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Pharmacology > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

What are NSAIDs generally used for

A

To treat inflammation, pain and fever

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2
Q

What causes inflammation pain and fever and how does NSAIDs stop them

A

The increase in production of prostaglandins leads to those symptoms, so NSAIDs help decrease the production of prostaglandins

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3
Q

What’s the mechanism of action of NSAIDs

A

They work by inhibiting COX enzymes which produce prostaglandins from arachidonic acid, so by inhibiting COX we inhibit the production of prostaglandins

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4
Q

What’s an example of an irreversible cox inhibitor

A

Aspirin

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5
Q

What’s a selective COX 2 inhibitor

A

Celecoxib

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6
Q

How long before a surgery should aspirin be discontinued

A

1 week earlier

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7
Q

Aspirin mode of administration

A

Taken orally

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8
Q

What effect does aspirin have on COX

A

It inhibits both COX 1 and 2 irreversibly

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9
Q

How does aspirin inhibit both COX 1

A

In the blood stream it irreversibly inhibits COX1 in platelets by ACETYLATION decreaseing the production of thromboxane A2-> it’s a platelet activator making aspirin a useful anti platelet medication

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10
Q

How does aspirin inhibit both COX 2

A

In the liver aspirin get metabolised in to salicylate which has no anti-platelet activity but has anti inflammatory activity
- salicylate works by inhibiting COX 2 -> decrease in prostaglandins production decreasing inflammation, pain and fever

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11
Q

Aspirin anti inflammatory activity is achieved at which does

A

4-6g/day

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12
Q

Aspirin antipyretic and analgesic activity is achieved at which does

A

2-3G/day

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13
Q

Aspirin antiplatelet activity is achieved at which does

A

75mg-150mg/day

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14
Q

What’s aspirins lethal dose

A

20-30g

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15
Q

Aspirin indications

A

Analgesia, fever, inhibition of platelet aggregation, rheumatoid arthritis and other rheumatoid diseases

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16
Q

What’s the effect of aspirin of Alzheimer’s and colon cancer

A

Decrease the incidence

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17
Q

Aspirin adverse effects

A

GI system, Hepatitis, Reyes syndrome, bleeding, aspirin asthma hypersensitivity asthma

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18
Q

What is salicylism

A

Acid base disturbances, tinnitus and deafness

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19
Q

What’s the treatmeant of salicylism

A

Activated charcoal, alkalinity urine and electrolyte replacement

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20
Q

What irreversibly inhibits Cox 1 and 2

A

Non selective COX inhibitors

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21
Q

Non selective COX inhibitors derived from proprionic acid derivatives

A

Ibuprofen, naproxen

22
Q

Non selective COX inhibitors from acetic derivatives

A

Indomethacin and sulindac

23
Q

Non selective COX inhibitors from heterosexual acetic acid derivatives

A

Do life ax and ketorelac

24
Q

Why shouldn’t we give non selective Cox inhibitors with aspirin

A

They compete with aspirin on COX1 receptors decreasing the anti platelet activity since they are reversible

25
Q

What are the indications of Non selective COX inhibitors

A

Since they inhibit COX 2 they have the same indications as aspirin

26
Q

Which NSAIDs should be given to patients with information during a gout attack

A

Ibuprofen, naproxen and indomethacin

27
Q

Why is aspirin contraindicated in gout attacks

A

Because it competes with uric acid excretion in the kidney

28
Q

Ibuprofen right dosing

A

400 mg

29
Q

Which NSAID is used for tooth ache

A

Ibuprofen

30
Q

Which NSAID causes the closure of ductus arteriosus

A

Ibuprofen —> most correct

indomethacin —> can be correct

31
Q

Which NSAID is used to treat severe pain after surgery

A

Ketorolac

32
Q

Which NSAID is used for long term treatment of rheumatoid arthritis osteoarthritis and ankylosing spondylitis

A

Diclofenac

33
Q

What’s the only COX 2 selective inhibitor and what are its contraindications

A

Celecoxib and is contraindicated in people with increased risk of thrombosis and CVD

34
Q

Can celecoxib be used with aspirin and why

A

Yes as it only inhibits COX2 and won’t compete with aspirin over COX 1

35
Q

Why are there contraindications to Celecoxib

A

Since it doesn’t have an effect on COX 1 they can increase the ability of blood to clot —> increase the risk of heart attack and stroke

36
Q

How do NSAIDs cause GI symptoms

A

By inhibiting COX 1 reducing the products of cytoprotective prostaglandins leading to ulcers of gastritis

37
Q

What’s the order of severity of GI symptoms with different drugs

A

Aspirin> Non selective COX inhibitors > Celecoxib

38
Q

What is samters triad

A

People with asthma and nasal polyps are more likely to experience NSAIDs hypersensitivity reactions

39
Q

How to prevent GI upset with NSAIDs

A

Take them with food

40
Q

Why can’t aspirin be taken with antaacids

A

Reduces absorption

41
Q

Why can’t aspirin be taken with heparin

A

Can lead to haemorrhage

42
Q

What are the contraindications of aspirin

A

Hyper sensitivity to salicylate and bleeding disorders

43
Q

What is another name for paracetamol

A

Acetaminophen

44
Q

What is acetaminophen used for

A

Antipyretic and analgesic drug

45
Q

Does acetaminophen have any anti inflammatory activity

A

Little to no anti inflammatory activity

46
Q

What acetaminophen lethal does and lethal does in alcoholics

A

12 grams

2.7 grams

47
Q

What’s the maximal single does of acetaminophen

A

650 mg

48
Q

What are the adverse effects of acetaminophen

A

Hepatotoxicity

49
Q

What’s the antidote for acetaminophen

A

N-acetylcysteine, activated charcoal and fluids

50
Q

What do we give and don’t give to febrile children

A

We don’t give aspirin to febrile children

We administer paracetamol 10-15 mg/kg or ibuprofen 7-10mg/kg

51
Q

What is the Toxic by product of acetaminophen

A

NAPQI or N acetyl p benzoquinoneamine

52
Q

Naproxine is contraindicated

A

People with CVD

Pharmacology (33 decks)

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