NSAIDs

Question 1

Why is aspirin contra-indicated in children under 16?

Answer 1

There is a link to Reye’s Syndrome when given to under 16s. Check with GP before prescribing.

Question 2

Why is aspirin contra-indicated in patients with a bleeding disorder?

Answer 2

Can result in GI bleeding, and can magnifiy the severity of existing bleeding disorders.

Question 3

Give a brief description of how NSAIDs work to reduce inflamation.

Answer 3

NSAIDS work by inhibiting the function of the cyclooxygenase (COX) enzyme and thereby reducing the production of prostaglandins - molecules which regulate pain/inflammation.

Question 4

Which NSAIDs are irreversable COX inhibetors.

Answer 4

Aspirin is an irreversible inhibitor of COX; the remaining NSAIDs work in a reversible manner.

Question 5

What are prostaglandins?

Answer 5

Prostaglandins are hormones that exert of influence over key physiological processes in your body—including pain levels and inflammation.

Question 6

Which prostaglandins lead to pain stimuli?

Answer 6

Production of prostaglandin E2 and prostaglandin F2a results in sensitisation of nocioceptic nerve fibres to painful stimuli following tissue injury.

NSAIDs cause a reduction in their synthesis and therefore analgesia

Question 7

Which enzymes do NSAIDS act upon?

Answer 7

COX I and II

Question 8

Describe the arachidonic acid pathway, and state its significance.

Answer 8

Membrane phospholipids are converted to arachidonic acid* (via phospholipase A2)*

Arachindonic acid is converted into prostaglandins (via COX I or II)

Prostaglandins can then be converted further depending on the type of tissue the damage was caused in.