Cyclooxygenase inhibitors Flashcards
What enzyme breaks down arachidonic acid into prostaglandins?
cyclooxygenase
What are the effects of COX-1 activation?
GI PROTECTION: ↓gastric acid secretion, ↑ mucous production, maintenance of GI mucosal perfusion.
RENAL PROTECTION: maintenance of renal perfusion and renal function.
SMOOTH MSL: Vasodilation and bronchodilation
Regulates platelet aggregation
How does blocking COX-1 prevent against strokes?
Disrupts platelet aggregation
What happens when COX-2 is activated?
The inflammatory response sx (vasodilation, edema, pain, ↑ capillary permeability)
What are the possible risks of COX-2 inhibitors?
vasodilation is blocked but platelet aggregation still continues
T/F. ASA affects platelets irreversibly?
True
How do NSAIDs work?
They reduce the production of prostaglandins by blocking COX-1 and COX-2
Why should children who have chicken pox or flu sx not be treated with ASA?
d/t association with Reye’s syndrome
T/F Celecoxib (Celebrex) is a 2nd generation NSAID
True
Why is Celecoxib (Celebrex) a last choice NSAID drug?
It is a selective cox-2 inhibitor so it will have serious cardiovascular risks like MI and stroke b/c it does not have an antiplatelet effect
Why should NSAIDs be given with milk or food?
To prevent GI upset
What do you do if a pt with a feeding tube needs an NSAID?
Don’t crush enteric coated drugs instead call the pharmacy to send non enteric coated
Why does Acetaminophen not have anti-inflammatory characteristics?
it only blocks prostaglandins in the CNS not the periphery
What organ function are we concerned about when giving NSAIDs or Tylenol?
Tylenol- mainly liver
NSAIDs-kidney
What are the side effects of ASA and nonselective cox inhibitors?
they block COX1(and 2) so reduce protective prostaglandins which can lead to gastritis, gastric ulcers, or bleeding
