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general pharmacology > Anti-inflammatory - NSAIDs > Flashcards

Anti-inflammatory - NSAIDs Flashcards

1
Q

what are the signs of inflammation?

A
  1. Rubor (redness)
  2. Calor (heat)
  3. Dolor (pain)
  4. Tumor (swelling)
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2
Q

what are the mediators of inflammation?

A

look at image.
image also indicates properties.

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3
Q

What is the MOA for NSAIDs?

A

NSAIDs block formation of prostaglandins by inhibiting COX 1, COX 2, or Both enzymes.

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4
Q

Describe the Arachidonic acid pathway.

A
  • Damage associated with inflammation acts on cell membranes to release lysosomal enzymes –> phospholipase A2 enzyme converts em into Arachidonic acid (AA) –> AA can follow 2 pathways:
    oLipoxygenase pathway –> formation of leukotrienes that promote bronchoconstriction & inflammation (asthma).
    o Cyclooxygenase (COX) pathway –> formation of prostaglandins and thromboxane which promote inflammation and bronchoconstriction.
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5
Q

what are effects of COX 1?

A
  1. inhibit gastric secretions
  2. influence gastric motility
  3. synthesize thromboxane
  4. platelet aggregation
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6
Q

what are effects of COX 2?

A
  1. inflammation
  2. pain
  3. fever
  4. . angiogensis
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7
Q

What are 5 systemic NSAIDs? What is the pneumonic?

A

Pneumonic: PAIIN
1. Piroxicam
2. Aspirin ibuprofen
3. Ibuprofen
4. Indomethacin
5. Naproxen

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8
Q

Which drug falls under an NSAID but is a selective COX 2 inhibitor?

A

Celecoxib

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9
Q

what drug is an NSAID but is an irreversible inhibitor?

A

Aspirin

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10
Q

What are clinical indications for systemic NSAIDs?

A
  1. anti-inflammatory effects (reduce inflammation)
  2. Analgesic (pain reducer)
  3. Antipyretic effects (reduce fever)
  4. inhibit platelet aggregation
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11
Q

what are the adverse effects of systemic NSAIDs?

A
  1. GI bleeding or ulcers
  2. increase risk of bleeding in eye
  3. stroke/MI
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12
Q

Aspirin – What are the unique MOA, clinical indications, SE, and contraindication?

A
  • MOA –> inhibits synthesis of prostaglandins & thromboxanes by irrevesibly inhibiting COX 1 & 2.
  • Clinical indication –> reduce risk of recurrent heart attacks in patients with known heart disease
  • S/E –> can cause Reye’s Syndrome (encephalopathy in children, aspirin asthma
  • C/I –> asthma
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13
Q

List 4 systemic NSAIDs that are reversible?

A
  1. indomethacin
  2. ibuprofen
  3. naproxen
  4. Piroxican
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14
Q

what is the NSAID of choice in children?

A

Acetaminophen

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15
Q

reversible NSAID – What are the unique MOA, S/E, C/I?

A
  • MOA –> reversible COX 1 & 2 inhibitors.
  • S/E –> do not cause Reye’s Syndrome
  • C/I –> heart Dz, Hx of coronary artery dz or stroke, scleritis, episcleritis, should be taken with food to reduce gastric effects.
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16
Q

what are the unique ocular side effects of indomethacin?

A
  1. increase bleeding in eye
  2. whorl keratopathy
  3. retinal pigmentary changes (in macula)
17
Q

what drug is used for prevention and treatment of NSAID-induced stomach ulcers?

A

Misoprostol

18
Q

Celecoxib – what are the unique MOA and S/E?

A
  • MOA –> selective COX 2 inhibitor, spares COX 1 which helps minimize gastric SE.
  • S/E –> Less GI SE, stevens-johnson syndrome
19
Q

What are all ophtalmic and systemic NSAIDs C/I against?

A

Hx of allergic rxn to other NSAIDs & aspirin

20
Q

List 5 ophthalmic NSAIDs?

A
  1. bromfenac
  2. diclofenac
  3. nepafenac
  4. ketorolac
  5. flurbiprofen
21
Q

what are some clinical uses for ophthalmic NSAIDs?

A
  1. post-op cataract patient –> reduces risk of CME due to prostaglandins
  2. recurrent corneal erosion
  3. corneal abrasion
  4. allergic conjunctivitis
22
Q

What are ocular S/E of ophthalmic NSAIDs?

A
  1. corneal toxicity
  2. corneal melt
  3. stinging upon instillation
23
Q

Which ophthalmic NSAID is approved for topical tx of seasonal allergic conjunvtivitis?

A

ketorolac

24
Q

Which topical drop should not be given to someone with sulfa allergy?

A

Xibrom, contains sodium sulfite

general pharmacology (6 decks)

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