____ in children and young adults < 20 y/o with viral fever | reyes syndrome |
| these are propionic NSAIDs | Fenoprofen, Ibuprofen, ketoprofen, Naproxen |
| which NSAID is an acetate prodrug | Nabumetone |
| Propionic NSAIDs & Acetate prodrug MOA | Reversible, Non-selective COX inhibitor |
| Propionic NSAIDs & Acetate prodrug is used for | inflammation, pain, fever and anti-thrombotic |
| Propionic NSAIDs & Acetate prodrug have a BLACK BOX WARNING on | CV thrombotic events, GI bleeding , ulceration and perforation |
| which propionic NSAID has a longer t1/2 | Naproxen |
| Acetic acid derivatives NSAIDs are | Diclofenac, etodolac, indomethacin, sulindac |
| Acetic acid derivatives NSAIDs MOA | Reversible, Non-selective COX inhibitor |
| Acetic acid derivatives NSAIDs is used for | inflammation, pain, fever and anti-thrombotic |
| Acetic acid derivatives NSAIDs have a BLACK BOX WARNING on | CV thrombotic events, GI bleeding , ulceration and perforation |
| Enolic acid derivates NSAIDs (Oxicams) are | Meloxicam, piroxicam |
| Enolic acid derivates NSAIDs (Oxicams) MOA | Reversible, Non-selective COX inhibitor ( > COX-2) |
| Enolic acid derivates NSAIDs (Oxicams) is used for | inflammation, pain, fever and anti-thrombotic |
| Enolic acid derivates NSAIDs (Oxicams) have a BLACK BOX WARNING on | CV thrombotic events, GI bleeding , ulceration and perforation |
| Coxibs NSAIDs are | Celecoxib |
| Coxibs MOA | reversible, COX 2 selective inhibition |
| coxibs is used for | inflammation, pain, fever, pro-thrombotic |
| Coxibs have a BLACK BOX WARNING on | Serious CV and GI risk |
| the non selective NSAIDs equally inhibit COX1 and COX2 ? true or false | false |
| Ketorolac has more GI or CV risk | GI Risk |
| Flubiprofen has more GI or CV risk | GI Risk |
| Ketoprofen has morę GI or CV risk | GI Risk |
| Indomethacin has more GI or CV risk | GI Risk |
| Tolmetin has more GI or CV risk | GI Risk |
| Aspirin has more GI or CV risk | GI Risk |
| NSAIDs inhibit inflammation but do not | halt progression nor induce remission |
| Which OA patient is better candidate for treatment with celecoxib | a patient with high GI risk but low CV risk |
| RA is an | autoimmune disorder that causes chronic inflammation of the joint lining |
| RA Neuroinflammatory is | systemic autoimmune mediated |
| RA pain type is an | Nociceptive: inflammatory synovium |
| Meloxicam has more GI or CV risk | CV risk |
| Diclofenac has more GI or CV risk | CV risk |
| Celecoxib has more GI or CV risk | CV risk |
| Valdecoxib has more GI or CV risk | CV risk |
| Etodolac has more GI or CV risk | CV risk |
| Rofecoxib has more GI or CV risk | CV risk |
| Etoricoxib has more GI or CV risk | CV risk |
| Lumiracoxib | CV risk |
| RA treatment are | NSAIDs, DMARDs, and Biologic agents |
| RA affect which joints | Hands, feet, knees, elbows/shoulders |
| Hydroxychloroquine MOA | T-lymphocyte suppression, decreased leukocyte chemotaxis, lysosome stabilization |
| Hydroxychloroquine Used to | reduce pro-immune factors, malaria |
| Hydroxychloroquine side effects/ toxicities | ocular toxicity & CV events |
| Leflunomide MOA | Pyrimidine synthesis inhibitor |
| Leflunomide is used for | Anti-inflammation and - proliferation |
| Leflunomide side effects are | infections and lymphomas |
| Leflunomide Box warnings are | pregnancy (embryonic lethality, teratogenicity) and hepatotoxic |
| Leflunomide requires drug clearance to pursue ___ | pregnancy |
| this drug is a prodrug that requires hepatic activation | Leflunomide |
| Methotrexate MOA | Dihydrofolate reductase inhibitor, decreases purine production nd DNA synthesis, antifolate and increase adenosine |
| methotrexate is used for | Anti-inflammation, - proliferation, extraarticular effect |
| methotrexate side effects are | infection and malignancy |
| methotrexate Box warnings are | pregnancy (embryo-fetal toxicity) and hypersensitivity |
| when given methotrexate it needs to be give with what supplement | folate |
| Sulfasalazine MOA | inhibits cytokine secretion |
| Sulfasalazine is used for | anti inflammatory |
| Sulfasalazine side effects are | sulfa allergy , contraindication |
| this drugs is a prodrug, 5-ASA & sulfapyridine | Sulfasalazine |
| Abatacept MOA | Inhibits T-cell activation, blocks CD80/86 on APC |
| Abatacept side effects | infection and malignancy |
| TB test are required, what drug class can't be combine with anakinra and TNF-a blockers | Biologic DMARDs |
| Anakinra MOA | inhibits IL-1 |
| anakinra side effects | infection and malignancy |
| Rituximab MOA | Induces B-cells apoptosis, CD20 antibody |
| Rituximab Box warnings | infusion and mucocutaneous reaction |
| Tocilizumab & Sarliumab MOA | Inhibits IL-6 |
| Tocilizumab & Sarliumab Box warnings | infection risk |
| which drugs are Biologic DMARDs | abatacept, anakinra, rituximab, tocilizumab & sarliumab |
| Which drugs are TNF-a inhibitors | adalimumab, certolizumab,etanercept, golimumab, infliximab |
| TNF-a inhibitors Box warnings | malignancy and TB risk |
| which drugs are DMARDs; JAK | tofacitinib, Baricitinib, Upadacitinib |
| tofacitinib, Baricitinib, Upadacitinib MOA | Selective JAK inhibitor , decreasing proliferation of NK, T and B cell |
| tofacitinib, Baricitinib, Upadacitinib Box warning | infection, malignancy thrombosis |
Created by:
arcervantes
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