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NURS 252 (Pharmacology 2) > Anti-inflammatory and Antigout drugs > Flashcards

Anti-inflammatory and Antigout drugs Flashcards

1
Q

What are the activities of NSAIDs

A

Analgesic
Anti-inflammatory
Antipyretic
Aspirin-platelt inhibition

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2
Q

What are the 7 uses of NSAIDs?

A

Mild to moderate headaches
Myalgia
Neuralgia
Arthralgia
Post op pain
Gout and hyperuricemia
Pain associated with arthritic disorders

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3
Q

What properties do all NSAIDs share?

A

Antipyretic
Analgesic
Anti-inflammatory

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4
Q

Name a salicylate NSAID

A

Aspirin

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5
Q

Name 3 acetic acid derivatives

A

Diclofenac sodium
Indomethacin sulindac
Ketorolac

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6
Q

Name one cyclo-oxygenase (COX)-2 inhibitors

A

Celecoxib

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7
Q

Name 2 propionic acid derivatives

A

Ibuprofen
Naproxen

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8
Q

Aspirin is shown to reduce ________ after a MI

A

Cardiac death

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9
Q

What is the difference between COX-1 and COX-2?

A

COX-1 maintains the GI mucosa
COX-2 promotes synthesis of prostaglandins involved in the inflammatory process

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10
Q

What is the MOA of NSAIDs?

A

Inhibition of leukotriene or prostaglandin pathway
Blocking the chemical activity of the enzyme COX

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11
Q

What is the MOA of aspirin?

A

Reduces formation of thromboxane A2, a substance that promotes platelet aggregation. (antiplatelet)

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12
Q

What is the only NSAID that has antiplatelet effects?

A

Aspirin

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13
Q

What are the contraindications of NSAIDs?

A

Allergy
Conditions that place the pt at risk for bleeding. (i.e: Rhinitis, Vitamin K deficiency and PUD)

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14
Q

What are the adverse effects of NSAIDs?

A

Heartburn to severe GI bleeding
Acute kidney injury
Noncardiogenic pulmonary edema
Altered hemostasis; bleeding doesn’t stop
Hepatotoxicity
Skin eruption, sensitivity reaction
Tinnitus, hearing loss

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15
Q

What is the purpose of misoprostol in relation to NSAIDs?

A

Misoprostol is given to prevent NSAID-induced ulcers/GI bleeding

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16
Q

Why can’t misoprostol be taken during pregnancy?

A

It induces uterine contractions

17
Q

Why can NSAIDs compromise kidney function?

A

Kidney function partly depends on prostaglandins

18
Q

What is the major health canada warning for all NSAIDs except aspirin?

A

There is an increased risk of adverse cardiovascular thrombotic events, including a fatal MI and stroke

19
Q

What is the difference regarding the administration of aspirin(once a day vs multiple times a day)

A

Once a day: Prevention of thrombotic events
Multiple times: Pain

20
Q

What is Reye’s syndrome?

A

Acute condition involving progressive neurological deficits that can lead to coma and may also involve liver damage

21
Q

What can trigger Reye’s syndrome?

A

Viral illnesses such as influenza, as well as by salicylate therapy itself in the presence of a viral illness

22
Q

What is chronic salicylate intoxication called?

A

Salicylism

23
Q

What are the signs of salicylate intoxication?

A

Increased HR
Tinnitus, hearing loss, dimness of vision, headache, confusion, drowsiness
Nausea, vomiting, diarrhea
Hypo or hyperglycemia, sweating, thirst, hyperventilation

24
Q

What are the uses and forms available for indomethacin?

A

RA
Osteoarthritis (OA)
Bursitis or tendonitis
ankylosing spondylitis
Acute gouty arthritis
Oral and rectal routes

25
Q

Why is ketorolac tromethamine primarily used for pain management?

A

Its analgesic effects are comparable to narcotic drugs such as morphine

26
Q

What is the indication and adverse effects of ketorolac tromethamine?

A

Short term use (5 to 7 days) to manage moderate to severe pain
AE: Kidney impairment, edema, GI pain, dyspepsia and nausea

27
Q

What is the most commonly used NSAID and what are it’s indications?

A

Ibuprofen
RA, OA
Dysmenorrhea
Dental pain
MSK disorders
Antipyretic

28
Q

What is are the indications and AE and a CI for celecoxib?

A

ID: OA, RA, pain, Ankylosing spondylitis, primary dysmenorrhea
AE: Headache, sinus irritation, diarrhea, fatigue, dizziness, edema, HTN
CI: Sulpha allergy

29
Q

What are the renal and cardiovascular adverse effects of NSAIDs?

A

R: Decreased creatinine, acute tubular necrosis
C: Noncardiogenic pulmonary edema

30
Q

What are possible interactions with NSAIDs?

A

Alcohol
Anticoagulants
ASA
Biphosphonates
Corticosteroids and ulcerogenic meds
Protein-bound drugs
Diuretics and ACE inhibitors

31
Q

What is gout?

A

A condition that results from inappropriate uric acid metabolism:
Underexcretion of uric acid
Overproduction of uric acid
Uric acid crystals are deposited in tissues and joints, resulting in pain

32
Q

Name 3 antigout drugs

A

Allopurinol
Colchicine
Probenecid

33
Q

What are the indications and AE for allopurinol ?

A

ID: Prevention of uric acid production and prevention of acute tumour lysis syndrome
AE: Exfoliative dermatitis, stevens-johnson syndrome and toxic epidermal necrolysis

34
Q

What are the indications for probenecid?

A

Inhibits the reabsorption of uric acid in the kidneys and thus increases the excretion of uric acid

35
Q

What are the indications for colchicine?

A

Reduces the inflammatory response to the deposits of urate crystals in join tissue
AE: Short term leukopenia because it inhibits cell mitosis

36
Q

How is colchicine used prophylactically?

A

Prophylaxis of acute attacks

37
Q

What are glucosamine and chondroitin?(ID, AE, IE, CI)

A

Used to treat OA
G AE: GI discomfort, drowsiness, headache and skin reactions
C AE: GI discomfort
IE: Warfarin and may increase insulin resistance
Do not take w pregnancy

38
Q

Why should salicylates not be given to children or teenagers?

A

The risk for Reye’s syndrome

NURS 252 (Pharmacology 2) (23 decks)

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