NSAIDs

Question 1

Cardioprotective Capabilities of Aspirin

Answer 1

Because low doses inhibit COX1 irreversibly, inhibits TXA2 in platelets (terminal cell, can’t produce more) blocking aggregation and vasoconstriction

Question 2

Gastric Irritation of NSAIDs

Answer 2

COX1 creates PGI2/PGE2 activates GPCR Gi which inhibits Gs from H2R stimulated by histamine which pumps H+ into lumen. So inhibiting COX increases stomach acidity

Question 3

Misoprestol

Answer 3

Oral PGE2 that can reduce ulcers from NSAID treatment

Question 4

Salicylism

Answer 4

Acute aspirin toxicity, dizziness headaches and tinnitus and need to discontinue immediately

Question 5

Celecoxib/Celebrex

Answer 5

COX2 inhibitor so less GI effect but significant likelihood of heart problems bc don’t make PGI2 which inhibits TXA2

Question 6

2 Other Toxic Problems of NSAIDs

Answer 6

Nephrotoxicity bc interferes with blood flow bc COX2 constitutively active in kidneys/endothelials
Asthma because blocks 1/2 of AA pathways so more go into leukotrienes like LTC/D4 which are bronchoconstrictors/anaphylactic agents

Question 7

Acetaminophen

Answer 7

Not COX inhibitor, so less anti-inflammatory effect but still other effects so better for hemophiliacs. No GI or cardio effects, good or bad