Analgesics Antipyretics

Question 1

Acetaminophen (APAP) MOA

Answer 1

inhibition of PG synthesis in CNS; less PNS effect.

analgesic, anti-pyretic

Question 2

NSAIDs MOA: Ibuprofen, Naproxen

Answer 2

Reversible inhibition of PG synthesis in CNS and PNS through non-specific inhibition of COX-1 and 2
analgesic, anti-pyretic, anti-inflammatory

Question 3

Salicylates MOA: ASA, Mag. Salicylate

Answer 3

Irreversible inhibition of PG synthesis in CNS and PNS through nonspecific inhibition of COX-1 and 2
Inhibition of platelet aggregation
analgesic, anti-pyretic, anti-inflammatory

Question 4

Common APAP brands

Answer 4

Tylenol, Midol, Pamprin

Question 5

Common NSAIDs

Answer 5

Ibuprofen: Advil, Motrin

Naproxen Sodium: Aleve

Question 6

Common ASA brand

Answer 6

Bayer, Ecotrin, St. Joseph

Question 7

APAP formulations/strength per dose

Answer 7

Tylenol IR: regular 325mg, extra strength 500mg

Tylenol ER caplets: 650mg

Question 8

APAP peds formulation/strength per dose

Answer 8

Tylenol kids/infant suspension: 160mg/5ml

Question 9

Ibuprofen formulations/strength per dose

Answer 9

Advil/Motrin tablets/captlets/capsules: 200mg

Question 10

Ibuprofen peds formulation/strength per dose

Answer 10

Advil/Motrin kids suspension: 100mg/5ml

Question 11

Naproxen formulations/strength per dose (NO PEDS)

Answer 11

Aleve tablets/caplets/capsules: 220mg

Question 12

APAP adult dosing

Answer 12

325-1000mg every 4-6 hrs

Question 13

APAP max daily dose

Answer 13

4000mg or 4g

Question 14

Ibuprofen adult dosing

Answer 14

200-400mg every 4-6 hrs

Question 15

Ibuprofen max daily dose

Answer 15

1200mg

Question 16

Naproxen adult dosing

Answer 16

220mg every 8-12hrs

Question 17

Naproxen max daily dose

Answer 17

660mg if 12-65, 440mg if > 65

Question 18

APAP peds daily dose

Answer 18

10-15mg/kg/dose every 4-6 hrs

Question 19

APAP peds max daily dose

Answer 19

5 doses (calculate)

Question 20

Ibuprofen peds daily dose

Answer 20

5-10mg/kg/dose every 6-8 hrs

Question 21

Ibuprofen peds max daily dose

Answer 21

4 doses (calculate)

Question 22

APAP SE

Answer 22

N/V, HA, ALT elevation, hepatic injury (rar), SJS, TEN (skin rxns)

Question 23

APAP high risk populations

Answer 23

pt with prior liver disease, acute or chronic alcohol users at risk for liver damage

Question 24

NSAID SE

Answer 24

Dizziness, fatigue, nervousness, HA, N, ulcer, bleeding, increased risk of CV event (ore than with Naproxen)

Question 25

NSAID high risk population

Answer 25

Renal injury more common if elderly, HTN, DM, on diuretics, or atherosclerosis

Question 26

ASA SE

Answer 26

N/V, dyspepsia, gastritis, ulceration, bleeding, renal, Reye's (under 19)

Question 27

ASA high risk population

Answer 27

Renal injury more common if elderly, HTN, DM, on diuretics, or atherosclerosis

Question 28

NSAIDs, Salicylates, and GI irritation

Answer 28

increase gastric acid secretion reduce bicarb and mucus production gastric erosion, ulcers, and bleed at higher doses

Question 29

NSAIDs, Salicylates, and Kidney function

Answer 29

Reduced GFR, reduced urinary sodium excretion. | Stay away from NSAIDs in pt with risk of kidney disease

Question 30

NSAIDs and CV safety

Answer 30

risk depends on dose, duration, and frequency in addition to prior hx. - potential to increase BP, exacerbate heart failure - anti-platelet effects if given with ASA Naproxen may have lower risk

Question 31

ASA/NSAID sensitvity

Answer 31

COX inhibition shifts balance of production towards leukotriene = bronchial spasms Effects: Rhinitis with nasal polyps Asthma exacerbation

Question 32

Salicylates Labeling

Answer 32

- name of salicylate - warning for Reye's syndrome - potential for allergic rxn - potential for stomach bleed in: age >60, hx of ulcers/bleeds, > 3 drinks/day

Question 33

NSAIDs Labeling

Answer 33

- name of NSAID - potential for allergic rxn, especially if allergic to ASA - potential for stomach bleed (same population as ASA)

Question 34

APAP and Hepatotoxicity

Answer 34

- Uncommon at recommended dose | -