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Pharm test 3 > NSAID II > Flashcards

NSAID II Flashcards

1
Q

What are the uses of ASA (other than AAA)?

A

PPX for MI and colon CA
Gout tx
Anticoagulation

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2
Q

Why do you have to use high doses of ASA to treat gout?

A

at low doses, it will actually decrease excretion of uric acid in urine (uricosuria), and make gout worse.

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3
Q

What are the 3 contraindications to ASA?

A

known bleeding DO
tartrazine dye allergies (cross-reactivity)
ASA syndrome

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4
Q

What is ASA syndrome?

A

ASA allergy: asthma, angioedema, nasal polyps

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5
Q

In patients with ______, you should use ASA cautiously. Why (3 things)?

A

peptic ulcer dz - because they

1) decrease mucus production in the GI tract
2) anticoagulate
3) acidic

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6
Q

What is misoprostol used for?

A

to prevent NSAID induced ulcers

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7
Q

What is Reye’s syndrome?

A

Post viral infection + NSAIDs …leads to encephalitis, sz, death in children

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8
Q

Other than peptic ulcer dz, what other patients should be prescribed ASA cautiously?

A

Renal dz

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9
Q

What are the main signs of a ASA OD? and what is tx guided by?

A

Tinnitus & metabolic acidosis

-Done Nomogram

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10
Q

Buffered ASA and enteric-coated ASA are good for what AE? What is good about an enteric coated ASA?

A

GI upset
They are coated in base so ASA release is delayed. It will then be released in the duodenum, which is less acidic. ASA will cause less harm here.

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11
Q

Why is tinnitis an understandable OD side effect?

A

Because by inhibiting the COX pathway, you get a build up of AA that is toxic to the auditory nerve.

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12
Q

What can patients do when taking ASA to decrease GI irritation

A

Take with food.

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13
Q

What Preg category is ASA? what about lactation?

A

C/D.

ASA will appear in the breast milk.

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14
Q

What is Nabumetone good for? Why?

A

NSAID that causes less GI upset because it is NON-ACIDIC.

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15
Q

Oxaprozin is special for what reason? Who should you use this cautiously in?

A

It is called Daypro. It is dosed 6-1200 mg QD.

Elderly - crappy kidneys

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16
Q

Dicofenac + Misoprostol = what drug? what preg category is this drug?

A

Arthrotec

X- causes uterine contractions

17
Q

Which NSAID is particularly good for sport medicine type injuries?

A

Naproxen

18
Q

What is the I in indomethacin for? what is an odd AE?

A

IV dosage form for the closure of patent ductus arteriosus in neonates.
AE - frontal lobe HA

19
Q

Sulindac is special for what?

A

It is the NSAID that is least likely to drop PG levels in the afferent arterioles. Safer for kidney dz.

20
Q

Piroxicam and Meoxicam have short/long half life.

A

LONG- not good idea for elderly.

21
Q

Meloxicam has what special quality among the nonselective NSAIDs? It is called MOBIC.

A

It is the most selective of the NON-selectives.

22
Q

What is the I in Ibuprofen stand for?

A

IV dose

23
Q

What is NeoProfen used for? What NSAID is it?

A

Ibuprofen - close PDA

24
Q

IV Ibuprofen has another indication other than analgesia and goes by what brand name? (Not neoprofen)

A

Caldolor. It is the ONLY IV anti-pyretic.

25
Q

What is the only IV anti-pyretic?

A

Caldalor – Ibuprofen

26
Q

Caldolor and Ketorloac have what in common?

A

They are IV analgesics.

27
Q

Which drug can be used as a narcotic alternative? What is the guideline?

A

Ketorloac (Toradol).

Can only use for 5 days max because it is very GI and renal toxic.

28
Q

What are the COX 2 selective NSAIDs? What happened with two of them? Which one can be bad with sulfa allergy?

A

Celecoxib, Rofecoxib, Valdecoxib.
V and R patients had heart attacks– procoag and inhibit angiogenesis.
Celebrex (sulfa moiety) is the least potent and still on the market.

29
Q

Where is tylenol metabolized?What Nomogram us used with Acetaminophen toxicity?

A

Liver - during metabolizm, a toxin is produced.

Rumack-Matthew- can predict how much liver damage will develop.

30
Q

What are the 3 GI friendly NSAIDS?

A
  1. Nabumetone -non-acidic
  2. Meloxicam (Mobic) - resembles COX 2 selective
  3. Celecoxib (Celebrex) - COX 2 selective (probably not a good drug for MI hx)
31
Q

What is the antidote to Tylenol OD? What other use does it have?

A

N-Acetylcysteine (NAC)

Mucomist – breaks up mucus (stinks). It is renal protective (anti-oxidant), too.

32
Q

How does Acetaminophen work? How is it different from ASA?

A

Reduces PGs. More lipophilic, less helpful with inflammation.

33
Q 
Alcohol + APAP can lead to...
Contrast dye (oxidative stress) + APAP...
A

Synergistic Hepatotoxicity.

Nephrotoxicity

34
Q

Leukotriene RB blocks cannot be used to treat angioedema because…

A

They only come PO.

Pharm test 3 (9 decks)

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