Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Question 1

What does NSAIDs stand for?

Answer 1

Non-Steroidal Anit-Inflammatory Drug

Question 2

What are the therapeutic actions of NSAIDs?

Answer 2

Reduce pain and inflammation resulting from the inhibition of cyclooxygenase-1 and -2 (COX-1 and _2) with a subsequent decrease in production of inflammatory prostaglandins and thrompoxanes

Question 3

What mechanism creates analgesia?

Answer 3

• Inhibition of inducible COX-2 at sites of tissue injury

- Intermediate prn doses

Question 4

What mechanism creates the antipyretic effect?

Answer 4

• Inhibition of inducible COX-2 in the hypothalamus

- intermediate prn doses

Question 5

What mechanism creates the anti-inflammatory effect?

Answer 5

• Inhibition of inducible COX-2 at sites of inflammation.

- Scheduled doses

Question 6

What mechanism creates the antithrombogenesis ?

Answer 6

• Inhibition of constitutive COX-1 in platelets

- Low doses daily

Question 7

Name five common side effects of NSAIDs.

Answer 7

1. GI side effects
2. Increased incidence of bleeding problems
3. Renal side effects
4. Uterine side effects
5. Increased thrombotic events

Question 8

Why do we see GI side effects?

-What are the symptoms?

Answer 8

Inhibition of constitutive COX-1 in gastric cells

Ulceration, bleeding, nausea

Question 9

Why do we see increased incidence of bleeding problem?

Answer 9

Inhibition of constitutive COX-1 in platelets

Question 10

Why do we see renal side effects?

-What are the symptoms?

Answer 10

Inhibition of constitutive COX-1 or induced COX-2 in kidney cells

Acute renal failure and interstitial nephritis

Question 11

Why do we see uterine side effects?

What are the symptoms?

Answer 11

Inhibition of induced COX-2 in uterine smooth muscle

Interfere with uterine contraction in late-term pregnancy

Question 12

Why do we see increased thrombotic events?

What are the symptoms?

Answer 12

Unopposed inhibition of COX-2 in vascular endothelial cells

Potential for increased cardiovascular events, including myocardial infarction and strokes

Question 13

What are the four main groups of NSAIDs?

Answer 13

1. Traditional NSAIDs
2. Acetaminophen
3. COX-2 Selective Inhibitors
4. Aspirin

Question 14

Tradition NSAIDs __________ bind COX-1 and COX-2.

Answer 14

Reversibly

Question 15

Name five types of traditional NSAIDs..

Answer 15

1. Salicylates
2. Pyrazolone derivatives
3. Acetic/carboxylic acids
4. Oxicam derivatives
5. Propionic acid derivatives

Question 16

What are three types of acetic/carboxylic acids?

Answer 16

indomethacin
ketorola
nabumetone

Question 17

Give one example of oxicam derivatives.

Answer 17

meloxicam

Question 18

Give three examples of propionic acid derivatives.

Answer 18

Ibuprofen
naproxen
ketoprofen

Question 19

What NSAID does not inhibit either COX-1 or COX-2 in the periphery, but inhibits COX-2 in the CNS?

Answer 19

Acetaminopen

Question 20

What is the generic name for acetaminophen?

Answer 20

Tylenol

Question 21

What NSAID has analgesic and antipyretic properties, but lacks anti-inflammatory activity?

Answer 21

Acetaminophen

Question 22

What drug selectively and reversibly inhibits COX-2?

Answer 22

Celecoxib

Question 23

What irreversibly inhibits COX-1 and COX-2?

Answer 23

Acetylsalicyclic acid aka Aspirin