NSAIDs

Question 1

Name examples of NSAIDs

Answer 1

Ibuprofen, mefenamic acid, naproxen, aspirin

Question 2

NSAIDs have been shown to reduce menstrual blood loss by x% to x% or more in x women with heavy menstrual blood loss.

Answer 2

NSAIDs have been shown to reduce menstrual blood loss by 25% to 35% or more in three-quarters of women with heavy menstrual blood loss

Question 3

List a set of pharmacological agents used for the treatment of menorrhagia

Answer 3

Question 4

The reduction effect of NSAIDs on menstrual blood loss is directly proportional to…

Answer 4

the volume of pre-treatment loss

Question 5

What is the mechanism of NSAIDs reducing MBL?

Answer 5

NSAIDs inhibit the cyclooxygenase (COX) enzyme system responsible for the conversion of arachidonic acid to cyclic endoperoxidases (prostaglandins and leukotrienes).
Some NSAIDs (mefenamic acid, meclofenamic acid) are also believed to act by binding with the receptor of the vasodilator prostaglandin E2.

Question 6

What is the mechanism of antifibrinolytics and reduced MBL

Answer 6

Women with heavy MBL have higher levels of plasminogen activators in the endometrium compared with those with normal menstrual loss. Antifibrinolytics competitively inhibit the conversion of plasminogen to plasmin and counteract the fibrinolytic activity with the endomentrium.

Question 7

What is the mechanism of ibuprofen administration on reduced MBL?

Answer 7

ibuprofen is a well-known cyclo-oxygenase inhibitor, on primary and myoma-associated menorrhagia.

The endometrial uptake of arachidonic acid, an essential precursor for prostanoid biosynthesis, is increased (Downing et al. 1983) and conversion of exogenous arachidonic acid to prostaglandin E2 (PGE2) (Smith et al. 1981a) and prostacyclin (PGI2) (Smith et al. 1981b) is enhanced in menorrhagic endometrium. PGE2 and/or PGI2 are vasodilatory and antiaggregatory agents and could account for the increased menstrual blood loss.

The ratio TxB2/6-keto-PGF,, was inversely related to menstrual blood loss in women with measured menstrual blood loss exceeding
70 ml. There is a PGI, dominance in the endometrium of patients with menorrhagia.

Question 8

What is the effect ibuprofen on menstrual blood loss?

Answer 8

Ibuprofen treatment at 1200 mg/day decreased the median blood loss by 25% (P