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Ama - Musculoskeletal > NSAID > Flashcards

NSAID Flashcards

1
Q

Non-selective COX-1/COX-2 inhibitors

A
  • Aspirin
  • Diclofenac
  • Ibuprofen
  • Indometacin
  • Mefenamic acid
  • Meloxicam
  • Naproxen
  • Piroxicam
  • Phenybutazone
  • Tiaprofenamic acid
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2
Q

Selective COX-2 inhibitors

A

Celecoxib
Etorocoxib
Parecoxib

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3
Q

Indometacin

A

GI disturbances
Headache
Dizziness
Driving

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4
Q

Mefenamic acid

A

Haemolytic anaemia/diarrhoea

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5
Q

Naproxen

A

Choice drug for inflammation

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6
Q

Piroxicam

A

High risk of GI side effects - gastric protection necessary
Serious skin reactions

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7
Q

Phenybutazone

A

Haematological SE

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8
Q

Tiaprofenamic acid

A

Severe cystitis

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9
Q

Side effects

A
  • Hypersensitivity
  • Photosensitivity (topical)
  • Nephrotoxicity
  • Sodium + fluid retention
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10
Q

Hypersensitivity

A

C/I if history of hypersensitivity to NSAIDs or aspirin
- Bronchospasms
- Rash
- Angioedema
- Hives
- Rhinitis

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11
Q

Photosensitivty

A

Topical preparations
Esp ketoprofen

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12
Q

Nephrotoxicity

A

Caution in renal impairment
Reduce eGFR and are renally cleared
Temporarily stop on sick days = AKI

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13
Q

Sodium + fluid retention

A

Caution in:
- Renal impairment
- Liver impairment
- Congestive HF
- Hypertension

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14
Q

Asthma + NSAIDs

A

Caution
May worsen asthma - bronchospasm
C/I in history of asthma attack with NSAID.

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15
Q

GI Toxicity

A

NSAIDs commonly cause stomach irritation
Take with or after food
- GI bleed
- GI ulcers
- GI perforation

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16
Q

High risk

A

Ketoprofen
Ketorolac
Piroxicam

17
Q

Medium risk

A

Naproxen
Diclofenac
Indometacin

18
Q

Low risk

A

Ibuprofen

19
Q

Lowest risk

A

COX-2 selective “coxibs)

20
Q

C/I

A

Active GI bleeding/ulcers
History of NSAID-induced ulcer/bleeding
1 episode with piroxicam/ketoprofen/ketorolac
> 2 episodes with other non-selective NSAIDs

21
Q

NSAID + Cardiovascular

A

Small increased risk of thrombotic events
C/I in severe HF
Highest risk:
- High dose ibuprofen (2.4g faily)
- Dexibuprofen
- Diclofenac
- Acelcofenac

22
Q

Pregnancy

A

AVOID esp in 3rd trimester
- Delays laour
- Pulmonary hypotension in newborn
- Premature closure of foetal ductus ateriosis

23
Q

Interactions - increased risk of AKI

A

ACEi
Diuretics
Ciclosporin
Tacrolimus

24
Q

Interactions - increased risk of bleeding

A

Warfarin
- Displaced by NSAID = high free drug concentrations
NOACs
Antiplatelets
Low dose aspirin
Heparin
SSRI
Venlafaxine
Steroid

25
Q

Interactions - increased risk of toxicity

A

Following drugs are renally cleared
Increased risk of toxicity with methotrexate + lithium

26
Q

Interactions - increased risk of hyperkalaemia

A

Potassium sparing diuretics

26
Q

Interactions - increased risk of convulsions

A

Quinolones

Ama - Musculoskeletal (5 decks)

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