Summary Pharmaco - Pathology MSK

Download as pdf or txt
Download as pdf or txt
You are on page 1of 6

Benz MDSU 09

Pharmacology of muscle

f
I. Immune response during inflam •
'
LOX


eicosanoid :& ioñpnuñsiiiioirinmionirou

product riwionmririw 02 Yuri fatty oi

-
Arachidonic acid iitwairoisoiwfwmrroiiseicosanoid

Eicosanoid
Clinical
pharmacology of

② Reproductive system
-
Abortion
-
PGE & PG Fu
,
UÑsoonwmow9nÑ noon - ÑU Waren
Lothian's : Dino pro stone coils PGE 2)

Misoprostol Mifepristone Carti progestin )


with

titis anti progesterone c progesterone nihilo:O ? www.nnwmwl


-

Facilitation of Labor : to's noon


-

Su / pros tone CPGE , ) ,


PGF
,& ,
Dino pro store

2. Ñ stimulus winroiw Phospholipase A cfn : oin arachidonic "a -

Dysmenorrhea : Usa Uorinñow


,

00min cell membrane) -

PGE , I PGF , a

uÉswou
-

NSAID → block Cox n' Ii


prostaglandin
÷

;;;÷:*
. ""
ICOXI 1 Lox ] ② Renal system
L Leukotrienes
L Posta
gland in Battery syndrome

{ Prostacydin

target "> asthma _
mini , > prostaglandin oonanioo =
,
www.ou

%!¥%ni; riri hormone response niowoio angiotensin K+ loss


-

fi
Udon IÑOOUN -

COX inhibitor doo bas . block prostaglandin


• COX ,
& COX 2

③ Cardiovascular system

cepoprostenohnihiuaonnwoiwlnoahidoo.no
-

Pulmonary Hypertension : hi PGI ,


inion Venetia
-
Patent Ductus Arteriosus ( PSA )

Libo .

NSAID -1 indomethaein) :ni4iuaoaÑoaÑn


Alprostadil :n;4ñunonÑooÑn
COX -1 :
Aoi, Prostaglandin Ei ( PGE 1) → aÉDiÑon&n=lW7=
⑨ Blood rslectively inhibit platelet Cox -1

n-wtsitu-irfonnisoislbutmrn-isiwvotmtaioicso.in
ñismÉopn induce iidwantiplatet
COX -2 : a- cex . onion -46 low dose aspirin
lwioihsñw cardiovascular nisñ 2
'

induce →
⑤ Respiratory system 6. Piroxicam
nifiiunonnsnunois
PGF ITXA
strong Broncho constriction
- :

,, ,

-

Asthma :
Monte / ukast a- block leukotriene receptor 7 .
Mefenamic acid I Ponstan )
-

Corticosteroid -
HñJsaUtinÑow t
Dysmenorrhea )

⑥ Gastrointestinal
system Non opioid analgesic
-

Misoprostol ñoniiw " 1 .


Paracetamol ( Acetaminophen )
-

weak Cox -1 & Cox -

a inhibitor nisi anti.int/am-


⑧ Glaucoma oiouw ni acetaminophen glucuronic
+ /
-

Latanoprost sulfate a nontoxic

⑨ Hypotrichosis www.ou bit ñiiuñu CYP a. toxic ñu liver


-

Bimatoprost niki won in > motorist counter attack irtw

glutathione rialto toxic -


non-toxic

/ oioiñpomeprazdeoinanrorc Proton pump inhibitor ) lioiñiñweoniiititoo .

glutathione Yaiwo
Nga , g → Liver cell death
↑ N -

acetyl cysteine CNAC )

1. Aspirin its antidote us


para
iiñoolaiuisoio ,iÑwÑonuÑÑw'qañw )
-

irreversibly block platelet Cox at salfhydryl group


Hiv toxin
-

pain rinr-iwr.iuoontoiiion.IM litmus 946


glutathione nosy
tailor bcs .

Rheumatoid arthritis 1ˢᵗ line artery thrombosis www.iwmembranetailoi

µ
coronary
:
- -

Osteoarthritis
-

transient ischemic attack -

mild -
moderate pain
-
Ad effect : -

Hyperthermia roses 'Wo


-
Ad effect : -
reversible twin hepatic
enzyme
- iwn-uiua.tw'Ñ
Reye 's syndrome ( hepatic encephalopathy )
hepatotoxicity
-

is
g-
-

in hemophilia
-

iiiontuntaiueyn I -
riowwiño
Topical
'
-

G- 6- Po -

near term
pregnancy NSAID
loinñoia viral I (
Cooter irritant mnniar.mu/oFos
-
-

Kinnan -

metabolic acidosis iibnociceptoriunnwiiuib.sn


Drug interaction TRP channel
-

-
-
:

6
-

ASA + Probenecideniñi =
ineffective antidote : NAHCO
,

ASA + Warfarin uioiiwmrnisoioucsi 'Ñoa =


bleeding tuntsiuqa
-

ASA + Anti -

hypertensive ± decrease effect


ASA Diuretics oomph Ébioono
- + =

winner

8. Coxib
-
selective block cox -2 if .
:uaoaÑonñYnpnwñ , ) 1 .
Rubefacients
buaooifoodnunoiahnrostoiw-oe.org *
→ vanish edema →
congestive heart failure 2.
Salicylate

hypertension
* -

methyl salicylate :
cooter pain uiuaios
,

Cooter irritant
myocardial infarction cna-wiiioii.to ones -
-
-

62 safe noioioiña cardiovascular disease


-

Yai north broken skin


-

inhibit Cox -2 -
Cox -

I nisiwanniiw inn thromboxane Ñw anti plate tannin -

2. Diclofenac 3 .
Menthol
-

Eis -
frnñu Cliver function -

Promiscuous action oongnÉYUñ's

3.
Ibuprofen 4. Capsaicin
Ñ TRPV channel Iifwoio
sensory
-

4. lndomethacin -

Phase 1 :
nr=oIw vanilla'd receptor .
you win

in ductus arteriosus -
Phase 2 : Desensitize plasma membrane TRPV , receptor
Ysiisr " " Nian criifu-hiiiun.in
5. Naproxen
-
selective Cox 2
Gout _

fiwnwñ
'

under excretion %nÑri9i allopurinol ,


febuxostat
-

mirror :
now Vos monosodium urate Yayoi
-

Aim roses
-

Taiki now acute attack → visa -

s week ñoo4i
-

relieve acute gouty attach invioimr Joo -

Ad effect 61 irritation : - -

nephrotic syndrome
-

prevent recurrent gout bikinis.in -

Rash
Note Benzbomarone
:
-

idiosyncratic hepatotoxicity
1.
Synoviocyteouñis uric an Hindi ow ←

riwiinocryiitñtwiñn stone formation


PG ,
IL -

I 00AM colchicine -
Yainortiiñu kidney disease
o_0
2. PG
nigh PMN hell 12in lion V12 )

3. 1L -1 nr.o.in MNPC
macrophage > Nouri u 2.2 Xanthine oxidase inhibitor : block mirin uric an

uric oi → Uniounrironinu IL -
MO -

Allopurinol
lndomethacinl NSAID -

inhibit xanthine oxidase


l
Hypoxanthine a. iÉaÉw cfnisroiisnnio purine ]
ÑoÑnÑn gout
Alcohol
kidney disease nr
:p'w
- →
, ,

ñhnrionoiins
Chronic urate
lowering therapy niki : uric
-
-

> 2 attack /year chronic kidney disease


-

-
twins nihilo cnn.uaiiburitaissoimri.hu
:
-

-1-0

1. Colchicine
-

an pain iwnwiiw gout only & in flam -

Allopurinol metabolise like Alloxanthinenioonrynitowiw


Yaiaiwaoio metabolism & excreatoosurateywritiiuric.ci First line in gout
-

anas

-
a- uñu protein tubulin Cisneros microtubule riaiwooiomriniiowtua ) ↑ oiosmrso HLA-B# 5801 how
→ inhibit leukocyte -

gout flare oianor.oiuuricahnioonnfu-iasuriorir.rs


:

9Émwy%1ñ Bcs sina.nu cell mitosis & tubulin


.

polymerization snoiouyonnuoi Hunn notifier NSAID


> →

-
Acute
gout attack -

prolong prophylaxis Clow dose) -

Ad effect : -

precipitating gout / colchicine


-
inter critical period Yaiwoimrñitñ -

hepatic toxicity
-
Ad effect : -
Diarrhea often)* -

AHS ( allopurinol hypersensitivity syndrome )


-
Ésiownvosoiiigiio ( tries .nu
gene HLA-B # 5801

Allopurinol Azathioprine oiinuiwii> & RA


-

-1

NSAID in
gout =
block titi azathioprine inactive nikitin toxicity
lndomethacin used replacement for colchicine ) oicsno dose azathioprine
commonly as i. as
-

All other NSAID


salicylate & to / metin into Allopurinol cyclophosphamide invnisfo 9 effect
'

except aspirin +
-
-
=

naproxen ibuprofen diclofenac & celecoxib ) Probenecid & oral


anticoagulant inhibit metabolism
-
( en
-

, ,

Irvin gout flare ñuiwuyaioi


2. Urate -

lowering agents
2. I Uricosuric agent : iuuricoonanni.is Tinio goutrinnviiu -

Febuxostat
-

Probenecid & Benzbomarone " icñ 00^4%5600 -

potent oonynÉw > + selective non -

purine inhibitor
-

" urate %nwñ' tophaeeoo , gout -


Ani , allopurinol uÑo7HW9
gout attack
:
-

own iioo
like uricaseñiihiers allantois
ikr "
minion Pegloticase :
uric a' →

OAT : its transporter niki


iu +
a. oniiuricñ Glucocorticoids in gout
i. Probenecid a- block ñu inhibit prostaglandin
-

too block phospholipase A2
iuoon +
a. auric antiunion
-
Prednisone
Mri net result -4in:O -
Linton di NSAID colchicine Yayoi ,
( ,

( renal allopurinol

uric oiiooonsnnii IIÑ
two excreation impairment / chronic kidney disease
-

wean

Probenecid + Penicillin =Ñso=ñu Penicillin ishii'oYññÉw ) -


Ad effect : -
immune
suppression
THE ñu renal stone within bcs a. institutor fluid retention
-
-
.

oiooñwiiiieo = + niki urine pltiilwiunr 960=4 oiiuoontoioi


-

mood change
Rheumatoid arthritis CRA )
-

autoimmune disease
in flam
Aim reduce pain improve functioning
-

→ -

slow

joint damage

Pathogenesis
1.
nr-o.in innate cellular immune response

I. Methotrexate
- Prints ,
01 Ñw
,
as ID
-

folic an antagonist →
on 's
supply a- so folic d / ucovorin
-

uiwiihrnwnis

2. Azathioprine
-4in'u allopurinol oicsfiidose anas

nikitin concerto naniwa Union NUDT , # inn leuhopeniatñ


'

3.
Cyclophosphamide
-

n' hi DNA into fossils &


replicate Taibi
-

cross - link DNA


-

Pancytopenia aiwoñupn cell cell rims ,

hemorrhagic cystitis onishi mesna -

-
n' hi cell D- wake

a.
Cyclosporine & Tacrolimus
-

inhibit calcineurin riointwoio mirin 1L -1,1L -

hypertension -

Bladder cancer

sterility iefuuaiw

5. Chloroquine &
Hydroxychloroquine
Ocular -4in unionists
toxicity
-

-
Slide Bone : & joint parts
J Psh
Achondroplasia
.

I. nnr=

disease / Osteitis
-

autosomal dominant trait 8.


Paget deform ans )
tach fibroblast growth factor & thin
epidy seat plate sinus uoiniisuaiiñw
'
saw &
-
-

↳ linin
long bone -

wuhinwoiqioo.mn
-42hr.nu mental &
intelligent -

high output heart failure ,


osteosarcoma hsiooiw
-

FGFRS
gene
IÑU Ñsnw

2.
Osteogenesis imperfecta or :pnWn=
abnormal collagen synthesis
type 1
-

blue sclera e Minotti ,


deafness
-

type I a- monsoon

3.
Osteoporosis nr-pnwr.ir
-
reduction of bone mass win:p -nésUnÑoÉ
-
in onn →
age postmenopausal
to Yw n' oufiisiw localized
,

'

ex own win
( endocrine disturbance
-

,
neoplasm ,
61 ,
corticosteroid
Bone mineral
density ( BMD ) S D
-
< 2.5 -
.

Yaiaioimr moist complication c


fragility fracture ) I. Fracture
fracture
Mostly hip
-

arts n' on
-

kypho scoliosis

4. Rickets & Osteomalacia naps dow


-

Irian Vit D
deficiency / pain Vit D YñYaiñ
-

oh > mourn mineral Ninian> initiations bone Ñuoi osteoid


bow Vin's lumbar lordosis
leg no
:p ninian
's so
-

,
frontal
bossing no
:p nuiiiwnfu's ,
rachitic
rosary nr-rifnb.vn
IV. noisy
, pigeon breast
-

deformity iv. pnuwionfu's


thrioin
-

thicket :
triathlon
-

growth plate Ñur Viis


.

-
bone pain , easy fracturing , bending bone a adult

5. Osteitis fibro sa cystic a

severe
primary hyperparathyroidism
-

osteoclast creabsorp bone ] loin Nuno


-

a- lieu nr.ph /
Ñwfwosy

6. Renal osteo
dystrophy
Dinu "nñuYé9aiÑ
chronic osteo
dystrophy n' Ca
-

7.
Osteopetrosis riparia
-
inherited disease c autosomal recessive & dominant )
dense bone bmalignant hdenign
-

abnormally
-
stone bone
-

cause unknown

cranial v91 > N skull ( CN CN8


no nerve 2 MUON
YU won )
-

inion -_pnYU replace hematopoietic cell c bone marrow )


,

initio in WBC RBC


,
etc toils'S
2.
Aneurysmal bone
cyst
Bone tumor
-
Ñ cyst iriaiw iioitsiiwiis N' w benign
-

cause unknown
-
inuifoo -

curettage 4iiÑ"osÑoyo
ten bloc resection oiaoonri's block

3. Osteo necrosis ( Avascular necrosis )


-

V10 Info or

nr-pnciowquoizdw.sn > ( Osteochodritis dissecans )

linen trauma ,
radiation , systemic disease

Infection osteomyelitis :

I. Suppurative
osteomyelitis
5.
-

hematogenous route
aureus arms (1%00)
-
loinwniilw
-

Subperiosteal abscesses
, draining sinus uwcsoonnis

sinus , suppurative arthritis ,


sarcoma Yoi
-

drain + hi antibiotic
guns
↑ strum lhionrpnñiw I lÑwuw
segue ,
-

-
↑ involucrum inion pnriaiisfudnnwo-wn.tw'ÑU
:

2. Tuberculous osteomyelitis
muscle to
'

win no :p nirwuris
psoas
-

You might also like