NSAIDS Flashcards

1
Q

Cox 1 = is _______ and expresses _____ primarily

Cox 2 = is ________ and expresses _____

A

Cox 1 = constitutively and noninflammatory cells

Cox 2 = inducible and inflammatory cells

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2
Q

Leukotriene play a key role in _____

A

allergies, allergic rhinitis, & asthma

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3
Q

Cox-1 is located ____ role is _____

A
Platelets
Vasoconstriction + increase platelet aggregation = thrombosis
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4
Q

Cox-2 is located ____ and role is

A

Endothelial cells

vasodilation + decrease platelet aggregation

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5
Q

Thromboxane and Prostaglandins

A

Cox-1

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6
Q

Prostaglandins and Prostacyclin

A

Cox-2

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7
Q

Non-selective NSAIDs effects

A

reduce inflammation
reduce pain
reduce fever

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8
Q

Aspirin at low dose =

A

anti-platelet effects

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9
Q

Non-selective NSAIDs adverse effects

A
  • increased gastric acid –> peptic ulcers + GI bleeds
  • decreases renal blood flow –> increased RAAS, blood Ka+ levels & TPR
  • Increased bleeding (anti-platelet)
  • Increased cardiovascular events (MI & Stroke because of decreased prostacyclin) - except aspirin
  • increased asthma
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10
Q

Contraindication for non-selective NSAIDs

A

Pregnancy = conception (hard for implantation)+ 3rd trimester (increased bleeding)

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11
Q

Aspirin MOA

A

irreversibly inhibits COX

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12
Q

Aspirin is _____ plasma protein bound and has first order kinetics at ___ does and zero order kinetics at __ does

A

highly
low
high

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13
Q

We must ____ urine to increase aspirin excretion

A

Alkalinize

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14
Q

Aspirin ADRs

A

anti-platelet = gastric ulceration because of ion trapping in gastric cells

increased bleeding risk

Hypersensitivity rxns

Asthma in people in aspirin hypersensitivity

Reye’s syndrome

Salicylism = respiratory alkalosis then metabolic acidosis + respiratory acidosis (increased lactic acid)

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15
Q

Non-selective NSAIDS =

A

Ibuprofen
Naproxen
Indomethacin (great inflammatory)
Ketorolac = greater analgesic effectiveness

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16
Q

____ helps keep ductus open

A

PGE1

17
Q

Ibuprofen is dosed for

A

anti-inflammatory responses

18
Q

Naproxen is useful for

A

acute gout + ankylosing spondylitis

19
Q

Ketorolac is the only non-selective NSAID that is

A

potent analgesic = efficacy similar to morphine

ONLY available in parental formulation

20
Q

Celecoxib

A

selective Cox-2 inhibitor that interacts with warfarin because of 2c9
also sulfa allergies

21
Q

Acetaminophen MOA

A

Inhibits Cox-3 = analgesic & antipyretic effects

very weak Cox-1 & 2

22
Q

Acetaminophen is preferred for patients that

A

current or previous peptic ulcers or GI bleeds

hemophilia

23
Q

Acetaminophen FDA limit is

A

4000 mg/day

24
Q

Acetaminophen is ____ plasma protein bound

A

poorly