Chapter 75 COX Inhibitors, NSAIDS, APAP Flashcards
Cyclooxygenase Inhibitor use? Which medication protects against Stroke and MIs ONLY? A/e?
Anti-inflammation, relieve pain, anti-pyretic…
ASPIRIN does all of this and protect against MI or Stroke
A/e - gastric erosin, bleeding, and renal impairment
Drugs WITH anti-inflammatory properties?
NSAIDS such as Aspirin, Celecoxib, Ibuprofen, Naproxen
Drugs WITHOUT anti-inflammatory properties?
Acetaminophen
1st Generation NSAIDS do what? COX-1 & COX-2 Inhibitors do what?
Inhibit COX 1 & COX 2
Used to tx inflammatory disorders (RA, arthritis, bursitis)
Alleviate mild to mod pain, suppress fever, relieve dysmenorrhea
Have risk of serious harm
Generally, COX-1 & COX-2 do what?
COX-1 (seen as good)
Gastrointestinal Mucosal Protection: COX-1 helps maintain the lining of the stomach and intestines, protecting them from digestive juices.
Renal Function: It plays a role in maintaining kidney function, including blood flow.
Platelet Function: COX-1 is involved in platelet aggregation (clotting).
COX-1 generates prostaglandins that are involved in these protective and homeostatic functions.
COX-2 (seen as bad)
COX-2 is primarily induced (meaning its expression increases) at sites of inflammation.
Roles in Inflammation and Pain:
Inflammation: COX-2 is a key enzyme in the inflammatory response, producing prostaglandins that mediate inflammation.
Pain: Prostaglandins produced by COX-2 also contribute to pain sensation
Increase fever
Vasodilates the colon
Aspirin (ASA) does what? Tx? A/e?
Nonselective inhibitor of cyclooxyrgenase (COX)
Analgesia, antipyretic, platelet aggregation suppression, cancer prevention
A/e- GI issues, bleeding, Salicylism, Reye’s syndrome
What is Salicylism? What a/e will you see? What should you do?
ASA poisoning syndrome
S/sx: Tinnitus, sweating, HA, dizziness
Hold medication until symptoms go away and then start ASA at a smaller dose
What is Reyes Syndrome? Who do we not give ASA to?
DO NOT GIVE to children who have flu or chickenpox d/t risk of precepitating Reyes syndrome
flu/chicken pox + ASA = Reyes Syndrome
When would you stop ASA for major procedures? Can you still take low dose ASA for elective procedures?
Roughly 1 week PRIOR to elective sx or anticipated date of childbirth
Yes to low dose (81mg) NOT high dose (320mg)
ASA taken by MOTHERS with FETUS’ can cause what?
CAT D - crosses placenta
premature closure of the ductus arteriosis = potential death of infant
NON ASA 1st generation NSAIDS inhibition is?
Reversible inhibition (unlike ASA) BUT does not protect against MI or stroke, increase the risk of thrombotic events
2nd generation NSAIDs benefits compared to 1st generation?
Somewhat lower risk of GI side effects
INCREASES risks for MI or stroke
What NSAID lowers risk for MI or stroke?
ASA NOT 1st gen or 2nd gen NSAIDS
Celexcoxib (Celebrex) is what medication? Choice of admin? A/e? When should you not use this med?
2nd gen cox-2 inhibitor
LAST CHOICE DRUG FOR LONG TERM PAIN MGMT
A/e- sulfonamide allergy, CV impacts (MI,stroke, etc)
DO NOT USE in pregnancy d/t premature closure of the ductus arteriosis
Acetaminophen (tylenol) is what medication? MOA? What does this medication not impact compared to other NSAIDs? A/e? Overdose tx? Drug interactions?
Analgesic and Antipyretic STRICTLY (NO anti-inflammatory nor anti-rheumatic effects)
MOA - inhibits prostaglandin synthesis in the CNS
A/e - HEPATIC NECROSIS
Antidote - Acetlcysteine (mucomyst) w/n 8-10 hours is 100% effective
Interactions - ETOH (<2g/day of acetaminophen)
Should you give an NSAID after a vaccine?
NO!!
This can blunt the effect of the immune response to childhood vaccines.
What are common adverse effects for naproxen?
GI ulceration, impired renal fx, increased risk for CV events
