NSAIDs

Question 1

What are the 4 things an NSAID must do?

Answer 1

• Decrease inflammation
• Reduce fever
• Relieve mild to moderate pain
• Decrease risk of blood clotting (inhibit platelet aggregation)

Question 2

Why is acetaminophen not considered an NSAID?

Answer 2

it does not have anticoagulant properties

Question 3

How do NSAIDs work?

Answer 3

Inhibit COX enzyme which is the 1st step in the synthesis of an endogenous compound called prostaglandins, which are produced when cells undergo damage

Question 4

Why do NSAIDs target postaglandins?

Answer 4

Inflammation – prostaglandins play an important role in inflammation, inhibition of this will help manage acute and chronic inflammation
Pain – increase prostaglandins increase the sensitivity of pain receptors
Fever – increased prostaglandins promotes fever

Question 5

What is the difference between COX-1 & COX-2 enzyme?

Answer 5

COX-1 enzyme produces prostaglandins that help regulate normal cell activity and maintain cell homeostasis

COX-2 enzyme is produced primarily in injured cells

Question 6

To get the best clinical results for NSAIDS is one that inhibits _____ and spares _____

Answer 6

COX-2 , COX-1

Question 7

T/F: Aspirin is the primary NSAIDs for an adult fever as well decreases chances of colorectal cancer

Answer 7

True

Question 8

What is the primary side effect of NSAIDs?

Answer 8

GI damage (GI hemorrhage, ulceration due to loss of protective prostaglandins)

Question 9

Which of the following BEST associated with cardiovascular risks and why? COX-1 or COX-2?

Answer 9

COX-2 – causes vasodilation so the selective drugs cause vasoconstriction which increases BP

Question 10

T/F you cant OD on aspirin

Answer 10

False: it is known as aspirin intoxication or poisoning

Question 11

Why may it not be appropriate for a teen to take aspirin?

Answer 11

they can develop Reye syndrome

Question 12

Why might someone not be prescribed aspirin following a fracture?

Answer 12

inhibits bone healing

Question 13

Name 3 differences between NSAIDs and Aspirin

Answer 13

1. Non-aspirin NSAIDs have less GI discomfort but overall can have some stomach irritation
2. Certain NSAIDs are less toxic to other organs (liver and kidneys) than aspirin
3. Cost of prescription or non prescription NSAIDs is 5-20x more than aspirin

Question 14

COX-2 selective drugs have increased risk of ____, but less of _______

Answer 14

increased risk in heart attack and stroke in patients with cardiac risk factors – HTN, heart disease
less gastric irritation

Question 15

T/F: Most NSAIDs and aspirins are non-selective

Answer 15

True

Question 16

What is the only COX-2 selective drug on the market and why?

Answer 16

celecoxib (celebrex), all the others are off market because of great risks (ie: vioxx)

Question 17

T/F acetaminophen is used widely in treating non-inflammatory conditions that have mild to moderate pain, especially if there is a history of gastric damage (ulcers)

Answer 17

True

Question 18

How does acetaminophen work?

Answer 18

Works by inhibiting the cyclooxygenase enzyme

Question 19

Can acetaminophen be toxic? To what organ?

Answer 19

yes to the liver & it can be fatal (esp for alcoholics)