Notes in 09 NSAIDs, DMARDs, Anti-Gout Drugs

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Status	Last Update	Fields
Published	07/30/2024	Aspirin/Acetylsalicylic Acid (ASA) MOA: Irreversibly acetylates and inhibits…Low Doses: {{c1::COX-1 (TAX2)}}Higher Doses: {{c1::COX-1 &…
Published	07/30/2024	Aspirin/Acetylsalicylic Acid (ASA) Clinical Uses:{{c1::AnalgesiaAntiplateletAntipyretic effect::3 Anti}}: via COX inhibition in CNS & IL-{{c1::1}}…
Published	07/30/2024	{{c2::-coxib & Meloxicam::Drugs}} MOA: {{c1::selective COX-2 inhibitor}}
Published	07/30/2024	-Coxibs ADE: {{c1::↓ Kidney Function (↓ Na excretion, ↓ Renin, ↓ GFR) → Edema & HPN}}
Published	07/30/2024	{{c1::Etori}}coxib has the highest selectivity ratio for inhibition of COX-2 relative to COX-1
Published	07/30/2024	Ibuprofen ADE: {{c1::Anaphylactoid reaction}}
Published	07/30/2024	{{c1::Naproxen}} is the only NSAID marketed as single enantiomer
Published	07/30/2024	NON SELECTIVE COX INHIBITORSKetoprofenMOA: inhibits COX (nonselectively) and lipoxygenaseAdverse effects: affects {{c1::GIT and CNS}}
Published	07/30/2024	{{c1::Ketorolac & Paracetamol::2 NSAIDs}} are used as analgesic but w/ no anti-inflammatory effects)
Published	07/30/2024	NON SELECTIVE COX INHIBITORS[enumerate]{{c1::Ibuprofen, Naproxen, Ketoprofen, Oxaprozin, Indomethacin, Meclofenamate/ Mefenamic acid, Diclofenac, Keto…
Published	07/30/2024	Paracetamol Clinical Uses: {{c1::DOC for patients allergic to aspirin for analgesia and antipyresis}}
Published	07/30/2024	Paracetamol Dose:Recommended: <{{c1::4}} g/dayLethal: {{c1::15}} g
Published	07/30/2024	Paracetamol is partially metabolized by hepatic microsomal enzymes and conjugated w/ {{c1::Sulfate and Glucuronide::2}}
Published	07/30/2024	Paracetamol Important Metabolite: {{c1::N-acetyl-𝘱-benzoquinone}}
Published	07/30/2024	Indol & indiene acetic acid derivatives{{c1::Indomethacin, Sulindac, Etodolac}}
Published	07/30/2024	Paracetamol ADE: {{c1::↑ Hepatic enzymes, dizziness, excitement, disorientation}}
Published	07/30/2024	Paracetamol Contraindications: Px w/ {{c1::alcoholism}}
Published	07/30/2024	COX 1 > COX 2 selectivitiy{{c1::Aspirin, Indomethacin, Piroxicam, Sulindac}}
Published	07/30/2024	COX1 = COX2 selectivity{{c1::Ibuprofen, Meclofenamate}}
Published	07/30/2024	COX1 < COX2 selectivity{{c1::Celecoxib, Etoricoxib}}
Published	07/30/2024	Methotrexate MOA: {{c1::Inhibition of AICAR Transformylase and Thymidylate Synthetase}} --> Affects {{c2::Dihydrifolate Reductase}} --> Dec…
Published	07/30/2024	Cyclophosphamide MOA: {{c3::Cross-links DNA to prevent cell replication}} --> {{c4::T and B cell supression}}
Published	07/30/2024	Cyclosporine MOA: {{c1::Inhibits interleukin-1 and interleukin-2 receptor production → Inhibits macrophage-T cell interaction and T cell responsi…
Published	07/30/2024	Azathioprine MOA: {{c1::Inosinic acid synthesis suppressionB cell suppressionIL-2 suppression → T cell suppression::3}}It performs all of its actions …
Published	07/30/2024	Chloroquine / Hydroxychloroquine MOA: {{c1::DNA and RNA synthesis inhibition → suppression of T lymphocyte response to mitogens}}
Published	07/30/2024	{{c1::Prednisone}} is a glucocorticoid used for serious extra-articular manifestations of rheumatoid arthritis (e.g., pericarditis, eye involvement, p…
Published	07/30/2024	Colchicine MOA:{{c1::Binds to tubulin → prevent polymerazation into microtubules → ↓ leukocyte migration and phagocytosisInhibits leukotriene B4::2}}
Published	07/30/2024	Allopurinol MOA: {{c1::Purine-analog Xanthine Oxidase Inhibitor}}
Published	07/30/2024	Febuxostat MOA: {{c1::Non-purine Analog Xanthine Oxidase Inhibitor}}
Published	07/30/2024	Uricosuric Drugs ({{c2::Probenecid, Sulfinpyrazone::2}}) MOA: {{c1::URAT1 Blocker}}
Published	07/30/2024	NSAIDs are generally weak acids except {{c1::nabumetone::bonus points on what type of drug it is}}
Published	07/30/2024	Salicylic Acid Derivative Representative Drugs: {{c1::SulfasalazineAcetylsalicylic acidSodium SalicylateDiflunisal::4}}
Published	07/30/2024	Aryl & heteroaryl acetic acid Derivatives Representative Drugs: {{c1::IbuprofenNaproxenFenoprofenOxaprozin::4}}
Published	07/30/2024	Indol & indiene acetic acid Derivatives Representative Drugs: {{c1::IndomethacinSulindacEtodolac::3}}
Published	07/30/2024	Anthranilic acid Derivatives Representative Drugs: {{c1::DiclofenacMeclofenamic AcidMefenamic Acid::3}}
Published	07/30/2024	Enolic acid Derivatives Representative Drugs: {{c1::PiroxicamMeloxicam::2}}
Published	07/30/2024	ASA Dose:Children: {{c1::50-75}} mg/kg/dAdults: {{c1::45}} mg/kg/dLethal: {{c1::>500}} mg/kg
Published	07/30/2024	ASA ADE: {{c1::Gastric Upset/Ulcers, Salicylism}}
Published	07/30/2024	Salicylism Clinical Findings:{{c1::VomitingTinnitusDecreased hearingVertigo}}Occurs at >{{c1::150}} mg/kg or >{{c1::30}} mg/dL
Published	07/30/2024	ASA Overdose Tx: {{c1::Activated charcoal, Sodium Bicarbonate::2}}, Dialysis
Published	07/30/2024	ASA Contraindications: {{c1::Children w/ Flu-like symptoms and viral illness::Bonus point as to why}}
Published	07/30/2024	[QC] Half-Life1. -coxib2. -xicam{{c1::B}}
Published	07/30/2024	{{c1::Ibuprofen and Indomethacin::2}} are NSAIDS that can be used for the closure of the patent ductus arteriosus in preterm infants
Published	07/30/2024	Ibuprofen Important Drug Interactions: {{c1::antagonizes the irreversible platelet inhibition induced by aspirin}}
Published	07/30/2024	Ibuprofen Dose:Children: {{c1::30-40}} mg/kg/dAdults: {{c1::1200-3200}} mg/d
Published	07/30/2024	Naproxen ADE: allergic pneumonitis, {{c1::leukocytoclastic vasculitis, psudoporphyria::2}}
Published	07/30/2024	Ketoprofen MOA: {{c1::Nonselective COX and Lipoxygenase Inhibitor}}
Published	07/30/2024	Oxaprozin MOA: {{c1::Nonselective COX Inhibitor}}
Published	07/30/2024	Oxaprozin Contraindication: Px w/ {{c1::uric acid stones}}
Published	07/30/2024	Do not give {{c1::salicylates (aspirin), tolmetin::2 NSAIDs}} to px with goutDo not give {{c1::oxaprozin::NSAID}} to px with uric acid stones
Published	07/30/2024	{{c1::Oxaprozin}} is an NSAID with the longest half-life of 50-60 hours
Published	07/30/2024	Indomethacin MOA: {{c1::Nonselective COX and Phospholipase A and C Inhibitor}}
Published	07/30/2024	Indomethacin Indications: {{c1::Gout, Ankylosing spondylitis::2}}, Closure of Patent Ductus Arteriosus
Published	07/30/2024	Fenamate MOA: {{c1::Nonselective COX and Phospholipase A2 Inhibitor}}
Published	07/30/2024	Diclofenac MOA: {{c1::Nonselective COX Inhibitor}}
Published	07/30/2024	Diclofenac ADE: {{c1::↑ Serum Aminotransferases}}
Published	07/30/2024	Diclofenac in combination with {{c1::misoprostol}} decreases upper gastrointestinal ulceration but may result in diarrhea
Published	07/30/2024	Diclofenac of >{{c1::150}} mg/day appears to {{c2::impair renal blood flow and GFR}}
Published	07/30/2024	{{c1::Ketorolac::NSAID}} can be used to decrease opioid requirement by 25-50%
Published	07/30/2024	Paracetamol/Acetaminophen MOA: {{c1::Selective COX-3 Inhibitor}}
Published	07/30/2024	Paracetamol Overdose Tx: {{c1::Acetylcysteine}}
Published	07/30/2024	Paracetamol Overdose Clinical Findings: {{c1::hepatotoxicity with centrilobular necrosis, Acute Renal Tubular Necrosis}}
Published	07/30/2024	Rheumatoid Arthritis DMARD DOC: {{c1::Methotrexate}}
Published	07/30/2024	Methotrexate Important Drug Interactions:{{c1::Oral Probenecid::Drug}} - {{c1::↑ Methotrexate::Event}}
Published	07/30/2024	Methotrexate ADE:{{c1::Nausea, Mucosal UlcersPseudolymphomatous reactions↑ Uric Acid → Uric Acid Neuropathy}}
Published	07/30/2024	Methotrexate Contraindications: Px w/ {{c1::Pregnancy and Diabetic Neuropathy}}
Published	07/30/2024	Cyclophosphamide Clinical Uses:{{c1::Systemic Lupus ErythematosusVasculitisWegener’s granulomatosis::3 Diseases}}
Published	07/30/2024	Cyclophosphamide Important Metabolite: {{c1::phosphoramide mustard}}
Published	07/30/2024	Cyclosporine Important Drug Interactions:{{c1::Grapefruit::Drug}} - {{c1::↑ Cyclosporine::Event}}
Published	07/30/2024	Cyclosporine Clinical Findings: {{c1::Retards bony erosions in rheumatoid arthritis}}
Published	07/30/2024	Azathioprine Clinical Uses:{{c1::Psoriatic ArthritisReactive ArthritisPolymyositisSLEBehcet’s Disease::5}}
Published	07/30/2024	Azathioprine ADE:{{c1::Bone marrow suppression → InfectionsGIT disturbancesLymphomas::3}}
Published	07/30/2024	Chloroquine /Hydroxychloroquine Clinical Uses: {{c1::NOT very efficacious DMARD; does not alter bony damage in RA}}
Published	07/30/2024	Chloroquine /Hydroxychloroquine ADE: {{c1::Ocular toxicity}}
Published	07/30/2024	Low {{c1::yield}}
Published	07/30/2024	Colchicine Clinical Uses:{{c1::Prophylaxis of recurrent episodes of gouty arthritis during 1st week of allopurinol therapyAntiprotozoal agent::2}}
Published	07/30/2024	Colchicine ADE:Generalized Abdo SymptomsHepatic toxicity{{c1::Rarely, Hairloss, bone marrow depression, peripheral neuritis, myopathyFatal ascending C…
Published	07/30/2024	Colchicine Overdose Clinical Findings:{{c1::Burning throat pain,Bloody diarrhea, Shock, Hematuria, and Oliguria::5}}
Published	07/30/2024	Colchicine Lethal Dose: {{c1::8}} mg in 24 hours
Published	07/30/2024	Allopurinol Clinical Uses: {{c1::First-line agent for the treatment of chronic gout in the period between attacks}}
Published	07/30/2024	Allopurinol ADE: {{c1::Can precipitate gout}}
Published	07/30/2024	Febuxostat Clinical Uses: {{c1::Px w/ allopurinol intolerance}}
Published	07/30/2024	Uricosuric Drugs ADE: {{c1::Nephrotoxicity and Urolithiasis}}
Status	Last Update	Fields