4 - Anti-Inflammatory

Question 1

The family of COX inhibitors includes:

Answer 1

Aspirin and all of its related drugs

Question 2

Only one COX inhibitor can protect against MI and stroke:

Answer 2

Aspirin

Question 3

What is cyclooxygenase?

Answer 3

the enzyme responsible for synthesizing prostaglandins from Arachidonic Acid

Question 4

What is the role of COX at sites of tissue injury?

Answer 4

catalyzes the synthesis of PGE₂ and Prostacyclin

promotes inflammation and sensitizes pain fibers

Question 5

What is the role of COX in the stomach?

Answer 5

PGE and prostacyclin to protect the gastric mucosa

Question 6

What is the role of COX in platelets?

Answer 6

promotes synthesis of TXA₂, which stimulates platelet aggregation

Question 7

What is the role of COX in blood vessels?

Answer 7

promotes synthesis of prostacyclin, which causes vasodilation

Question 8

What is the role of COX in the kidney?

Answer 8

synthesis of PGE and prostacyclin promote vasodilation and maintain renal blood flow

Question 9

What is the role of COX in the brain?

Answer 9

prostaglandins mediate fever and contribute to perception of pain

Question 10

What is the role of COX in the uterus?

Answer 10

prostaglandins help promote contractions at term

Question 11

Where do you prostaglandins, TXA2, and prostacyclin act: locally or systemically

Answer 11

they all ONLY act locally!

Question 12

Which COX is found in the stomach and on platelets?

Answer 12

COX 1

Question 13

Which COX is responsible for kidney perfusion?

Answer 13

Both

Question 14

Which COX is found in injured tissue?

Answer 14

COX 2

Question 15

Which COX has actions in the brain?

Answer 15

COX 2

Question 16

There is only one irreversible COX inhibitor:

Answer 16

Aspirin

Question 17

Aspirin will halt a fever, but it will not decrease temperature that has become elevated in response to physical activity or environmental temperature. Why?

Answer 17

ASA targets set-point elevation, not temperature elevation

Prostaglandins that are created in response to endogenous pyrogens are responsible for increased set point, and ASA inhibits their production

Question 18

The life of a platelet is about ______

Answer 18

8 days

Question 19

What should you do if you have a patient who needs Aspirin but is at risk for developing an ulcer?

Answer 19

Prophylactic PPI

Question 20

How does aspirin effect stroke likelihood?

Answer 20

Makes an ischemic stroke less likely

Makes a hemorrhagic stroke more likely in patients with BP > 150/90

Question 21

What are the signs of Salicylism?

Answer 21

Tinnitus

Sweating

Headache

Dizziness

Respiratory Alkalosis (from increased RR)

Question 22

Use of _______ in children young than 18 is associated with Reye Syndrome

Answer 22

Aspirin

Question 23

What are characteristic symptoms of Reye Syndrome?

Answer 23

Encephalopathy

Fatty Liver Degeneratio

Question 24

Why is it dangerous to give ASA and glucocorticoids?

Answer 24

Both are very hard on the stomach

risk of gastric ulceration is very high when they’re given together

Question 25

If a patient is taking Aspirin for stroke prevention, should they take Tylenol at the same time?

Answer 25

No! Interestingly, taking other non-aspirin NSAIDS will block aspirin’s access to COX-1

Just wait about 2 hours after taking aspiring to take any other NSAIDs, that way the aspirin can fully bind