Analgesics and Anti-inflammatories - NSAIDS (2)

Question 1

Ibuprofen: Basic pharmacodynamics?

Answer 1

Reversibly inhibits cylooxygenase (COX-1 and COX-2), preventing the production of prostaglandins and thromboxane A2.

Question 2

Should ibuprofen be taken with food?

Answer 2

Yes - with food, milk or antacids, to reduce the risk of GIT adverse effects. However, food will slow the absorption of ibuprofen.

Question 3

Describe the key drug interaction between ibuprofen and warfarin.

Answer 3

Both are highly protein-bound, so ibuprofen will cause displacement of warfarin from albumin which can cause fatal haemorrhage.

Question 4

Name two contraindications to ibuprofen.

Answer 4

Asthmatics - inhibition of COX means that more arachidonic acid will be converted to leukotrienes, which cause bronchospasm.
3rd trimester of pregnancy - can cause closure of the fetal ductus arteriosus.

Question 5

Ibuprofen is metabolized in the ______ and excreted in the ______.

Answer 5

Metabolized in the liver, excreted in the urine.

Question 6

Ibuprofen: half-life?

Answer 6

2 hours.

Question 7

Naproxen - describe two differences between naproxen and ibuprofen.

Answer 7

Naproxen’s incidence of GIT bleeding is double that of ibuprofen. The half-life of naproxen is much longer: 12 hours.

Question 8

Diclofenac - describe the basic pharmacodynamics.

Answer 8

Non-selective COX inhibitor. Also inhibits lipoxygenase.

Question 9

Diclofenac - routes of administration?

Answer 9

Orally, rectally, topical gel, eye drops…

Question 10

Ketorolac - half-life?

Answer 10

5-6 hours.