Ch. 75- Cox-Inhibitors- NSAIDs + Acetaminophen Flashcards
What are the primary uses of Cox-inhibitors?
Suppress inflammation, relieve pain, reduce fever, protect against MI & stroke (only aspirin)
MI: Myocardial Infarction
What are the adverse effects of Cox-inhibitors?
Gastric erosion & ulceration, bleeding, renal impairment
Adverse effects can vary by specific drug.
What are the classifications of Cyclooxygenase Inhibitors?
Drugs with anti-inflammatory properties (NSAIDs) and drugs without anti-inflammatory properties (Acetaminophen)
NSAIDs include Aspirin, Celecoxib, Ibuprofen, Naproxen.
What is the mechanism of action of First-Generation NSAIDs?
Inhibit COX-1 and COX-2
Used to treat inflammatory disorders and alleviate pain.
What are some therapeutic uses of Aspirin (ASA)?
Analgesic, antipyretic, anti-inflammatory, suppression of platelet aggregation, protects in thrombotic disorders, dysmenorrhea, cancer prevention
Thrombotic disorders include conditions like heart attacks and strokes.
What adverse effects are associated with Aspirin (ASA)?
Gastrointestinal effects, bleeding, renal impairment, salicylism
Salicylism includes symptoms like tinnitus and dizziness.
True or False: Aspirin should be given to children with chickenpox or influenza.
False
It can precipitate Reye’s syndrome.
What should be done if Reye’s syndrome develops?
Do NOT give aspirin to children with chickenpox or influenza.
Reye’s syndrome can lead to serious complications.
What are the characteristics of Nonaspirin First-Generation NSAIDs?
Fewer GI, renal, & hemorrhagic effects than ASA, reversible inhibition of COX-1 & COX-2, can suppress platelet aggregation but do NOT protect against MI & stroke
Examples include Ibuprofen and Naproxen.
What are Second-Generation NSAIDs known for?
Just as effective as traditional NSAIDs in suppressing inflammation and pain, lower risk for GI side effects, but can impair renal function and increase risks for MI and stroke
Celecoxib (Celebrex) is a key example.
What are the therapeutic uses of Acetaminophen (Tylenol)?
Analgesic, antipyretic
It does NOT have any anti-inflammatory or antirheumatic actions.
What is the mechanism of action of Acetaminophen?
Inhibits prostaglandin synthesis in the CNS with minimal effects on cyclooxygenase at peripheral sites
This contributes to its lack of anti-inflammatory effects.
What are the adverse effects of Acetaminophen?
Few at normal doses, hepatotoxicity with overdose or in patients with liver failure
Early symptoms of overdose include N/V/D, sweating, abdominal pain.
What is the treatment for Acetaminophen overdose?
Acetylcysteine (Mucomyst)
Must be given within 8 to 10 hours for 100% effectiveness.
What should be avoided when taking Acetaminophen?
Alcohol
Should not exceed 2 gm/day of acetaminophen.
What are the steps outlined by the AHA for chronic pain management using COX inhibitors?
- Begin with nondrug measures. 2. If ineffective, use acetaminophen or aspirin. 3. If still ineffective, try other nonselective NSAIDs. 4. As a last resort, use celecoxib
Nondrug measures include physical therapy, exercise, and heat/cold application.
What should be monitored when a patient is prescribed celecoxib and warfarin?
Bleeding
Warfarin increases bleeding risk.
What caution should be given to a patient consuming alcohol and taking acetaminophen?
Limit intake of acetaminophen to less than 2g/day
This helps reduce the risk of liver damage.
