135 - NSAIDS, Anti-inflammatories

Question 1

List the effects of COX-1 (GOOD) enzyme stimulation:

Answer 1

Always present in body

Stimulated by usual wear and tear of body, results in normal repair

Question 2

List the effects of COX-2 (BAD) enzyme stimulation:

Answer 2

Produces prostaglandins associated with inflammation and in kidney for normal renal function
Responds to injury and results in inflammation
Not always present in body

Question 3

List the actions / effects of prostaglandins in the inflammatory process:

Answer 3

Areas of inflammation – vasodilation, pain, swelling, impaired cellular function

Question 4

List the actions / effects of thromboxanes in the inflammatory process:

Answer 4

Vasoconstriction, platelet aggregation

Question 5

List the actions / effects of leukotrienes in the inflammatory process:

Answer 5

Inflammatory mediators and respond to allergy and inflammation, bronchoconstriction, vascular permability

Question 6

Discuss the anti-inflammatory effects of NSAIDs:

Answer 6

Decrease inflammation antipyretic
Analgesia anticancer
Platelet aggregation inhibition

Question 7

Discuss the inhibition of platelet aggregation effects of NSAIDs:

Answer 7

Inhibits thromboxane production

Question 8

What is the mechanism of action for NSAIDs:

Answer 8

Inhibits cyclooxygenase
May decrease prostaglandin activity
Decrease phagocytic function of neutrophils

Question 9

List the side effects of NSAIDs:

Answer 9

GI irritation GI ulcers
Anorexia diarrhea
Decrease renal blood flow hepatotoxicity

Question 10

Define analgesia.

Answer 10

Inability to feel pain

Question 11

Define inflammation as to causes and components:

Answer 11

Occurs as response to sub lethal injury to cells
Components consist of increased blood flow to area, increased capillary permeability, pain, chemotaxis leads to phagocytosis, coagulation and fibrinolytic pathways activated

Question 12

List some of the damage that the inflammatory processes can do:

Answer 12

Allergy shock edema proud flesh

Question 13

List the cardinal signs of inflammation:

Answer 13

Heat
Edema
Erythema
Pain
Loss of function

Question 14

List the general categories of activity of the glucocorticosteroids:

Answer 14

Anti-inflammatory anti-shock
Antipruritic immunosuppressive
Metabolism influence on CHO, fat, protein

Question 15

Explain how glucocorticoids work to produce an anti-inflammatory effect:

Answer 15

Stabilize cell membranes, stabilize lysosomal membranes, disrupt histamine synthesis, inhibit interleukin synthesis, reduce exudative process

Question 16

List the possible uses for glucocorticoids:

Answer 16

Decrease swelling, pain after inury
Decrease pruritis, hypersensitivity and allergic reactions of skin and mucous membranes
Alter immune response in autoimmune disorders, aplastic anemia
Rupture lymphocytes in neoplasia’s
Shock reversal
Diagnostics
Replacements

Question 17

List some drawbacks to the use of glucocorticosteroids:

Answer 17

Overuse in medicine, no pain or fever relief

Question 18

List the common side effects of glucocorticosteroids:

Answer 18

Polyuria polydipsia
Polyphagia weight gain
GI ulcers bleeding
Depressed healing infection susceptibility
Muscle weakness thin, dry, coarse fur
Behavior changes iatrogenic Cushings or Addisons Dz
K+ loss Na, H20 retention > edema, ascites
Abortion

Question 19

Discuss why glucocorticosteroids are tapered off after therapeutically using them for more than two days.

Answer 19

After administration, the body ceases manufacture of cortisol; the body can not recover fast enough to prevent problems from this

Question 20

Explain the role of histamines in inflammation:

Answer 20

Chemical inflammatory mediator and responsible for hypersensitive reactions

Question 21

List the effects of histamine on the body:

Answer 21

Histamine causes vessel dilation, capillary permeability, smooth muscle spasm, glandular secretion increase, bronchiole constriction

Question 22

Explain how antihistamines function – mechanism of action:

Answer 22

They prevent histamine from attaching to receptor sites

Question 23

State the effect of H1 receptor / histamine 1 receptor stimulation:

Answer 23

Capillary vasodilation, increased capillary permeability, results in flushing of face, headache and tends to lower arterial pressure. Contraction of smooth muscles, such as bronchial and digestive.

Question 24

State the effect of H2 receptor / histamine 2 receptor stimulation:

Answer 24

increase of gastric secretion of HCl, the main H2 effect, cardiac stimulation, vasodilation: stimulation of H2 receptors induces vasodilation, but the H2 vasodilator effect of slower onset and more durable than that of H1, small bronchodilator effect.