Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pharmacology > Exam 4: NSAIDs/Non-Opioids yo-Part 2 NSAIDs & Tylenol > Flashcards

Exam 4: NSAIDs/Non-Opioids yo-Part 2 NSAIDs & Tylenol Flashcards

1
Q

Inhibiting cyclooxygenase reduces formation of _________ precursors and ____________ from arachidonic acid

A

prostaglandin…. thromboxanes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 2 categories of NSAIDs?

A

Non-selecitve (COX-1 & COX-2 inhibitors) & Selective (COX-2 inhibitors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Pharmacokinetics of NSAIDs…..Peak in ___-___ hours, metabolized by the ______, excreted by the _______.

A

1-2…liver..kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pharmacokinetics of NSAIDs…..what is the half life?

A

IT VARIES by product

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 3 actions of NSAIDs?

A

1.Anti-Inflammatory 2.Analgesic 3.Antipyretic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Actions of NSAIDs…..________ effects on blood platelets

A

REVERSIBLE (opposite of aspirin!!!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Actions of NSAIDs……their effect lasts only as long as _________.

A

the drug is in the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

If there is a need to DISCONTINUE NSAIDs before surgery, time is based on _______…..ibuprofen = ___ day(s) naproxen = __ day(s)….

A

HALF LIFE…..1 day….4 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If you need to discontinue NSAIDs COUNT BACK ____ to ____ half lives!

A

4 to 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

_________ can interfere with the antiplatelet effect of low-dose aspirin (81 mg), potentially rendering aspirin less effective when used for cardioprotection and stroke prevention

A

ibuprofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

FDA recommends for patients who use immediate release aspirin (not enteric coated) and take a single dose or chronic doses of ibuprofen 400 mg, dose the ibuprofen at least 30 minutes or longer ______ aspirin ingestion or MORE than 8 hours ______ aspirin ingestion to avoid attenuation of aspirin’s effect….so like when?

A

AFTER…BEFORE…..before bed time (when MI/stroke most commonly occur)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Occasional use of ibuprofen or other NSAIDS pose _____ risk for attenuation of anti-platelet effects of low-dose aspirin

A

little

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are our 2 examples of NSAIDs?

A

1.ibuprofen 2.Naproxen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the 4 brand names for ibuprofen? Which one is the Rx name?

A

1.Advil 2.Midol 3.Motrin (Rx) 4.Ultraprin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 3 brand names for naproxen? What are the 2 Rx?

A
  1. Aleve 2.Anaprox (Rx) 3.Naprosyn (Rx)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the NSAID with the MOST drug interactions?

A

IN-DO-METH-A-CIN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which organ is most susceptible to NSAID use?

A

KIDNEYS (no not liver dawg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Adverse Events with NSAIDs!!! Increased risk of ____, stroke

A

MI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adverse Events with NSAIDs!!! New onset or worsening of ________.

A

hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adverse Events with NSAIDs!!! Compromised _____ function…Excessive or chronic use = ________…..Contraindicated in patients with advanced ______ disease… Age group more susceptible to this damage _______.

A

renal…nephrotoxicity…renal…elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Adverse Events with NSAIDs!!! _________ ulceration, irritation, bleeding and perforation…Consuming more then ___ alcoholic drinks per day increases risk for GI bleeding… and this age group is most susceptible to bleeding.

A

Gastrointestinal..3…Elderly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F NSAIDs have CNS effects.

A

TRUE! Dose-dependent effects…Sedation, dizziness, confusion, mental depression, headache, vertigo, convulsions…Blurred vision, TINNITUS…Caution operating heavy machinery, driving…No addiction, no tolerance, no withdrawal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Skin reactions are also associated with ______ adverse events.

A

NSAID

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Avoid NSAIDs in pts with an _____ allergy and if they have decreased _____ function too.

A

aspirin…liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is STEVEN-JOHNSON syndrome and what is it a sign of?
sloughing off of skin on palms and soles....hypersensitivity to NSAIDs
26
Target organ for NSAIDS is ______!!! (not liver)
KIDNEY
27
NSAIDs: Inhibiting prostaglandins shuts down ______ blood flow...which can result in _______, especially beyond use for ___ days with high doses.
renal...renal necrosis...5 days
28
Short-term use of NSAIDs: _____ to _____ risk if normal kidney function...Slight increased risk for ____, cystitis
little to no..UTI (i wonder why!?)
29
ibuprofen (MOTRIN): Available both OTC and prescription strength...OTC dose = _____ mg tablets....Prescription dose = ____ – _____ mg
200 mg....Rx-400 - 800 mg
30
ibuprofen (MOTRIN): _______ onset of analgesia (30-60 minutes)
RAPID
31
ibuprofen (MOTRIN): ______ duration of action (4-6 hours)
Short
32
ibuprofen (MOTRIN): ______ half-life (2-4 hours) = must take frequently
Short
33
ibuprofen (MOTRIN): Dental dosing (analgesic/fever reduction) Children: __-__ mg/kg/dose every __-__ hours...Use of ______ to select dose is preferred!!
4-10 mg/kg/dose every 6-8 hours..WEIGHT
34
ibuprofen (MOTRIN): Adults: 200-400 mg/dose every 4-6 hours for a maximum daily dose of _____ mg...WHAT is the upper dose of ibuprofen for arthritic pain?
1200 mg...3200 mg for arthritis
35
Please compare the limit for daily ibuprofen vs aspirin...
1.2 g for ibuprofen vs 4 g for aspirin
36
PRACTICAL APPLICATION-----ibuprofen (MOTRIN): Preoperative use of ibuprofen at a dose of ____-____ mg every __ hours for ____ hours before the appointment decreases postoperative edema and hastens healing time!!!!! ANTICIPATORY
400-600 mg....4 hours... 24 hours
37
Ibuprofen is unique, it has a “______” effect for dental pain where the optimal analgesia occurs at ____ mg dose
"ceiling"...400 mg
38
NSAIDs and Arthritis-Takes ____ to _____ to reach anti-inflammatory effects, from gradual reduction in prostaglandin synthesis
days to weeks
39
In our Rx example of ibuprofen, what was the daily limit?
3200 mg (directed by a physician)
40
naproxen: ______ onset of analgesia (1 hour)
quick
41
naproxen: _____ half life (12-17 hours)
long
42
naproxen: Duration of action (analgesia: < 7 hours; anti- inflammatory: < ____ hours; peaks after ___ weeks)
12...2 weeks
43
naproxen: Dental dosing = adults: ____ mg initially, then 250 mg every 6-8 hours; maximum: _____ mg /day...this is called a "_____" dose
500 mg...1250 mg..."loading" dose
44
________ (Feldene) = **longest acting of all NSAIDS *...10 mg 2 times per day...Long half life = ___-___ hours
PRI-OXI-CAM...45-50 hours
45
What are the 3 "other important NSAIDs in Dentistry?
1.Pir-oxi-cam 2.flur-bi-profen 3.keto-ro-Lac
46
_______ (Toradol)* = used for up to 5 days for severe acute pain requiring analgesia at opioid level; taken primarily by injection; causes renal damage
Keto-RO-Lac
47
______=“super aspirin” = No greater efficacy than | aspirin...____ half life- ___ to ___ hours.
di-flu-nis-al...8-12 hours
48
What are the two ways to Rx for pain? Why do we do this?
1. As needed for pain 2.every 6 hours....keep the [ ] in blood at therapeutic level
49
Sometimes its useful to think about ________ considerations:...A prescription drug gives more relief to a patient than an OTC drug....More relief with expensive drug vs. cheap drug...More relief from colored pills vs. white pills
psychological considerations
50
WHAT IS THE ONLY COX-2 INHIBITOR AVAILABLE? What is it indicated for?
cel-e-cox-ib (Celebrex)...arthritis
51
_____ inhibitors have better adverse events profile
COX-2 (then why aren't there more of them???)
52
Interesting...Celebrex has been shown to reduce risk for _______ of the colon...also improvements in ____ cancer, and possibly ____ cancer
adenocarcinoma...lung...oral
53
Freaking wonder drug- Celebrex shown to delay onset and degree of severity of _________ too!!
Alzheimer’s disease
54
Celebrex can be used for acute DENTAL pain!! Initial ____ mg "losing" dose, followed by an additional ____ mg dose if needed on day 1.
400 mg...200 mg
55
COX-2 inhibitors OK to use with ________.
low dose aspirin
56
COX-2 inhibitors; Monitor _______ when used with antihypertensives (reduces effectiveness)
blood pressure
57
COX-2 inhibitors- Assess ________ when used with warfarin
bleeding times
58
Celebrex contains _____ atom = some may be allergic
SULFA (or sulfer, wtf?)
59
Celebrex is _______ in pregnancy.
CONTRAINDICATED
60
DRUG INTERACTIONS-NSAIDs & aspirin!!!!! _______ and ibuprofen/aspirin-Used for autoimmune diseases and cancer....Ibuprofen _______ the breakdown of this drug..., causing toxicity...Cannot give aspirin = displaces this drug and interferes with its ______, increasing serum concentrations and causing toxicity (bone marrow depression).
Meth-o-trex-ane...INHIBITS...clearance
61
DRUG INTERACTIONS-NSAIDs & aspirin!!!!!....________ = used for bipolar disorder (manic depression) = NSAIDS block excretion, resulting in toxicity.
Lithium
62
DRUG INTERACTIONS-NSAIDs & aspirin!!!!! aspirin = separate dosing intervals with NSAIDS to avoid attenuation of ______ effects of aspirin.
anti- platelet
63
DRUG INTERACTIONS-NSAIDs & aspirin!!!!! NSAIDS = taking multiple NSAIDS together can give an ______ toxic effect
ADDITIVE!!
64
DRUG INTERACTIONS-NSAIDs & aspirin!!!!! Alcohol increases the risk for _____ bleeding associated with aspirin and NSAIDS
GI
65
DRUG INTERACTIONS-NSAIDs & aspirin!!!!! Aspirin and NSAIDS may decrease the effectiveness of many common ________ medications = monitor BP if giving NSAIDS to patients taking BP meds
antihypertensive
66
What is the abbreviated name for acetaminophen?
APAP (n-Acetyl-P-AminoPhenol)
67
Acetaminophen is categorized as a "_______" analgesic..It blocks _____.
"miscellaneous"...COX-3
68
Where does acetaminophen work most, peripherally or centrally?
centrally...CNS COX-3
69
Acetaminophen DOES NOT-inhibit _______ aggregation....irritate the ______....cause broncho_______.
platelet....GI tract...bronchoconstriction
70
Pharmacokinetics of acetaminophen- _______ and completely absorbed from GI tract
rapidly
71
Pharmacokinetics of acetaminophen- Peak plasma level occurs in __ to __ hours..Metabolized by ____
1 to 3 hours..liver
72
Pharmacokinetics of acetaminophen- Metabolite is BOTH ________ and ________.
hepatotoxic and nephrotoxic
73
Pharmacokinetics of acetaminophen- Half-life of ___ to ____ hours... Excreted by ______
1-4...kidneys
74
AWESOME SYNOPSIS- Pt has GI problems? Rx this...
Acetaminophen
75
AWESOME SYNOPSIS- Pt has decreased kidney function/ diabetes? Rx this...
Acetaminophen
76
AWESOME SYNOPSIS- Pt has compromised liver function? Rx this...
NSAID
77
Effects of Acetaminophen...it is an ________, ________, but it is NOT an __________!!!!!!
Analegesic...antipyretic...anti-inflammatory!!!!!
78
How do acetaminophen and aspirin compare in POTENCY?
EQUAL!
79
While acetaminophen is not irritating to the ______, it is toxic to the ______.
GI...liver
80
What is the maximum dose of acetaminophen? But what about Tylenol?
4 g....3 g they are toning it down a bit
81
``` Remember this (YOU EXCEDRIN USERS)....Acetaminophen and aspirin are: Equally ________ (reduces same degree of pain)....Equally _____ (same dose in milligrams needed for effect)....BUT __________ is less useful clinically, because it is NOT anti-inflammatory ```
efficacious..potent... Acetaminophen
82
Unlike aspirin, acetaminophen has no effect on ______ acid.
uric
83
acetaminophen dosing-------Usual dental dosing....Children (
10-15.....325 mg...4000 mg...2 grams
84
Alcohol stimulates the _______ enzymes that metabolize acetaminophen to its toxic metabolite. yikes.
oxidizing
85
WARNING: An important dental drug interaction....Taking ________ with warfarin (Coumadin) causes enhanced anticoagulation..... One study showed that taking 4 325 mg tablets for one week raised the INR (bleeding time test) ______ above those NOT taking this drug; risk also occurred in patients taking 6 tablets or fewer of 325 mg this drug in one week
acetaminophen...10x

Pharmacology (23 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions