NSAID's

Question 1

True or False:
Diflunisal is an anti-pyritic agent

Answer 1

False

Question 2

Which NSAID is good for treating dysmenorrhea?

Answer 2

Celecoxib

Question 3

If you are trying to treat
RA or Osteoarthritis you can use NSAID except ___ and ___

Answer 3

ketorolac or mefenamic acid

Question 4

What two drugs are indicated for treating juvenile RA?

Answer 4

Naproxen and Tolmetin

Question 5

True or False:
You can treat juvenile RA with Indomethacin

Answer 5

False

Question 6

Mechanism of action for Diflusinal vs. Aspirin?

Answer 6

Diflusinal: Reversible inhibition of COX-1/COX-2
Aspirin: Irreversible inhibition of COX-1 and -2

Question 7

Misoprostol is a prostaglandin analogue with ____ effects, can be used for long term RA treatment

Answer 7

anti-ulcer effects

Question 8

Nabumetone is activated by the ___

Answer 8

liver

Question 9

Having tinnitus/hearing loss while taking aspirin indicates?

Answer 9

Chronic salicylate intoxication/salicylism

Question 10

Aspirin is contraindicated in?

Answer 10

Hemophilia
vWB disease
Telangiectasia

Question 11

What kids do not get aspirin? What can you use instead?

Answer 11

-Those with chicken pox/flu-like disease
-Puts them at higher risk of Reye’s Syndrome
-Use acetaminophen

Question 12

Chronic NSAID use can cause:
1) Acute Renal Insufficiency
2) Interstitial nephritis
3) Hyperkalemia
4) Hypernatremia
5) Papillary Necrosis - irreversible

Mechanism?

Answer 12

Inhibition of renal prostaglandin (COX-2) synthesis

Question 13

COX makes prostaglandins from ____

Answer 13

arachidonic acid

Question 14

At low pH (stomach)aspirin is ____ while at a high pH (small intestine) it is ____ and dissolution occurs because absorption not limited because of large SA!)

Answer 14

non-ionized; ionized

Question 15

How does changing pH of urine help get aspirin out of the body?

Answer 15

The more basic the urine, the greater the renal clearance

Question 16

Why can tubular necrosis occur in patients taking aspirin?

Answer 16

Inhibition of renal prostaglandin synthesis (COX2) causes renal medullary ischemia

Question 17

The urticaria or angioedema you can get while taking aspirin are a type ___ reaction associated with __

Answer 17

Type I, IgE

Question 18

Aspirin sensitivity, asthma, nasal polyps, and bronchospasm describes ___ ___

Answer 18

Aspirin Triad

Question 19

You shouldn’t use aspirin in expecting mothers since there’s an association with congenital abnormalities and hemorrhaging, but its ok for ___

Answer 19

pre-eclampsia

Question 20

Anti-coags and ___, taking with aspirin can increase bleeding risk while ___ will increase renal clearance of aspirin

Answer 20

thrombolytic agents; corticosteroids

Question 21

Aspirin intoxication presentation in kids?

Steps?

Answer 21

Hyperventilation

1) CNS stimulation (salicylate lag)
2) CNS depression
(death, coma, respiratory failure)

Question 22

Acetaminophen is used to treat fevers bu acting on ____ heat regulating center

Answer 22

hypothalamic

Question 23

____, also known as paracetamol, ___inhibits COX1/2

Answer 23

Acetaminophen; weakly

Question 24

The small amount of acetaminophen metabolized by cytochrome P450 can form a toxic intermediate, which can damage __ and ___

Answer 24

liver; kidney

Question 25

____ is the specific antidote for acetaminophen toxicity

Answer 25

Oral N-acetylcysteine

Question 26

What two NSAID's are associated with headache?

Answer 26

Indomethacin and ketorolac

Question 27

What NSAID is associated with headache and worsening depression?

Answer 27

Indomethacin

Question 28

Autoimmune hemolytic anemia - type ___ drug allergy is associated with use of what NSAID? Antibodies?

Answer 28

II; Tometin; IGG

Question 29

___ and ___ and ____ __ are not recommended for kids under 14 yoa (risk of hepatotoxicity)

Answer 29

Indomethacin, Mefenamic acid, and meclofenamate

Question 30

What two NSAID's induces closure of the fetal ductus arteriosus via inhibition of prostaglandin E2?

Answer 30

Ibuprofen and Indomethacin

Question 31

How do you eliminate aspirin from system?

Answer 31

Alkalize the urine (IV sodium bicarbonate)

Question 32

When should you discontinue use of Aspirin if you have upcoming surgery?

Answer 32

5-7 days prior

Question 33

Post-op hematomas are common when __ is given IM

Answer 33

ketorolac

Question 34

How does oral N-acetylcysteine fix acetaminophen toxicity?

Answer 34

Restores glutathion levels

Question 35

__ is a good substitute for aspirin, but its anti-inflammatory effects are weaker

Answer 35

Acetaminophen

Question 36

Nephrotoxicity and hepatoxicity, as well as rash/allergic reaction is most worrisome for ____

Answer 36

acetaminophen

Question 37

___ should not be given to a patient who has has asthma, rash, or allergic-type reaction to sulfonamides, aspirin, or NSAID's

Answer 37

Celecoxib

Question 38

Celecoxib inhibits ___

Answer 38

COX-2

Question 39

NSAID's can prolong ___ and should be avoided in ___ trimester

Answer 39

labor; trimester

Question 40

____ necrosis is a irreversible type of renal injury associated with use of ___

Answer 40

Papillary; Difusinal

Question 41

What is the first choice for anti-inflammatory and analgesic effects in RA, JA, and OA treatment?

Answer 41

Aspirin

Question 42

Adult daily dosage range for aspirin?

Answer 42

2.4-3.6

Question 43

___ and ___ are most common signs of chronic aspirin intoxication in adults - could be accompanied by metabolic ___ and respiratory ___

Answer 43

tinnutis/hearing loss acidosis; alkalosis

Question 44

Lethal dose of aspirin in kids? adults

Answer 44

4g; 10-30 g