NSAID

Question 1

what is the difference between COX1 and COX2?

Answer 1

COX1-
Constitutive -– prostaglandins used for normal physiological functions such as
* stomach mucous production
* regulation of gastric acid
* kidney water excretion

COX2-
Induced - Used for signalling pain and inflammation – prostaglandins used in inflammatory response
* Stimulated only as part of immune response
* Production is stimulated by inflammatory cytokines and growth factors

Question 2

how can COX-1 activity be decreased?

Answer 2

traditional NSAIDs

Question 3

how can COX-2 activity be decreased?

Answer 3

traditional NSAIDs
selective COX2 NSAIDs
Anti-inflammatory stimuli IL10

Question 4

how can COX-2 activity be increased

Answer 4

inflammatory stimuli IL1/ IL6/ IL8/ Trauma

Question 5

what are some examples of selective COX2 inhibitors?

Answer 5

celecoxib

Question 6

what are some side effects of selective COX2 enzymes?

Answer 6

inhibit vasodilation
reduced GFR
increase risk of heart failure

Question 7

what are NSAIDs with reduced GI and stomach adverse effects?

Answer 7

meloxicam
Etodolac
nabumetone
nimesulide

Question 8

what is the legal legislation for oral diclofenac use?

Answer 8

associated with small increase risk of CV side effects therefore no longer under P, required POM

Question 9

what is the MHRA and NICE recommended over the counter NSAID use?

Answer 9

ibuprofen at higher doses
or ideally naproxen