Eicosanoids, NSAIDs, Acetaminophen

Question 1

Leukotrienes

Answer 1

5-LOX found in leukocytes, mast cells, and dendritic cells

Associated with asthma and anaphylactic shock

Question 2

COX 1

Answer 2

Expressed in most cells

Question 3

COX 2

Answer 3

Inducible–expressed at sites of inflammation

Produces PGI2

Question 4

Action of prostanoids on smooth muscle

Answer 4

Relaxation: PGI2, PGD2, PGE2
Constriction: TXA2, PGF2a, PGE2

Question 5

Action of prostanoids on platelets

Answer 5

Stabilization: PGI2, PGD2, PGE2
Aggregation: TXA2, PGE2

Question 6

Acton of prostanoids on GI

Answer 6

Cytoprotective
Increase mucus and bicarb
Increase motility

Question 7

Action of prostanoids on CNS

Answer 7

PGE2 causes fever
Wakefulness
Decreased NE release
Sensitize pain pathways

Question 8

Action of prostanoids on eye

Answer 8

PGE and PGF decrease intraocular pressure by increasing aqueous humor outflow

Question 9

NSAIDS block

Answer 9

synthesis of all prostanoids

Question 10

Misoprostol

Answer 10

PGE1 analog
Used for NSAID induced ulcer, to maintain PDA patency
Contraindicated in pregnancy

Question 11

Epoprostenol

Answer 11

PGI2 analog

Used for pulmonary hypertension

Question 12

Latonoprost

Answer 12

PGF2a analog

Used for treatment of glaucoma

Question 13

Dinoprostine and Carboprost

Answer 13

PGF2a analog

Used to induce labor or abortion

Question 14

NSAIDs

Answer 14

nonselective, competitive inhibitor of COX 1 and COX 2

Aspirin is the only irreversible inhibitor

Question 15

4 indications of NSAID

Answer 15

analgesic, antipyretic, anti inflammatory, anti platelet aggregation

Question 16

Aspirin doses and uses

Answer 16

80mg: anti-platelet for post MI and decrease TIA risk
300mg: analgesix and antipyretic
3-5g: anti inflammatory

Question 17

Aspirin and ETC

Answer 17

Acts as an uncoupler: causes combined acidosis in toxic doses

Question 18

OD management of aspirin

Answer 18

Supportive–no antidote

Question 19

Adverse effects of chronic aspirin use

Answer 19

GI irritation, exacerbation of asthma due to over action of LOX, angioedema and rash hypersensitivity, renal toxicity due to decreased prostaglandins

Question 20

Who should you not give aspirin to

Answer 20

Asthmatics and children <18 (Reye Syndrome risk)

Question 21

Other NSAID uses

Answer 21

Analgesic, antipyretic, anti inflammatory

Not anti platelet

Question 22

Acetaminophen

Answer 22

Blocks CNS COX; no peripheral COX inhibition so no antiplatelet or bronchospasm or anti inflammatory
Minimal GI distress and no uncoupling

Question 23

Hepatotoxicity of acetaminophen

Answer 23

requires >10-15g in adults

Question 24

Antidote of acetaminophen OD

Answer 24

N-acetylcysteine: must be given within 10 hours