Exam #3: Cyclooxygenase inhibitors

Question 1

Adverse effects of cyclooxygenase inhibitors

Answer 1

Gastric ulceration
Bleeding
Renal impairment

Question 2

Aspirin, celecoxib, ibuprofen, and naproxen

Answer 2

NSAIDS

Question 3

Aspirin

Answer 3

Nonselective inhibitor of cyclooxygenase
Irreversible inhibitor of cyclooxygenase (effects last 7 days)
Analgesic, antipyretic, anti-inflammatory
Suppresses platelet aggregation— aspirin is unique for this benefit

Question 4

Aspirin drug interactions

Answer 4

Anticoagulants: warfarin and heparin
Glucocorticoids- gastritis
Alcohol- gastritis, bleeding
Ibuprofen – 
ACE inhibitors and ARBs- renal impairment

Question 5

Mechanism of nonaspirin first generation NSAIDs

Answer 5

Inhibit COX-1 and COX-2: inhibition is reversible (unlike with aspirin)

Question 6

Ketoprofen

Answer 6

powerful analgesic, often used post-op, for short-term management of moderate to severe pain, not to exceed 5 days

Question 7

celecoxib

Answer 7

As effective as traditional NSAIDs in suppressing inflammation and pain
Increase risks for MI and stroke, use has sharply declined
Because of cardiovascular risks, last-choice drug for long-term management of pain

Question 8

Acetaminophen (Tylenol)

Answer 8

Does not have any anti-inflammatory or antirheumatic actions
Not associated with Reye’s syndrome
Action: Inhibits prostaglandin synthesis in central nervous system

Question 9

Acetaminophen toxicity

Answer 9

hepatic necrosis

Treatment for overdose: acetylcysteine (Mucomyst)

Question 10

Monitoring for aspirin renal toxicity

Answer 10

Renal impairment— watch BUN.creatinine, urine output, increasing S&S of fluid overload, esp in older patients

Question 11

Adverse effects of aspirin

Answer 11

Gastrointestinal effects
Bleeding
Renal impairment
Reye’s syndrome (avoid in children)
Pregnancy: Anemia, postpartum hemorrhage, may prolong labor, also premature closure of ductus arterious in fetus
Hypersensitivity reaction- can be very serious, treat with epinephrine