Learning Objectives

• Describe the roles of the major cell-derived mediators of inflammation (review)
• List and outline the synthesis of the major arachidonic acid metabolites, and describe their role in inflammation (review)
• Explain the mechanisms of action of, common adverse effects of, and precautions associated with non-selective and COX-2 selective NSAIDS (coxibs)
• Describe the effects of corticosteroids (glucocorticoids) on inflammatory cells and mediators, and relate this to their use in anti-inflammatory therapy
• Compare the indications, effects and pharmacokinetics of the major corticosteroid drugs, and discuss issues associated with long term treatment
• Outline the basic pathophysiology of osteoarthritis and rheumatoid arthritis
• Describe the mechanisms of action and major adverse effects of the main antirheumatic drug classes, including methotrexate, TNF-alpha antagonists, cytokine inhibitors and 5‑aminosalicylates
• Outline the pathophysiology of gout and the mechanism of action of colchicine in treatment

NSAIDs

• mechanism of action?
• indications?
• major adverse effects?
• important contraindications?

Coxibs

• mechanism of action?
• indications?
• important interactions?
• why do coxibs $\uparrow$ CV risk?