I&I antiinflammatory drugs
Terms
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- 3 products of arachadonic acid
-
Leukotrienes (lipooxegenase)
Thromboxanes (COX 1)
Prostaglandins (COX 2) - Action of Leukotrienes
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chemotaxis- eosinophils
vascular permeability - Action of Thromboxanes
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platelet aggregation
(clotting)
smooth muscle constriction
(via lowered cAMP) - Action of prostaglandins
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inhibit platelet aggregation
(via increased cAMP)
smooth muscle dilation (except PGD2)
Keep ductus arteriosis open - first generation H1 blockers
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dyphenhydramine
chlorpheniramine
promethazine
allergies, anti-nausea, sedation - second generation H1 blockers
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Citirizine
Fexofenadine
Loritidine
allergies w/o sedation
no anti nausea - H2 blockers
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Ranitidine (ramantidine is flu treatment)
Cimetidine - action of NSAIDS
- antipyretic, anti-inflammatory, pain
- NSAIDs use & special SE
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Asprin-
(inhibit plt aggregation, Reyes)
Ibuprofen- GI distress
Indomethicin- only inflamm
close ductus arteriosis (PGs keep open) - Non- NSAID
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Acetominophin
no anti-inflamm
liver toxic b/c quinone metabolites (glutithione)
Tx w/n-acetylcysteine - action of histamine binding H1 receptor
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acts on vessels
(initial increase IP3 & DAG)
increase EDRF (NO) & cGMP
vasodilate, vascular perm (kinin), increase HR (reflex tachy) - action of histamine binding H2 receptor
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acts on gut mucosa
increase cAMP & GI acid - side effects of LT receptor inhibitors
- interfere with metabolism of Warfarin & theophyline
- TNF alph inhibitors use & SE
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treat RA
increases infection & lupus
exacerbate demyelinating dz
heart failure - DSMARDs
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disease modifying anti-rheumatic drugs
hydroxychloroquine (malaria)
Penicillamine (chelating agent)
cyclosporin, glucocorticoids, leflunomide, gold salts (immunosuppres & cytos)
methotrexate (antineoplastic) - action of Anakinra
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IL-1 Inhibitor
tx RA