Anti-Inflammatory drugs

Question 1

Tissue injury causes the release of..

Answer 1

Prostaglandins

Question 2

Autacoids (local mediators) cause:

Answer 2

Vasodilation
Increased vascular permeability
Chemotaxis
Pain

Question 3

Is cox-1 or cox-2 responsible for platelet function?

Answer 3

COX-1

Question 4

COX-1 Is responsible for..

Answer 4

Homeostatic functions

GI tract
Renal
Platelet function
Vessels

Question 5

COX-2 Is responsible for..

Answer 5

Inflammation

Question 6

NSAIDS mechanism of action

Answer 6

Blocking either or both cyclooxygenase (COX) enzymes
•COX-1 and COX-2

Limits the undesirable inflammatory effect of prostaglandins and related substances

Question 7

Cyclooxygenase purpose

Answer 7

COX is the enzyme that converts arachidonic acid into prostanoids (prostaglandins and related compounds)

COX-1 and COX-2

Question 8

Properties of NSAID drugs

Answer 8

Analgesic
Anti-inflammatory
Antipyretic

Question 9

NSAID indications

Answer 9

Relief for mild to moderate pain

Question 10

Non-Selective NSAIDS

Answer 10

Inhibit both COX-1 and COX-2
•Alleviate mild - moderate pain
•Inflammatory disorders (rheumatoid arthritis, bursitis, osteoarthritis)
•Suppress inflammation but pose risk of serious harm

Question 11

Non-Selective NSAID drugs

Answer 11

Acetylsalicylic Acid (ASA): Aspirin

Ibuprofen (motrin, advil)

Ketoralac

Question 12

Acetylsalicylic Acid (ASA) - Aspirin

Answer 12

Anti-inflammatory
Analgesic
Antipyretic
Antiplatelet

Different to other NSAIDS
Irreversibly inhibits COX
(all other NSAIDS reversibly inhibit COX)

80-160 mg daily prophylactic for MI, stroke.

CI’s:
Pregnancy, bleeding disorders, caution in renal dysfunction

Adverse:
•GI bleeding
•Reye’s syndrome in kids
•Renal: reductions in creatinine clearance
•Salicylate toxicity: Tinnitus/hearing loss in adults, hyperventilation in kids

Question 13

Non-ASA NSAIDS

Answer 13

ASA-like drugs with fewer GI, renal, and hemorrhagic effects than aspirin (ASA)

•Inhibit COX-1 and COX-2: Inhibition is reversible unlike with ASA

DO NOT protect against MI and stroke like ASA does

Question 14

Selective COX-2 Inhibitors

Answer 14

COX-2: Responsible for inflammatory mediators

Just as effective as NSAIDS in suppressing inflammation and pain. Possible lower risk for GI adverse effects.

Can impair renal function, cause hypertension and edema.

Increased risk of MI and stroke

Celecoxib
•Sulfa drug allergies CI

Question 15

Drug used to reduce GI ulceration with NSAIDS

Answer 15

Misoprostol

Synthetic prostaglandin
Used in combination with NSAIDs to reduce ulceration

Question 16

Celecoxib NSAID type

Answer 16

Selective COX-2 Inhibitor

Question 17

NSAID - Antipyretic

Answer 17

Reduce fever

Inhibit prostaglandin E2 production within hypothalamus

Question 18

NSAID possible contraindications

Answer 18

GI lesions, peptic ulcer disease, bleeding disorders, pregnancy

Question 19

NSAIDS: Client Implications

Answer 19

Notify if GI pain occurs or evidence of GI bleed

Watch for occurrence of bleeding such as in stool
•Black or dark tarry stool

NOT to be given to children under age 12
•Reye’s syndrome

Question 20

Misoprostol

Answer 20

Synthetic prostaglandin
Used in combination with NSAIDs to reduce ulceration