Comprehensive Pharm 7
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| which leukotriene is a neutrophil attractant? | LTB4
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| which LT --> bronchoconstriction | LTC4, D4, E4
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| what reaction does phospholipase A2 catalyze | phospholipids --> arachidonic acid
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| what rxn does COX catalyze? | arachidonic acid --> PGG, PGH (endoperoxides)
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| what rxn does lipoxygenase catalyze? | arachidonic acid --> HPETEs (hydroperoxides)
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| what drug blocks lipoxygenase | zileuton
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| what drug blocks COX | NSAIDS acetominophen cox-2 inhibitors
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| what drugs block the effects of leukotrienes? | zafirleukast montelukast
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| actions of PGE? | increased uterine tone decreased bronchial tone decreased vascular tone
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| examples of nsaids | ibuprofen naproxen indomethacin ketorolac
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| mech of nsaids | reversibly inhibits cox 1 and 2, blocking PG synth
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| uses for nsaids | antipyretic analgesic anti-inflammatory
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| what drug is used to close PDA | indomethacin
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| toxicity of nsaids | renal damage aplastic anemia GI distress ulcers
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| MOA cox2 inhibitors | reversibly inhibits cox2, maintaining gastric mucosa (cox2 is found only in inflammatory cels that mediate inflamm and pain)
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| risks associated with cox 2 inibitors | thrombosis less gi risk
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| MOA actaminophen | reversibly inhibits cox (mostly in cns) inactivated peripherally
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| uses of acetaminophen | antipyretic analgesic NOT AN ANTI INFLAMMATORY!!!!!!!
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| toxicity of acetaminophen how? | hepatic necrosis a metabolite of acetaminophen depletes glutathione and forms toxic tissue adducts in liver
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| how is toxic hepatic damage from acetaminophen treated moa? | n-acetylcysteine - it regenerates glutathione
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| drugs that treat gout | colchicine allopurinol probenecid indomethacin
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| NSAIDS | And said: "I be napping in Keto" ibuprofin naproxen indomethacin ketorolac
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| which gout drugs are used to treat chronic gout? | allopurinol probenecid
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| which gout drugs are ued to treat acute gout | colchicine indomethacin
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| MOA colchicine | depolymerizes MT, impairing WBC chemotaxis and degranuation
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| side effects of colchicine | gi
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| what drug is a good alternative to colchicine? | indomethacin (less toxic, more commonly used)
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| MOA probenecid | inhibits resorption of uric acid
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| MOA allopurinal | inhibits xanthine oxidase, so less formation of uric acid
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| 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
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| what is the original source of uric acid | purines from diet and broken down nucleic acids
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| fxn of xanthine oxidase | hypoxanthine --> xanthine --> uric acid (blocked by allopurinol)
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| describe interference of probenecid and penicillin | inhibits secretion of penecillin
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| what promotes tubular secretion of uric acid | diuretics and low dose salicylates
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| MOA etanercept | recombinant form of TNF receptor that binds TNF-alpha
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| uses for etanercept | RA psoriasis ankylosing spondylitis
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| MOA infliximab | TNF-alpha AB
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| uses for infliximab | crohns dz RA ankylosing spondylitis
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| toxicity of infliximab | predisposes to infection (reactivates latent TB)
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| MOA cyclosporine | binds to cyclophilins, blocking differentiation and activiation of t cells by inhibiting calcineruin (prevents the production of IL2 and receptor)
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| fxn of calcineurin | phosphatase that activates IL2
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| use for cyclosporine | suppress organ transplants treats some autoimmune d/o
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| toxicity of cyclosporine | predisp to viral infx and lymphoma NEPHROTOXIC (prevent w mannitol diuresis)
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| MOA tacrolimus | binds FK-binding protein, inhibiting the secretion of IL2 and other cytokines
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| uses of tacrolimus | immunosuppression following organ transplant
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| toxicity of tacrolimus | nephrotoxic peripheral neuropathy HTN pleural effusion hyperglycemia
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| moa azathioprine | interferes with metabolism and synth of nucleic acids toxic to prolif wbc
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| uses of azathioprine | kidney transplant autoimmune d/o glomerulonephritis hemolytic anemia
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| toxicity of azathioprine | bone marrow suppression
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| 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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