15-NSAIDs

Question 1

What do COX-1 and 2 make?

Answer 1

COX-1 = thromboxane (platelet activation)
COX-2 = prostacyclin (anti-platelet)

Question 2

What are the effects of prostaglandin (PGE2)?

Answer 2

Bad:
Sensitises nociceptors and lowers the pain threshold
Stimulates hypothalamic neurones, causing increase in body temperature and pyrexia
Gi -> increase PLC, increased IP3, Ca2+ release, histamine release from mast cells - oedema
Stimulates IL-6 release and leukocyte recruitment

Good:
Downregulates HCl production in stomach and increase mucus and bicarbonate secretion

Question 3

Unwanted effects of NSAIDs?

Answer 3

Nephrotoxicity: Constriction of afferent arteriole, reduced flow and GFR
Bronchospasm: COX inhibition favours leukotriene production (bronchoconstrictors)