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AU14 Pharmacology > Exam 4; Aspirin and NSAIDs > Flashcards

Exam 4; Aspirin and NSAIDs Flashcards

1
Q

What are the four major effects NSAIDs

A

analgesic
anti-pyretic
anti-inflammatory
anti-platelet (decrease in clotting

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2
Q

What is the clinical use for aspirin and NSAIDs at low doses

A

aches and pains

inhibition of clotting

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3
Q

What is the clinical use for aspirin and NSAIDs at high doses

A

pain/arthritis

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4
Q

What is the chemistry behind aspirin

A

salicylic acid + acetyl group → acetylsalicylic acid

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5
Q

What is the pharmacokinetics behind acetylsalicylic acid

A

its a weak acid that is more readily absorbed in a weak acid like the stomach)

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6
Q

acetylsalicylic acid is dissociated in the plasma to what, which can have what effects

A

into salicylic acid which strongly binds to plasma proteins which then can displace other proteins and drugs

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7
Q

What is the mechanism behind aspirin

A

it inhibits prostaglandin metabolism by inhibiting the enzyme cyclooxygenase

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8
Q

What are the two different types of cyclooxygenase that aspirin effects

A

COX1; all cells have this and it regulates prostaglandin synthesis
COX2; inflammatory cells have it which is responsible for the inflammation process

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9
Q

How does aspirin affect temperature

A

it lowers the temperature of a fever, but only in those with fever
may act in the CNS to counteract pyrogens

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10
Q

How does aspirin affect peripheral vasculature

A

may cause mild peripheral vasodilation

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11
Q

The use of aspirin to treat this is potentially very dangerous

A

viral infection in children; could cause Reye’s syndrome

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12
Q

What is the mechanism behind the analgesic effect of aspirin

A

decrease PG production (which are neuromodullary and may regulate pain)
has both central and peripheral effects

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13
Q

What is the mechanism being the anti-inflammatory effect of aspirin

A

PGs serve as vital signs for inflammation, so decreasing them decreases the signs and may also decrease immune cell migration and activity

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14
Q

What is the mechanism behind the anti-clotting effects of aspirin

A

ASA causes irreversible inhibition of platelet COX preventing the synthesis of thromboxane

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15
Q

What is the lethal dose of aspirin in children

A

4gram or 12 regular aspirin

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16
Q

What is the lethal dose of aspirin in adults

A

20 grams or 50-60 regular aspirin

17
Q

What results in death from an overdose of aspirin

A

severe pulmonary edema

18
Q

Which side effects are the most common when taking aspirin

A

GI effects; salicylic acid is a direct irritant

19
Q

What is the mechanism behind GI upset involving aspirin

A

decreased mucosal production in GI

decreased bicarbonate in the GI; no longer a counter mechanism of stomach acid

20
Q

What are two CNS effects of aspirin

A

tinnitus

increase respiration rate

21
Q

In which patients is aspirin contraindicated

A

in patients with clotting deficiencies

22
Q

Aspirin has a direct effect on which part of the eye

A

the iris, it reduces mitosis that occurs during and after eye surgery

23
Q

How does aspirin affect the kidney

A

decreased kidney perfusion

24
Q

True or False

Aspirin does not cause hypersensitivity reactions

A

False, it does

25
Q

Aspirin causes this in pregnant women

A

inhibits labor, prolonging gestation

26
Q

Aspirin can cause this, especially with patients with nasal polyps

A

bronchospasms

27
Q

Which drug is not a NSAID because it has no anti-inflammatory or anti-platelet effects

A

acetaminophen

28
Q

An OD of acetaminophen (20-30) tablets can cause what

A

irreversible liver damage

29
Q

What is the mechanism behind acetaminophoen affecting the liver

A

most common cause of acute liver failure
reduces glutathione in the liver
will confound with an already damaged liver (like in alcoholics)

30
Q

Which drug family are the NSAIDs

A 
propionic acid derivatives; ibuprofen and the other "pro's"
naproxyn
fenoprofen
ketoprofen
flurbiprofen
oxaprozin
suprofen
31
Q

What are the three NSAIDs that are acetic acid derivatives

A

Indomethacin
tolmetin
sulindac

32
Q

What is the mechanism behind Indomethacin

A

very potent COX inhibitor

33
Q

What are the side effects of indomethacin

A

thrombocytopenia
corneal opacities
plastic edema

34
Q

What are side other NSAIDs

A 
pyroxicam
disclofenac
bromfenac
nepafenac
etodolac
nabumeone
35
Q

This is a selective COX2 inhibitor

A

celecoxib

36
Q

What is celecoxib used to help prevent

A

helps prevent the GI upset that aspirin usually cause

37
Q

2 similar drugs to celecoxib have been pulled from the market, why?

A

may cause in increase in MI and stroke

38
Q

All NSAIDs at high enough doses may have what

A

similar effects

AU14 Pharmacology (29 decks)

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