NSAIDs Flashcards
How do NSAIDs affect GI mucosa?
COX-1 inhibition leads to peptic ulcers and GI bleeds
How do NSAIDs affect kidneys?
Afferent arteriolar vasoconstriction
Na+ and water retention
Hypertension
Haemodynamic acute kidney injury
Effect of low dose aspirin
Selectively inhibits COX-1 thereby reducing production of thromboxane A2 thereby reducing vasoconstriction and platelet aggregation
It leaves COX-2 alone which causes vasodilation and inhibits platelet aggregation
Negative effect of NSAIDs on the CVS?
Inhibition of COX-2 leads to vasoconstriction and platelet aggregation becoming easier
Name the COx-2 selectively inhibitors
Calecoxib
Anything ending in coxib
Name and describe non-acetylated salicylates
Anything ending in salicylate like sodium salicylate
Effective anti-inflammatory drugs
However no COX inhibition
No platelet aggregation inhibition
Used when COX inhibition is undesirable
When is COX inhibition undesirable?
Patients with:
Asthma
Bleeding tendencies
Renal dysfunction
What is special about aspirin’s platelet aggregation inhibition?
It lasts 8 to 10 days so it covers the whole duration of a platelet in circulation
Describe mild and severe aspirin overdose
Mild salicylate intoxication (salicylism)-
mental confusion
dizziness
tinnitus
Severe salicylate intoxication-
Real bad
Contraindications of aspirin and why
Children due to risk of Reye’s syndrome
Pregnant women due to premature closure of the ductus arteriosus in fetus
Haemophilia
Describe Reye’s syndrome
Acute liver failure
Encephalopathy
When ate selective COX-2 inhibitors contraindicated?
In sulfa allergy as they have a sulfonamide structure
What is special about ketorolac
It is the only injectable NSAID
It is the most powerful NSAID, comparable to opioids
Which NSAID has the lowest risk of promoting a heat attack?
Naproxen
Why does paracetamol not have systemic side effects classically found with NSAID use?
It is inactivated peripherally
