non-steroidal anti-inflammatory drugs Flashcards
what are the pharmacological properties of NAIDs?
to decrease inflammation
to relieve mild to moderate pain
to decrease elevated body temp associated with fever
to decrease blood clotting by inhibiting platelet aggregation
what are mediators of fever and pain?
prostaglandin
thromboxanes
what is a PFA or platelet activating factor?
phsophatidylcholine
pro inflammatory but seem to be more important in mediating airway inflammation in conditions such as asthma and allergic rhinitis
LT or leukotriene
a group of lipid like compounds that exhibit a wide range of physiological activities
every type of living cell can produce it, except for RBCs
PG = prostoglandin
what type of cells tend to increase the production of prostaglandins?
cells subjected to various types of trauma or disturbances in homeostasis
which prostaglandins are responsible for increasing blood flow during inflammation?
PGE2 is responsible for increasing local blood flow and capillary permeability
how do prostaglandins help mediate painful stimuli?
increases the sensitivity of pain receptors to mechanical pressure
how do prostaglandins mediate fever?
alter thermo-regulatory set point (help raise body temperature)
what is dysmenorrhea?
painful cramps that accompany menstruation
what is thrombus formation?
TXA2 causes platelet aggregations that result in blood clot formation
a normal cell component that synthesizes PG to help regulate and maintain cell activity
COX-1
an emergency enzyme that synthesizes PG in response to cell injury (pain and inflammation)
COX-2
what are examples of COX inhibitors?
aspirin and other NSAIDs
what does it mean when aspirin and other traditional NSAIDS are nonselective?
they inhibit both COX-1 and COX-2 enzymes
true or false: COX-2 inhibitors are better.
true
what is the original (prototypical) NSAID, >100 years old, inexpensive, and w/o prescription?
aspirin
true or false: aspirin is a powerful and effective inhibitor of only COX-2
false: it is inhibits both COX-1 and COX-2
prostaglandin, thromboxane, and leukotriene are often referred to as _____.
eicosanoids
what enzymes are synthesized from the cyclooxygenase pathway (COX)?
prostaglandins and thromboxanes
what enzyme is synthesized from the lipoxygenase system?
leukotrienes
a drug that inhibits COX will also inhibit the formation of what enzymes in that cell?
prostoglandins and thromboxanes
NSAIDS and aspirin are what kind of inhibitors? (COX or LOX)
COX
leukotrienes are pro-inflammatory but also are important in mediating what other aspect?
airway inflammation in conditions such as asthma and allergic rhinitis
what prostaglandins produce vasodilation?
PGIs and PGEs
what prostaglandin along with thromboxanes are vasoconstrictors?
PGF
overproduction of COX-2 prostaglandins is linked to what chronic conditions?
chronic inflammatory conditions such as arthritis, inflammatory bowel disease, and other certain cancers
nonselective NSAIDS and aspirin decrease pain and inflammation by inhibiting what enzyme?
COX-2
why is it treating fever in children contraindicated?
causes Reye syndrome
what is frequently used as a nonprescription antipyretic NSAID in both adults and children?
ibuprofen
how does aspirin prevent heart attacks or other vascular disorders?
inhibits platelet-induced thrombus formation through its ability to inhibit thromboxane biosynthesis in coronary arteries
how does aspirin prevent tumor growth? (2 ways)
inhibit COX-2 enzyme in susceptible tissues and inhibit the synthesis of prostaglandins that would otherwise cause abnormal cell division in these tissues
inhibit platelet activation
how does aspirin and NSAIDS cause GI damage?
since they are non-selective, they inhibit the production of protective prostaglandins in the stomach and render the stomach more susceptible to damage
what are some strategies to manage GI problems caused by NSAIDS or aspirin?
enteric coated aspirin
taking with meals
(both may delay the onset of analgesic effects to relieve acute pain)
true or false: COX-2 selective drugs has a much lower incidence of gastric irritation than aspirin like drugs
true
why are patients who are at risk for prolonged bleeding and bruising preferred to take COX-2 selective drugs?
COX-2 inhibitors spare the production of thromboxanes, thus allowing normal platelet activity and less chance of excessive bleeding
is acetaminophen considered a NSAID?
no
what is a major advantage of acetaminophen?
less upper GI irritation
true or false: acetaminophen treats INFLAMMATORY mild to moderate pain
false: it is not a NSAIDS because it does not have anti-inflammatory properties
it only treats non-inflammatory mild to moderate pain
