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UNMC PA Pharmacology > NSAIDS > Flashcards

NSAIDS Flashcards

1
Q

aspirin chemical name

A

Acetyl-salicylic acid

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2
Q

NSAID target

A

Prostaglandin synthesis

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3
Q

Rate limiting step of prostaglandin synthesis

A

COX activity

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4
Q

COX-1 Functions

A

Fever
Pain
Protect mucosal lining of stomach
Increase platelet aggregation
Regulate kidney function

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5
Q

Prototype COX-1 inhibitor

A

Aspirin

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6
Q

COX-2 Functions

A

Pain
Protect mucosal lining of stomach
Decrease platelet aggregation in endothelial cells
Wound healing
Inflammation

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7
Q

Prototype COX-2 inhibitor

A

Celecoxib

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8
Q

Aspirin dose

A

325 mg

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9
Q

Aspirin is hydrolyzed to:

A

Salicylic acid

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10
Q

Salicylate NSAID metabolism
Low dose:
High dose:

A

Low dose: conjugated in liver; first order kinetics
High dose: excreted.by kidneys unmetabolized; zero order kinetics

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11
Q

Low dose aspirin uses:

A

Pain
Fever
Anticoagulation

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12
Q

High dose aspirin uses:

A

Inflammation

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13
Q

Aspirin mechanism of anti-coagulation

A

Salicylate Irreversibly/covalently binds to COX-1 to decrease platelet synthesis of thromboxanes

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14
Q

Aspirin side effects

A

Bleeding
GI irritation
Premature closure of ductus arteriosus

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15
Q

Aspirin contraindications

A

Clotting deficiencies
Children
Late pregnancy

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16
Q

Aspirin drug interactions

A

Warfarin, methotrexate, sulfonamides

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17
Q

Aspirin overdose treatment

A

Bowel irrigation
Activated charcoal
Volume repletion
Alkalinization of urine

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18
Q

Non-aspirin NSAIDs are derivatives of:

A

Proprionic acid

19
Q

Ibuprofen brand names

A

Motrin
Advil

20
Q

Celecoxib brand name

A

Celebrex

21
Q

Naproxen brand name

A

Aleve

22
Q

Ibuprofen dose:

A

200mg for pain and fever
400mg for anti-inflammatory

23
Q

Non-aspirin NSAID adverse effects

A

GI irritation
Increased bleeding time (shorter term than aspirin; reversible)
Drug interactions (high albumin binding)
Renal toxicity

24
Q

Indomethacin is a derivative of:

A

Acetic acid

25
Q

Indomethacin is more/less potent than aspirin?

A

More potent (10-20x)

26
Q

Indomethacin main use

A

Severe inflammation
Not used for pain or.fever due to severe side effects

27
Q

Celecoxib mechanism of action

A

Selective COX-2 inhibitor

28
Q

Celecoxib uses

A

Decrease inflammation and pain with less side effects than COX-1 inhibitors

29
Q

Celecoxib adverse effects

A

Edema
GI upset
Increase risk of MI

30
Q

Acetaminophen chemical name

A

Acetyl para-amino phenol (APAP)

31
Q

Acetaminophen MOA

A

Unknown
Probably COX and prostaglandin inhibition

32
Q

Acetaminophen dose

A

325mg

33
Q

Acetaminophen uses

A

Pain
Fever
NOT inflammation

34
Q

Maximum daily dose of acetaminophen

A

4g

35
Q

Acetaminophen adverse effects

A

Hepatic damage
Skin rash
Mucosal lesions
Nephrotoxicity

36
Q

Acetaminophen overdose symptoms

A

GI distress
Hepatotoxicity

37
Q

Acetaminophen overdose treatment

A

Supportive care
Activated charcoal
N-acetyl-cysteine (Acetadote)

38
Q

Which of the following drugs is specifically approved for and frequently
advertised for treating menstrual cramps and pain?
A. Indomethacin
B. Naproxen
C. Celecoxib
D. Aspirin
E. Acetaminophen

A

B. Naproxen

39
Q

In a setting of overdose toxicity with aspirin, which of the following
pairs the most serious concern with its appropriate treatment?
A. hepatotoxicity, treated with sodium bicarbonate.
B. hepatotoxicity, treated with N-acetyl-cysteine.
C. long-lasting inhibition of coagulation, treated with N-acetyl-cysteine.
D. risk of GI ulceration, treated with prostaglandin analogs, such as
misoprostol.
E. respiratory and metabolic acidosis, treated with sodium bicarbonate

A

E. respiratory and metabolic acidosis, treated with sodium bicarbonate

40
Q

A drug whose use is limited to specific types of severe inflammation
because of its significant toxicities in other settings is
A. naproxen sodium.
B. indomethacin.
C. celecoxib.
D. prednisolone.
E. acetaminophen.

A

B. indomethacin

41
Q

Aspirin is the only drug specifically recommended for decreasing the
risk of myocardial infarction and stroke in middle-aged and aging
persons or those with a prior incident. This is because aspirin
A. is more COX-2 selective than any other NSAIDs.
B. is the only NSAID that inhibits platelets significantly because of its
selective uptake by platelets.
C. has significantly greater COX-2 inhibition than any of the other orally
effective NSAIDs.
D. causes irreversible covalent acetylation of COXs in platelets.
E. inhibits prostacyclin production to a greater extent than
thromboxane production

A

D. causes irreversible covalent acetylation of COXs in platelets.

42
Q

GI distress and potential GI hemorrhage with prolonged use is a
greater concern with
A. aspirin than with other salicylates.
B. ibuprofen than with aspirin.
C. celecoxib than with naproxen.
D. aspirin than with celecoxib.
E. acetaminophen than with ibuprofen.

A

D. aspirin than with celecoxib

43
Q

A 3-year -old child is brought to the emergency room after ingesting the
remaining aspirin tablets from a 50-tablets bottle about 3 hours earlier
The mother estimates that 30-35 tablets were in the bottle. The child is
unconscious and given sodium bicarbonate intravenously. Which of
the following best describes the goal of the sodium bicarbonate?
A. To alkalinize the plasma, to prevent respiratory acidosis
B. To alkalinize the urine, to remove salicylate from the plasma by ion
trapping.
C. To neutralize the salicylic acid in the blood stream
D. To prevent binding of the aspirin to plasma binding proteins that can
cause indirect side effects
E. To serve as a sulfhydryl group “sink” to react with the excess salicylic
acid

A

B. To alkalinize the urine, to remove salicylate from the plasma by ion trapping

UNMC PA Pharmacology (23 decks)

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