NSAIDS

Question 1

names of nsaids

Answer 1

• ibuprofen
• meloxicam
• indomethacin
• ketorolac
• cox-2 inhibitor

Question 2

moa of nsaids

Answer 2

• block prostaglandin synthesis

- block cox 1-2 (exception of cox-2 inhibitor)

Question 3

indications for nsaids

Answer 3

• ra
• oa
• gout
• mild to moderate pain
• dysmenorrhea

Question 4

ae of nsaids

Answer 4

• gi bleeding

- bleeding ulcer

Question 5

contraindications for nsaids

Answer 5

• cabg surgery
• renal impairment
• hx of GI bleed
• risk of bleeding

Question 6

nsaids bbw

Answer 6

increased risk of serious cv thrombotic events (stroke, mi)

Question 7

ibuprofen use in children

Answer 7

• fever

- older than 6 months

Question 8

ibuprofen use in elderly

Answer 8

• analgesic and antipyretic

- long term: watch for GI blood loss, renal dysfunction, edema, htn, drug interactions

Question 9

adverse effects of ibuprofen

Answer 9

• gi: dyspepsia, heartburn, epigastric pain, nausea, gi ulceration with occult blood loss
• gu: nephrotoxicity, increased bun and cr, edema
• resp: dyspnea, bronchospasm, hemoptysis, pharyngitis

Question 10

ibuprofen implications

Answer 10

• don’t exceed 3200 mg daily
• always dilute fluids
• assess for dyspepsia/gi bleeding
• monitor cbc/clotting times
• hypersensitivity: rash and bronchospasm

Question 11

education for ibuprofen

Answer 11

• take with food/liquid
• drink 2-3 quarts of water daily
• report any sign of bleeding or difficulty breathing

Question 12

meloxicam ae

Answer 12

• ha
• dizziness
• drowsiness
• insomnia

Question 13

meloxicam contraindications

Answer 13

• aspirin allergy

- cabg surgery

Question 14

meloxicam implications

Answer 14

• don’t exceed 3200 mg daily
• always dilute fluids
• assess for dyspepsia/gi bleeding
• monitor cbc/clotting times
• hypersensitivity: rash and bronchospasm

Question 15

indomethacin main use

Answer 15

anti inflammatory

Question 16

indomethacin ae

Answer 16

• ha, dizziness, somnolence, insomnia
• decreased clotting time
• iv prep: pulmonary hemorrhage

Question 17

indomethacin caution/contraindications

Answer 17

• hx of salicylate hypersensitivity

- contraindicated in elderly, high risk of severity

Question 18

indomethacin implication

Answer 18

• take after meals or with antacid
• keep tabs in light protected container
• dilute for iv, admin 5-10 seconds
• potenial for extravasation

Question 19

ketorolac use

Answer 19

pain

Question 20

ketorolac route

Answer 20

-parenteral

Question 21

ketorolac risks

Answer 21

• gi irritation, inflammation, ulceration, bleeding, and perforation
• limit for 5 days due to risk of bleeding and nephrotoxicity

Question 22

cox 2 inhibitor route

Answer 22

po

Question 23

cox 2 inhibitor moa

Answer 23

• activated with inflammation, it inhibits enzyme decreasing the inflammation
• no effect on cox 1 thus protecting the gi tract and no effect on clotting factors

Question 24

cox 2 inhibitor indications

Answer 24

• juvenille ra
• ra
• oa
• acute pain
• dysmenorrhea

Question 25

cox 2 inhibitor contraindications

Answer 25

• sulfa allergy!
• nsaid allergy
• aspirin allergy
• renal impairment
• perioperative pain
• cabg surgery

Question 26

cox 2 inhibitor ae

Answer 26

• derm: rash, pruritis, sweating stomatitis

- anaphylactic reactions with surgery

Question 27

cox 2 inhibitor implications

Answer 27

• etoh and cigarette increase risk for bleeding
• take 2 hours before or after antacids
• light protected container