MSK - NSAIDs & ASA Flashcards
What is the mechanism of aspirin
Irreversibly inhibits COX-1 and COX-2 by acetylation
Decreases synthesis of thromboxane and prostaglandins
What is aspirin used for
Low dose - decrease platelet aggregation
Medium dose - antipyretic and analgesic
High dose - anti-inflammatory
What are toxicities to aspirin
Gastric ulceration, tinnitus
Chronic use can cause acute renal failure, nephritis, GI bleeds
What are some NSAIDs
Ibuprofen, naproxen, indomethacin, ketorolac, diclofenac
What is the mechanism of NSAIDs
Reversibly inhibit COX-1 ans COX-2
Block prostagladin synthesis
What are NSAIDs used for
Antipyretic, analgesic, anti-inflammatory
What are toxicities to NSAIDs
Nephritis Gastric ulcer (PG protect mucosa) Renal ischemia (PG vasodilate afferent arteriole)
What is the mechanism of celecoxib
Reversibly inhibit COX-2 which is found in inflammatory cells and vascular endothelium
“CELEctive COX”
Why doesnt celecoxib affect platelet function
Platelet function depends on thromboxane (TXA2) which is dependent on COX-1
What is celecoxib used for
Rheumatoid arthritis and osteoarthritis
Patients with GI ulcers of gastritis
What are toxicities to celecoxib
Increased risk of thrombosis
Sulfa allergy
What is the mechanism of acetaminophen
Reversibly inhibit cyclooxygenase, mostly in CNS
Inactivated peripherally
What is acetaminophen used for
Antipyretic and analgesic
Not anti-inflammatory
Reye syndrome in children
What are toxicities to acetaminophen
Overdose produces hepatic necrosis
