nonsteroidal anti-inflammatory drugs

Question 1

1

pharmacological profiles

Answer 1

• decrease inflammation
• relieve mild to mod pain
• decrease elevated temperature associated with fever [antipyresis]
• decrease blood clotting by inhibiting anticoagulation

Question 2

leukotriene

Answer 2

• Pro-inflammatory but seem to
  be more important in mediating airway inflammation in conditions such as asthma
  and allergic rhinitis.

Question 3

prostaglandin PG

Answer 3

• 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

Question 4

role of eicosanoids

Answer 4

Cells that are subjected to various types of trauma or disturbances in homeostasis tend to increase the production of prostaglandins.

Question 5

how do eicosanoids promote fever + pain

Answer 5

fever: promote fever by altering thermo-regulatory set-point
pain: increase the sensitivity of pain receptors to mechanical pressure

Question 6

how do eicosanoids promote inflammation

Answer 6

increase PGE2

Question 7

dysmenorrhea

Answer 7

painful cramps that accompany menstruation

Question 8

role of eicosanoids: thrombus formation

Answer 8

TXA2 causes platelet aggregations that result in blood clot formation

Question 9

COX-1 enzyme

Answer 9

enzyme is a “normal” cell component that
synthesizes PG to help regulate and maintain cell activity. (Not always beneficial)

Question 10

COX 2

Answer 10

often represents an “emergency” enzyme
that synthesizes PG in response to cell injury. (i.e., pain and inflammation) (Not always harmful)

Question 11

aspirin inhibits…

Answer 11

they inhibit
both COX-1 and COX-2 enzymes.

Question 12

aspirin

Answer 12

*Powerful and effective inhibitor of all cyclooxygenase activity (COX-1 and COX-2)
* Has the potential to affect several conditions involving
excessive prostaglandin and thromboxane production.
* Alleviating pain and inflammation, decreasing fever, and affecting blood clotting.
* prevents thromboembolic conditions and maybe certain forms of cancer

Question 13

aspirin pain & inflammation

Answer 13

• Provide analgesic effects similar to opioid drugs (e.g., morphine) but without the harmful or undesirable opioid side effects
• Mild-to-moderate pain of various origins

Question 14

aspirin fever

Answer 14

• The primary NSAID used in treating fever in adults.
• Treating fever in children is contraindicated (cause Reye syndrome.)
• ibuprofen - used frequently as a nonprescription antipyretic NSAID in
  both adults and children

Question 15

aspirin vascular disorders

Answer 15

• helps inhibit the onset/recurrence of <3 attacks by inhibiting thrombus formation in coronary arteries [platelet-induced clots]
• mechanism: inhibits thromboxane biosynthesis

Question 16

aspirin prevention of cancer

Answer 16

• decreases the risk of cancers

Question 17

side effects of aspirin like drugs

Answer 17

GI problems
CV problems

Question 18

GI problems aspirins

Answer 18

range: minor stomachache - upper GI hemorrhage and ulceration
- loss of prostaglandin from mucosal lining causes this
- history of ulcers, advanced age, high dose NSAIDS are risk factors

Question 19

strategies to manage aspirin GI problems

Answer 19

• take enteric coated aspirin tablets
• take it with meals
• use other drugs in conjunction [proton pump inhibitor, COX2 selective drugs]

Question 20

CV aspirin problems

Answer 20

• increases BP and chance of thrombotic events [aspirin reduces platelet induced clots]
  - mechanism: inhibition of PGE2 and PG12
  - can cause heart attack, myocardial infarction, heart attack

Question 21

COX2 selective drugs

Answer 21

• have lower incidence of gastric irritation than aspirin like drugs
• may be preferred in patients who are at risk for prolonged bleeding and bruising
• ***why? COX 2 inhibitors spare production of thromboxanes, allowing normal platelet acticity

Question 22

why do COX2 drugs increase heart attack and stroke risk?

Answer 22

• COX2 inhibition may lead to a loss of prostaglandins
• @ 21st slide