2 NSAIDs Flashcards
Using NSADs causes damage to gastric barrier how?
Inhibition of COX-1
COX-2 is constitutive where?
Kidney and Brain
What is the primary source of vascular prostacyclin?
Endothelial COX-2
Idomethacin use?
Gout
All NSAIDs can be used to treat gout except which ones?
Aspirin
Salicyclates
Tolmetin
Why is not aspirin used for gout?
- It inhibits urate excretion at low doses
- May increase risk of renal calculi at high doses
Tolmetin is ineffective for which arthritis?
Gout
Frequent use of aspirin is associated with a 50% DECREASE in the risk of what?
Colon Cancer
Niacin flushing is mediated by what?
Release of PGD2
Niacin flushing can be inhibited with what?
Aspirin
What is the DOC for closure of ductus arteriosus?
Indomethacin
What are the two mechanisms by which NSAIDs cause gastric damage?
1) Inhibition of COX-1 in gastric epithelial cells
2) Ulceration by local irritation of the gastric mucosa
Which drugs reduce the rick of gastric ulcer and are used in the treatment of gastric damage induced by NSAIDs
1) Misoprostol
2) PPI
3) H2 blockers
Which NSAID has the lowest risk of adverse GI effects?
Celecoxib
Which NSAIDs (3) are low risk for GI adverse effects?
1) Ibuprofen
2) Aspirin
3) Diclofenac
Which NSAIDs (2) are medium risk for GI adverse effects?
1) Naproxen
2) Indomethacin
Which NSAID has the highest risk for adverse GI effects
Piroxicam
How do NSAIDs cause adverse cardiovascular effects
Thought to be caused by NSAIDs upsetting the balance between TXA2 and PGI2
What are the cardiovascular effects of NSAIDs?
1) Vasocontriction
2) Platelet aggregation
3) Thrombosis
Which NSAIDs have more CV risk?
More COX-2 selective
What is the only selective COX-2 inhibitor in the US?
Celecoxib
How do NSAIDs affect the renal system? (3)
1) Decrease in Renal Blood Flow
2) Acute interstitial Nephritis
3) Analgesic Nephropahty
Why is Aspirin unique?
It IRREVERSIBLY acetylates COX
How does a low dose of aspirin affect platelets?
Production of PGI2 is relatively unaffected
What happens when a person is given 1g or more of aspirin?
-Conjugation enzymes become saturated and zero-order kinetics are observed
Why is not Acetaminophen not an NSAID?
Because it has no anti-inflammatory or antiplatelet effect
What is the DOC for pain relief in osteoarthritis
Acetaminophen
What is the DOC for short-term treatment of fever and minor pain during pregnancy
Acetaminophen
What is the DOC for short-term treatment of fever and flulike symptoms
Acetaminophen
