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Sketchy Medical > Anti-inflammatory Drugs: NSAIDs > Flashcards

Anti-inflammatory Drugs: NSAIDs Flashcards

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USMLE® Step 1 flashcards
1
Q

Arachidonic acid is the precursor molecule for

A

prostanoids and leukotrienes

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2
Q

Phospholipase A2 (PLA2) hydrolyzes arachidonic acid from the

A

cell membrane

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3
Q

Phospholipase A2 (PLA2) hydrolyzes

A

arachidonic acid from the cell membrane

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4
Q

Cyclooxygenase-1 (COX-1) is _________ expressed

A

constitutively expressed

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5
Q

Cyclooxygenase-2 (COX-2) expression is induced by

A

inflammation

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6
Q

Thromboxane A2 (TXA2) is synthesized by

A

COX-1

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7
Q

TXA2 (synthesized by COX-1) causes

A

vasoconstriction

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8
Q

COX-1 synthesizes

A

gastric cytoprotective prostaglandin

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9
Q

COX-2 is expressed in

A

vascular endothelial and smooth muscle cells

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10
Q

Prostacyclin (PGI2) is synthesized by

A

COX-2

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11
Q

PGI2 causes

A

vasodilation

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12
Q

PGI2 inhibits

A

platelet aggregation

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13
Q

COX-1 and COX-2 synthesize prostaglandins that

A

dilate the afferent arteriole

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14
Q

COX-2 synthesizes prostaglandins that

A
  1. Increase vascular permeability
  2. Increase pain sensitivity
  3. Induce fever
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15
Q

NSAIDs reversible inhibit

A

both COX-1 and COX-2

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16
Q

NSAIDs include

A
  1. Diclofenac
  2. Ketorolac
  3. Indomethacin
  4. Meolxicam
  5. Piroxicam
  6. Naproxen
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17
Q

Inhibition of COX-1 by NSAIDs can

A
  1. Prolong bleeding time
  2. Cause GI bleeding
  3. Cause gastric inflammation, erosions, and ulceration
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18
Q

NSAIDs can increase blood pressure due to

A

COX inhibition in the kidney, decreasing sodium excretion

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19
Q

NSAIDs can cause

A
  1. Acute interstitial nephritis
  2. Renal papillary necrosis (sloughing of renal papillae)
  3. Aplastic anemia
  4. Hypoaldosteronism (decreased mineralocorticoids)
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20
Q

NSAIDs cause afferent arteriole vasoconstriction, decreasing

A

GFR

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21
Q

NSAIDs cause _____ _______ vasoconstriction decreasing GFR

A

afferent arteriole

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22
Q

NSAIDs cause afferent arteriole ________ decreasing GFR

A

vasoconstriction

23
Q

NSAIDs can increase serum _____ concentrations

A

lithium

24
Q

NSAIDs (indomethacin most commonly) can cause

A

Aplastic anemia

25
Q

NSAID induced hypoaldosteronism can cause

A

hyperkalemia

26
Q

Aspirin irreversibly inhibits

A

COX- 1 and COX-2

27
Q

Aspirin acetylates COX-1 and COX-2 resulting in

A

irreversible inhibition

28
Q

Aspirin is useful in treating what childhood disease

A

Kawasaki disease

29
Q

Kawasaki disease is the most common

A

vasculitis syndrome of childhood

30
Q

Aspirin use in children can lead to development of

A

Reye’s syndrome

31
Q

Reye’s syndrome

A

rapidly progressive encephalopathy with hepatic dysfunction

32
Q

Reye’s syndrome occurs when

A

a child is given aspirin in the setting of a viral illness

33
Q

Reye’s syndrome encephalopathy

A
  1. Confusion
  2. Seizure
  3. Coma
34
Q

Reye’s syndrome hepatic dysfunction

A

hepatic steatosis and hepatomegaly

35
Q

Aspirin toxicity causes what metabolic disturbance

A
  1. anion gap metabolic acidosis

2. respiratory alkalosis

36
Q

Aspirin can cause

A
  1. anion gap metabolic acidosis
  2. respiratory alkalosis
  3. Reye’s Syndrome
  4. Tinnitus
37
Q

______ ______ can be used to absorb aspirin in setting of acute toxicity

A

Activated charcoal

38
Q

Alkalinization of the serum and urine with a basic solution (e.g. sodium bicarbonate) increases the renal excretion of

A

aspirin

39
Q

Minimize NSAID use in patients at risk for

A

acute kidney injury

40
Q

Avoid NSAIDs in which trimester of pregnancy

A

3rd trimester

41
Q

Avoid NSAIDs in 3rd trimester due to

A

risk of premature closure of ductus arteriosus

42
Q

Which NSAIDs have the highest risk of premature closure of ductus arteriosus in the 3rd trimester of pregnancy

A
  1. Indomethacin

2. Ibuprofen

43
Q

Celecoxib is a

A
  1. Selective COX-2 inhibitor

2. Sulfa drug

44
Q

Celecoxib has a reduced ulcer and bleeding risk by avoiding

A

COX-1 inhibition

45
Q

Celecoxib may increase the risk of

A

ischemic cardiovascular disease

46
Q

Celecoxib decreases the risk of

A

ulcer and bleeding

47
Q

Acetaminophen inhibits

A

COX-2

48
Q

Acetaminophen inhibits COX-2, acting as an

A

antipyretic and analgesic (not anti-inflammatory)

49
Q

Toxic levels of acetaminophen

A

deplete glutathione in the liver (inactivates the toxic metabolite: NAPQI)

50
Q

Acetaminophen can cause

A

hepatotoxicity

51
Q

Acetaminophen causes hepatotoxicity via the

A

toxic metabolite: NAPQI

52
Q

______ ________ can be used to absorb acetaminophen in setting of acute toxicity

A

activated charcoal

53
Q

_________ restores hepatic glutathione stores to treat acetaminophen hepatotoxicity

A

n-acetylcysteine

Sketchy Medical (46 decks)

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