NSAIDS 1 Flashcards
Almost all NSAIDS are what?
Plasma
Protein
Bound
What do NSAIDS block?
Cyclooxygenase enzyme and prostaglandins
What does COX I and COX II do? Which do NSAIDS block?
Cox I: stomach
Cox II: periphery
NSAIDS block BOTH
What is an NSAID allergy?
sensitivity, due to shunting to Lipooxygenase pathway. There are no antibodies present, so no allergy.
How does NSAID allergy present?
angioedema (due to bradykinin), patient usually has history of asthma (overproduction of histamines)
How do you manage NSAID allergy?
epinephrine then steroids
how do you manage asthma?
leukotriene receptor blockers
What are the 5 NSAID indications?
- Gouty arthritis
- Arthritic disease
- Pain syndromes
- Headache
- Chemotherapy
What are the NSAID effects?
Analgesia
Anti-inflammatory
Anti-pyuretic
T OR F
NSAIDS can cause hypothermia
FALSE
What is significant about aspirin?
only 40g causes the COX enzyme of a platelet to be IRREVERSIBLE inhibited for the life of that platelet (anticoagulation)
Are most NSAIDS irreversible?
NO, only ASPIRIN which is why it is giving for MI and should probably be prescription
If we could block one COX, which would it be?
COX 2, no GI side effects
Acetaminophen acts where?
Primarily in the hypothalamus and has limited anti-inflammatory activity
Is APAP lipophilic or hydrophilic?
Lipophilic
LT antagonists work how?
Block leukotriene receptors which mediate various allergic/inflammatory reactions.
Where do LT antagonists work?
Pulmonary system (asthma)
Corticosteroids act how?
Bind to corticosteroid receptors in the cytoplasm and translocate to the nucleus where they bind module genes
What do the module genes do?
encode for various pro-inflammatory cytokines and interleukins.
Provide inflammation
Why are corticosteroids so potent?
block AA formation upstreat
NSAID cautions? (8)
Highly protein bound Avoid alcohol (increase GI toxicity) Monitor guiac stools HTN Anticoagulation Masked febrile reactions/infection Asthma Renal disease
Nsaids and renal issues?
closes afferent arteriole
Why avoid alcohol and monitor guiac stools?
increase GI toxicity, increase ulcer risk
Why caution with NSAIDS and HTN?
drop in GFR can cause Na retention
