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Carlos Shared "16 MSK/Derm Pharm" - 13 Picmonics

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16 MSK/Derm Pharm

Arachidonic acid pathway
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Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
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51 secs
Aspirin
Indications
Fever
Pain and Headache
Cardiovascular Disease (CAD)
Mechanism of Action
Irreversible inhibition of COX-1 and COX-2
Suppress Thromboxanes and Prostaglandins
NSAID
Side Effects
Reye's Syndrome
Tinnitus
Peptic Ulceration
Mixed Acidosis/Alkalosis
Nephropathy
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2 mins
Reye's Syndrome
Cause
Aspirin (Salicylates) to Treat Viral Illness (In Children)
Assessment
Cerebral Edema
Lethargy (Decreased LOC)
Vomiting
Liver Failure
Interventions
Monitor for Increased ICP
Mannitol (Osmitrol)
Considerations
No Aspirin for Children
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2 mins
Celecoxib
Indications
Rheumatoid Arthritis
Osteoarthritis
Pain
Mechanism of Action
NSAID
Selectively Inhibits COX-2
Side Effects
Sulfa Allergy
Increased Risk of Thrombosis
GI Bleed
Contraindication
Pregnancy > 30 Weeks
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1 min
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Alendronate (Fosamax)
Mechanism
Inhibits Osteoclasts
Indications
Osteoporosis
Paget's Disease
Side Effects
Esophageal Ulcers
Musculoskeletal Pain
Vision Changes
Atrial Fibrillation
Osteonecrosis of the Jaw
Considerations
Take on Empty Stomach
Remain Upright
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2 mins
Teriparatide
MECHANISM
Recombinant PTH analog given subcutaneously daily.
Increases osteoblastic activity
CLINICAL USE
Osteoporosis. Causes increased bone growth compared to antiresorptive therapies (eg, bisphosphonates)
ADVERSE EFFECTS
Increased risk of osteosarcoma (avoid use in patients with Paget disease of the bone or unexplained elevation of alkaline phosphatase)
Avoid in patients who have had prior cancers or radiation therapy.
Transient hypercalcemia
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Leflunomide
Mechanism
Reversibly inhibits dihydroorotate dehydrogenase, preventing pyrimidine synthesis.
Suppresses T-cell proliferation.
CLINICAL USE
Rheumatoid arthritis
Psoriatic Arthritis
ADVERSE EFFECTS
Diarrhea
Hypertension
Hepatotoxicity
Teratogenicity
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Allopurinol
Competitive inhibitor of xanthine oxidase
Decreased conversion of hypoxanthine and xanthine to urate.
Besides treating Chronic Gout, it is also used in lymphoma and leukemia to prevent tumor lysis–associated urate nephropathy.
Increases concentrations of azathioprine and 6-MP (both normally metabolized by xanthine oxidase).
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Gout Treatment
Acute (Acute-angle)
NSAIDs
Glucocorticoids
Colchicine
Impairs Leukocyte Chemotaxis
Chronic Gout (Crone Goat)
Inhibit Xanthine Oxidase
Allopurinol
Febuxostat
Inhibit Reabsorption of Uric Acid
Probenecid
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1 min
TNF-Alpha Inhibitors Overview
Mechanism
Downregulates Pro-inflammatory Cytokines
Decreased Lymphocyte Activation and Migration
Granuloma Breakdown
Treats
Crohn's Disease
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Psoriasis
Ankylosing Spondylitis
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1 min
TNF-Alpha Inhibitor Drugs and Complications
Etanercept
Decoy TNF- Alpha receptor
Anti-TNF- Alpha antibody
Adalimumab
Infliximab
Complications
Increased risk of infection
Predispose to Tuberculosis (TB) reactivation
Order Baseline PPD- skin test
Quantiferon Gold In-Tube
Order Chest X-Ray
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2 mins

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