Multimodal: NSAIDs, COX, Celebrex Flashcards
What enzyme catalyzes the synthesis of prostaglandins?
COX (Cyclooxygenase)
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This form of COX is responsible for gastric protection, hemostasis, and renal function…
COX-1
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COX-1 or COX-2?
Ubiquitous, “physiologic”, inhibition of this enzyme is responsible for many adverse effects.
COX-1
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COX-1 or COX-2?
Pathophysiologic, expressed at sites of injury, not protective.
COX-2
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COX-2 propagation is responsible for which symptoms?
Pain, inflammation, and fever
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What are the three main properties of NSAID drugs?
Analgesic
Anti-inflammatory
Antipyretic
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Are the following drugs non-specific or COX-2 selective?
–Ibuprofen, naproxen, aspirin, and ketorolac–
What gastric symptomology would be seen with administration of these drugs?
Non-Specific
Increased gastric irritation with these drugs
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Celecoxib (Celebrex), Rofecoxib (Vioxx), Valdecoxib (Extra), Parecoxib (Dynastat) are all examples of what?
COX-2 Selective NSAIDs
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Do COX-2 selective NSAIDs effect platelets?
No
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Because COX-2 selective NSAIDs have no effect on platelets, this would increase the chance of what pathology?
Clotting (think MI and CVA)
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COX-2 selective and nonspecific inhibitors have _____________ analgesia
Comparable
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What was the first COX-2 inhibitor that decreases PG synthesis?
Celecoxib (Celebrex)
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What is the dosage for Celebrex?
200 to 400 mg PO QD
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Celebrex reaches its peak in…
3 hours
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What are the effects of NSAIDs?
- Decrease activation of peripheral nociceptors
- No addictive potential
- Preemptive analgesia
- Absence of ventilatory depression
- Less nausea and vomiting
- Absence of cognitive effects
- Long duration of action
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