Page 660 - Basic _ Clinical Pharmacology ( PDFDrive )

646 SECTION VI Drugs Used to Treat Diseases of the Blood, Inflammation, & Gout

Stimulus

Disturbance of cell membranes

Phospholipids
Phospholipase inhibitors – Phospholipase
Corticosteroids
Fatty acid substitution (diet) Arachidonic acid

Lipoxygenase inhibitors – Lipoxygenase Cyclooxygenase – NSAID, ASA

Leukotrienes
Receptor –
antagonists

LTB 4 LTC /D /E 4 Prostaglandins Thromboxane Prostacyclin
4
4
Phagocyte Alteration of vascular
attraction, permeability, bronchial
activation constriction, increased Leukocyte modulation
secretion
Colchicine –

Inflammation Bronchospasm, Inflammation
congestion,
mucous plugging

FIGURE 36–2 Prostanoid mediators derived from arachidonic acid and sites of drug action. ASA, acetylsalicylic acid (aspirin);
LT, leukotriene; NSAID, nonsteroidal anti-inflammatory drug.

O O
C OH C O Na
O C CH 3 OH
Aspirin O Sodium salicylate

O
O
C O –
HO C CH 3 OH
Acetic acid
Salicylate

Conjugation with Conjugation
glucuronic acid with glycine Oxidation
O H O
Ester and ether C N CH 2 COOH Free HO C OH
glucuronides salicylate
OH OH
Salicyluric acid Gentisic acid
(1%)

FIGURE 36–3 Structure and metabolism of the salicylates. (Reproduced, with permission, from Meyers FH, Jawetz E, Goldfien A: Review of Medical
Pharmacology, 7th ed. McGraw-Hill, 1980. Copyright © The McGraw-Hill Companies, Inc.)