NSAIDS 1

Question 1

Almost all NSAIDS are what?

Answer 1

Plasma
Protein
Bound

Question 2

What do NSAIDS block?

Answer 2

Cyclooxygenase enzyme and prostaglandins

Question 3

What does COX I and COX II do? Which do NSAIDS block?

Answer 3

Cox I: stomach
Cox II: periphery

NSAIDS block BOTH

Question 4

What is an NSAID allergy?

Answer 4

sensitivity, due to shunting to Lipooxygenase pathway. There are no antibodies present, so no allergy.

Question 5

How does NSAID allergy present?

Answer 5

angioedema (due to bradykinin), patient usually has history of asthma (overproduction of histamines)

Question 6

How do you manage NSAID allergy?

Answer 6

epinephrine then steroids

Question 7

how do you manage asthma?

Answer 7

leukotriene receptor blockers

Question 8

What are the 5 NSAID indications?

Answer 8

• Gouty arthritis
• Arthritic disease
• Pain syndromes
• Headache
• Chemotherapy

Question 9

What are the NSAID effects?

Answer 9

Analgesia
Anti-inflammatory
Anti-pyuretic

Question 10

T OR F

NSAIDS can cause hypothermia

Answer 10

FALSE

Question 11

What is significant about aspirin?

Answer 11

only 40g causes the COX enzyme of a platelet to be IRREVERSIBLE inhibited for the life of that platelet (anticoagulation)

Question 12

Are most NSAIDS irreversible?

Answer 12

NO, only ASPIRIN which is why it is giving for MI and should probably be prescription

Question 13

If we could block one COX, which would it be?

Answer 13

COX 2, no GI side effects

Question 14

Acetaminophen acts where?

Answer 14

Primarily in the hypothalamus and has limited anti-inflammatory activity

Question 15

Is APAP lipophilic or hydrophilic?

Answer 15

Lipophilic

Question 16

LT antagonists work how?

Answer 16

Block leukotriene receptors which mediate various allergic/inflammatory reactions.

Question 17

Where do LT antagonists work?

Answer 17

Pulmonary system (asthma)

Question 18

Corticosteroids act how?

Answer 18

Bind to corticosteroid receptors in the cytoplasm and translocate to the nucleus where they bind module genes

Question 19

What do the module genes do?

Answer 19

encode for various pro-inflammatory cytokines and interleukins.

Provide inflammation

Question 20

Why are corticosteroids so potent?

Answer 20

block AA formation upstreat

Question 21

NSAID cautions? (8)

Answer 21

Highly protein bound
Avoid alcohol (increase GI toxicity)
Monitor guiac stools
HTN
Anticoagulation
Masked febrile reactions/infection
Asthma
Renal disease

Question 22

Nsaids and renal issues?

Answer 22

closes afferent arteriole

Question 23

Why avoid alcohol and monitor guiac stools?

Answer 23

increase GI toxicity, increase ulcer risk

Question 24

Why caution with NSAIDS and HTN?

Answer 24

drop in GFR can cause Na retention

Question 25

Why treat premature baby with NSAID?

Answer 25

closes ductus arteriosus (PGs keep it open)

Question 26

When should you use APAP?

Answer 26

headache

fever

Question 27

What is APAP?

Answer 27

Acetaminophen (tylenol)