Biochemistry of Phospholipids and Eicosanoids
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Questions and Answers

Which of the following is considered the simplest structure of phospholipids?

  • phosphatidic acid (correct)
  • phosphatidylcholine
  • phosphatidylethanolamine
  • phosphatidylserine

Phospholipids are predominant lipids in which of the following?

  • cytosol
  • cell membrane (correct)
  • extracellular matrix
  • nucleus

Which of the following phospholipids does not contain a glycerol backbone?

  • phosphatidylethanolamine
  • sphingomyelin (correct)
  • phosphatidic acid
  • phosphatidylinostol

Which phospholipid's degradation affects calcium release and protein phosphorylation in the cell?

<p>Phosphatidylinositol 4,5-bisphosphate (B)</p> Signup and view all the answers

What are the degradation products of phosphatidylinositol 4,5-bisphosphate?

<p>Diacylglycerol (DAG) (B), inositol 1,4,5-triphosphate (IP3) (C)</p> Signup and view all the answers

Which phospholipid serves as a reservoir of arachidonic acid for prostaglandin synthesis?

<p>phosphatidylinositol (D)</p> Signup and view all the answers

Which of the following structures is composed of repeating disaccharide units?

<p>glycosaminoglycan (C)</p> Signup and view all the answers

Which biological structure has the ability to bind large amounts of water and forms a gel-like matrix in the extracellular matrix?

<p>chondroitin sulfates (A), glycosaminoglycan (B), hyaluronic acid (C)</p> Signup and view all the answers

Which lipase is primarily involved in the production of second messengers?

<p>Phospholipase C (D)</p> Signup and view all the answers

Which steroid is recognized as the most potent?

<p>Betamethasone (A)</p> Signup and view all the answers

Which of the following compounds can be classified as eicosanoids?

<p>Thromboxanes (B), Prostaglandins (C), Leukotrienes (D)</p> Signup and view all the answers

Which pathway is responsible for the biochemical synthesis of prostaglandins?

<p>Desaturation and elongation of linoleic acid (B), Oxidation cyclization by PGH Synthase (D)</p> Signup and view all the answers

Which enzyme is essential for maintaining healthy gastric tissue and is produced constitutively?

<p>COX 1 (B)</p> Signup and view all the answers

Which agent is an appropriate leukotriene modifier for a pediatric asthma patient?

<p>Montelukast (A)</p> Signup and view all the answers

What is the correct dosage of montelukast for a four-year-old child?

<p>A 4 mg chewable tablet taken once daily in the evening (D)</p> Signup and view all the answers

Arachidonic acid can be converted in the body by which of the following? Select all that apply

<p>Leukotrines (A), prostaglandins (B), Thromboxanes (C)</p> Signup and view all the answers

What is one method to administer granules to a child as advised?

<p>Mix with a spoonful of cool, mashed carrots and administer within minutes. (C)</p> Signup and view all the answers

Which of the following is a known warning associated with the use of Singulair?

<p>Neuropsychiatric events (B)</p> Signup and view all the answers

What is a common side effect of long-term prednisone therapy?

<p>Increased muscle mass (A), Elevated mood (B), Decreased appetite (C), Impaired wound healing and Osteoporosis (D)</p> Signup and view all the answers

What is the primary indication for Lovaza?

<p>To lower triglycerides in patients with TGs ≥ 500 mg/dL as an adjunct to diet (A)</p> Signup and view all the answers

Which patient would require caution when prescribed Vascepa?

<p>A patient allergic to fish or shellfish (D)</p> Signup and view all the answers

What is the mechanism through which aspirin exerts its antiplatelet effects?

<p>Inhibition of Cyclooxygenase-1 (B)</p> Signup and view all the answers

Which symptom might indicate toxicity from aspirin, when used with bismuth subsalicylate?

<p>Heart burn and dyspepsia (C)</p> Signup and view all the answers

Which agent is specifically noted for having a high degree of selectivity for cyclooxygenase-2?

<p>Celebrex (C)</p> Signup and view all the answers

What is the primary reason for using aspirin in a patient with chest pain?

<p>Inhibit platelet aggregation (A)</p> Signup and view all the answers

Which NSAID is generally regarded as the safest option for patients with a history of myocardial infarction (MI)?

<p>Naproxen (A)</p> Signup and view all the answers

What is the appropriate action regarding the child's use of aspirin given their past response?

<p>The occasional use of aspirin for mild illness in children is acceptable. (D)</p> Signup and view all the answers

Which of the following options correctly describes a mechanism of action of epoprostenol?

<p>It is a prostacyclin analogue. (C)</p> Signup and view all the answers

What is a crucial counseling point for a patient receiving Flolan?

<p>The drug must be protected from light during administration. (B)</p> Signup and view all the answers

Which medication is least likely to trigger a respiratory reaction in a patient with a history of nasal polyps and asthma after using aspirin?

<p>Acetaminophen (D)</p> Signup and view all the answers

In a patient weighing 75 kg receiving a continuous epoprostenol infusion of 3.8 mL/hr from two 1.5 mg vials diluted to 100 mL, what is the calculated dose in ng/kg/min?

<p>12.7 ng/kg/min (C)</p> Signup and view all the answers

What is the correct over-the-counter dosing for ibuprofen for an adult?

<p>200 mg tablets, Q4-6 hours, take 1-2 as needed. (A)</p> Signup and view all the answers

Which statement best describes the drug Arthrotec?

<p>This drug contains an NSAID and the prostaglandin analog misoprostol. (B)</p> Signup and view all the answers

What is true regarding the infusion of epoprostenol?

<p>The drug must be administered protected from light. (D)</p> Signup and view all the answers

Which receptor does aspirin inhibit to exert its therapeutic effects?

<p>Cyclooxygenase-1 (COX-1) (B)</p> Signup and view all the answers

Considering the patient's medical history, what is a significant concern regarding the use of celecoxib?

<p>Celecoxib is not an appropriate choice for this patient. (B)</p> Signup and view all the answers

Which medication listed does NOT act as a cyclooxygenase inhibitor?

<p>Epoprostenol (A)</p> Signup and view all the answers

What is the maximum appropriate daily dosage of aspirin for this child?

<p>10 mg/kg/day (D)</p> Signup and view all the answers

Which option correctly identifies a safer alternative for analgesia in this patient experiencing adverse reactions to aspirin?

<p>Acetaminophen (A)</p> Signup and view all the answers

What should the mother be advised regarding the use of aspirin formulations in children?

<p>Enteric-coated aspirin is preferred. (A)</p> Signup and view all the answers

Which medication provides the strongest protection from NSAID-induced gastrointestinal ulceration and bleeding?

<p>Rabeprazole (C)</p> Signup and view all the answers

What two agents are combined in the prescription for Yosprala?

<p>Naproxen and esomeprazole (C)</p> Signup and view all the answers

What is the correct mechanism of action for naproxen?

<p>Inhibits cyclooxygenase to reduce prostaglandin formation (D)</p> Signup and view all the answers

If a patient requires an NSAID with high COX-2 selectivity but finds Celebrex too expensive, which of the following would be the best alternative?

<p>Mobic (C)</p> Signup and view all the answers

What is the maximum combined duration of treatment for ketorolac across all formulations?

<p>5 days (D)</p> Signup and view all the answers

Which statements about ketorolac is correct?

<p>Begin with oral or nasal therapy and switch to IV as soon as possible (D)</p> Signup and view all the answers

What is the mechanism of action for the antiplatelet medication provided on a patient’s discharge list?

<p>Inhibits thromboxane A2 to prevent platelet aggregation (C)</p> Signup and view all the answers

What is the primary use of the Lidoderm patch?

<p>Local pain relief (A)</p> Signup and view all the answers

Flashcards

Simplest Phospholipid Structure

Phosphatidic acid is the simplest phospholipid, composed of glycerol, two fatty acid chains, and a phosphate group.

Where are Phospholipids Found?

Phospholipids are predominantly found in cell membranes, forming the lipid bilayer structure.

Non-Glycerol Phospholipid

Sphingomyelin is a phospholipid that lacks a glycerol backbone and instead utilizes sphingosine as its base.

Phospholipid Involved in Calcium Release

Phosphatidylinositol 4,5-bisphosphate (PIP2) plays a crucial role in calcium release and protein phosphorylation when degraded.

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Products of PIP2 Degradation

The breakdown of PIP2 produces inositol 1,4,5-triphosphate (IP3) and diacylglycerol (DAG), both involved in cell signaling.

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Arachidonic Acid Reservoir

Phosphatidylethanolamine serves as a reservoir for arachidonic acid, which is a precursor for prostaglandin synthesis.

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Biological Structure with Repeating Disaccharides

Glycosaminoglycans (GAGs) are complex carbohydrates consisting of repeating disaccharide units.

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Water-Binding Structures in ECM

Hyaluronic acid, chondroitin sulfates, and heparin are glycosaminoglycans that bind water, forming a gel-like ECM. They work together with collagen, elastin, and fibronectin to create the ECM.

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Phospholipase C

An enzyme that hydrolyzes phospholipids, specifically phosphatidylinositol 4,5-bisphosphate (PIP2), to produce diacylglycerol (DAG) and inositol triphosphate (IP3).

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Second Messengers

Small intracellular signaling molecules that relay signals from extracellular messengers, like hormones, to intracellular targets, often triggering cascades.

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Potent Steroid

A steroid with a high level of activity or efficacy, meaning it produces a desired effect at a lower dose compared to other steroids.

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Eicosanoids

A group of lipid-derived signaling molecules involved in diverse biological processes, including inflammation, pain, fever, and blood clotting.

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PGH Synthase

An enzyme that catalyzes the first step in the biosynthesis of prostaglandins from arachidonic acid, forming the prostaglandin precursor, PGH2.

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COX 1 (Cyclooxygenase 1)

An enzyme involved in the production of prostaglandins that are essential for various physiological processes, including gastric protection, renal homeostasis, and platelet aggregation.

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Leukotriene Modifier

A medication that blocks or inhibits the synthesis or action of leukotrienes, inflammatory mediators involved in asthma.

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Montelukast

A leukotriene modifier medication that blocks the action of leukotrienes, helping to reduce inflammation and improve symptoms of asthma.

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Aspirin Use in Children

Aspirin use in children is generally avoided due to the risk of Reye's syndrome, a serious and potentially fatal condition.

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Aspirin Sensitivity and Asthma

Patients with nasal polyps and asthma are often sensitive to aspirin and other NSAIDs, potentially triggering severe respiratory reactions.

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Ibuprofen Adult Dosage

The typical adult dosage of ibuprofen is 200-400 mg every 4-6 hours, as needed.

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Arthrotec: NSAID + Misoprostol

Arthrotec is a combination medication containing an NSAID and misoprostol, a prostaglandin analog used to protect the stomach from NSAID-induced ulcers.

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Celecoxib Use in High-Risk Patients

Celecoxib, a COX-2 inhibitor, should be used cautiously in patients with a history of cardiovascular disease, gastrointestinal bleeding, or other risk factors.

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Naproxen Use in Children

Naproxen is generally avoided in children, especially before surgery, due to the potential for serious complications.

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NSAID Sensitivity

Some individuals are hypersensitive to NSAIDs, potentially experiencing allergic reactions, such as difficulty breathing or swelling.

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Enteric-Coated Aspirin

Enteric-coated aspirin formulations are designed to release aspirin in the small intestine, reducing stomach irritation.

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NSAID-Induced GI Ulceration Protection

The medication that provides the strongest protection from NSAID-induced GI ulceration and bleeding is a proton pump inhibitor (PPI). PPIs work by blocking the production of stomach acid, which can help to reduce the risk of ulcers and bleeding.

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Yosprala - What's in it?

Yosprala is a combination drug containing naproxen, an NSAID, and esomeprazole, a proton pump inhibitor (PPI).

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Naproxen's Mechanism of Action

Naproxen is an NSAID that inhibits cyclooxygenase (COX) enzymes. COX enzymes are responsible for the production of prostaglandins, which are involved in inflammation and pain.

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High COX-2 Selectivity - Alternative to Celebrex

If a highly COX-2 selective NSAID is needed, but Celebrex is too expensive, Mobic (meloxicam) is a suitable alternative.

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Ketorolac - Maximum Treatment Duration

The maximum combined duration of treatment with ketorolac (parenteral, oral, and nasal formulations) is 5 days.

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What is a Proton Pump Inhibitor (PPI)?

A PPI is a type of drug that blocks the production of stomach acid. They are used to treat conditions such as heartburn, GERD, and ulcers.

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What is NSAID?

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of drugs that reduce pain and inflammation.

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Why is Ketorolac not used in patients with severe renal impairment?

Ketorolac can be toxic to the kidneys, so it is not recommended for patients with severe renal impairment.

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Aspirin's Primary Action

Aspirin's primary action in patients with chest pain is to inhibit platelet aggregation, preventing further clot formation.

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Safest NSAID After MI

Celecoxib is generally considered the safest NSAID for patients who have had a heart attack.

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Aspirin's Action Site

Aspirin inhibits the cyclooxygenase enzyme, specifically at the active site labeled 'A' in the figure. This action prevents the production of prostaglandins involved in inflammation and platelet aggregation.

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Epoprostenol Mechanism

Epoprostenol is a prostacyclin analogue, a powerful vasodilator that relaxes blood vessels and inhibits platelet aggregation.

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Epoprostenol Dosage Calculation

The patient's epoprostenol dosage is 25.3 ng/kg/min. This is calculated by considering the infusion rate, the concentration of the drug in the solution, and the patient's weight.

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Flolan Administration

Flolan is a drug that requires special handling and protection from light during administration.

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Epoprostenol Infusion Considerations

Epoprostenol infusions need to be meticulously managed, ensuring the drug is protected from light during administration and that the infusion pump is correctly calibrated.

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Epoprostenol Administration Risks

Parenteral administration of epoprostenol can potentially cause vision and hearing loss. It is critical to monitor patients for these adverse effects.

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Singulair Warning

Singulair (montelukast) is a leukotriene modifier used for asthma. It carries a warning about potential neuropsychiatric events, including mood changes, anxiety, depression, and suicidal thoughts.

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Prednisone Side Effects

Prednisone, a corticosteroid, can cause various side effects, including impaired wound healing, weight gain, osteoporosis, hyperglycemia, and a buffalo hump (fat deposit on the upper back).

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Lovaza Indication

Lovaza (omega-3 fatty acids) is used to lower triglyceride levels in patients with very high triglycerides (≥ 500 mg/dL) as an adjunct to diet.

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Vascepa Allergy Caution

Vascepa (icosapent ethyl) is an omega-3 fatty acid medication. It should be dispensed with caution to patients with fish or shellfish allergies.

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Aspirin's Antiplatelet Action

Aspirin's antiplatelet effect works by inhibiting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), enzymes involved in blood clotting.

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Aspirin Toxicity Signs

High doses of aspirin, especially with bismuth subsalicylate (Pepto-Bismol), can lead to signs like tinnitus (ringing in the ears), skin rash, and gastrointestinal upset.

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Highest COX-2 Selectivity

The question asks for the drug with the highest selectivity for COX-2. While the text snippet provides only an incomplete 'A.', we can deduce that Celecoxib (Celebrex) is a strong COX-2 inhibitor and likely the answer.

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Administering Granules

The text provides several options for administering medication granules, including mixing with applesauce, water, breast milk, or mashed carrots. The specific instructions depend on the type of granules and the patient's age.

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Study Notes

Phospholipid Structure and Function

  • Phosphatidic acid is the simplest structure of phospholipids.
  • Phospholipids are predominant lipids in cell membranes.
  • Some phospholipids lack a glycerol backbone, like sphingomyelin.
  • Degradation of phosphatidylinositol 4,5-bisphosphate affects calcium release and protein phosphorylation.
  • Arachidonic acid and inositol 1,4,5-triphosphate (IP3) are degradation products of phosphatidylinositol 4,5-bisphosphate.
  • Phosphatidylinositol is a reservoir of arachidonic acid and a substrate for prostaglandin synthesis.
  • Certain products contain omega-3 fatty acids, like lovaza.

Biological Structures

  • Glycosaminoglycans are composed of repeating disaccharide units.
  • Glycosaminoglycans, along with collagen, elastin, and fibronectin, make up the extracellular matrix.
  • Some biological structures, such as glycosaminoglycans, are composed of repeating disaccharide units.

Phospholipases and Lipids

  • Phospholipases, such as phospholipase A1, A2, B, C, and D, are enzymes that specifically act on phospholipids.
  • Phospholipase A2 plays a role in producing secondary messengers.
  • Certain phospholipases, particularly phospholipase A2, release arachidonic acid, a precursor to prostaglandins.
  • Steroids, such as hydrocortisone, methylprednisolone, triamcinolone, dexamethasone, and betamethasone, are classified as such.

Eicosanoids, NSAIDs and Other Drugs

  • Arachidonic acid is a precursor to prostaglandins, thromboxanes, and leukotrienes, which are eicosanoids.
  • Eicosanoids, which include prostaglandins, thromboxanes, and leukotrienes are considered eicosanoids.
  • NSAIDs like Ibuprofen, naproxen affect prostaglandin production.
  • Celecoxib is an NSAID with high COX-2 selectivity.
  • Certain drugs, like celecoxib, are associated with high COX-2 selectivity.

Other Medications

  • Montelukast is a leukotriene modifier used to treat asthma.
  • Aspirin is an NSAID used for pain relief, but is associated with side effects that need to be carefully considered like upset stomach.
  • Epoprostenol is a prostacyclin analogue.
  • P2Y12 receptors are targeted by some medications.

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Biochemistry PDF

Description

Test your knowledge on the fundamental structures and functions of phospholipids and eicosanoids in biochemistry. This quiz covers key concepts such as degradation products, enzymatic roles, and their impact on cellular processes. Perfect for students studying biochemistry or related fields.

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