NSAIDs Flashcards
Damage cells release, inflammatory mediators, such as
Histamine, bradykinin and prostaglandins
What did the inflammatory mediators do to blood vessels?
They cause blood vessels to leak fluid and proteins into the tissues producing edema to help isolate the foreign substance from further contact with body tissues
What effect do inflammatory mediators have on phagocytic leukocytes?
They attract them to the area of injury to consume bacteria and dead or damage cells
What are inflammatory response responses that are inappropriate
Chronic inflammation, autoimmune diseases and allergies
What are the enzymes responsible for the transformation of archaic acid into pro-inflammatory substances called prostaglandins
Cox one and Cox two
What is the primary effective of NSAIDs
To inhibit Cox
Which NSAIDundergoes extensive hepatic first past metabolism, which reduces its bio availability
Diclofenac
What pathway do NSAIDs work on for hepatic metabolism?
CYP2C9
How are NSAIDs primarily excreted?
In the feces and urine
What are the two selective Cox two inhibitors
Meloxicam and Celecoxib
What patient population should not take celecoxib
Patient with cardiovascular disease
What should you do if an NSAID does not treat a patient’s pain
Try a NSAID from a different class and on each attempt to achieve a response, you should wait two weeks at the maximum antiinflammatory dose range
What are the therapeutic effects of non-selective Cox inhibitors
Decreased effect in bradykinin and histamine reverse of vasodilation, platelet aggregation, inhibition, antipyretic, anti-inflammatory and analgesic
What are the adverse effects of non-selective Cox inhibitors
Gastric, erosion and ulceration, bleeding, tendencies, renal impairment, asthma, edema, hypertension, heart, failure, headache, tinnitus, and dizziness
What are the benefits of using a selective Cox two inhibitor Celebrex
As a lower incidence of G.I. symptoms, lower incidence of gastric ulcers, possible protection against colon cancer no effect on platelets no risk for bronchospasm or asthma
Were the adverse effects of the selective Cox two inhibitor Celebrex
And increase risk of ischemic events heart failure, increased blood pressure and cardiac arrhythmias can’ affect renal function and cause hypercalcemia, and it contains sulfonamide so patients with sulfa allergies cannot take this drug
What are the adverse effects of acetaminophen?
Hepatic toxicity and renal dysfunction
What is glucosamine and how can it be used?
Is a natural material found in articular cartilage in synovial fluid and it can be extracted stabilized and used as an agent to treat osteoarthritis and down regulation of inflammatory mediators
What patient should avoid glucosamine
Patient with a shellfish allergy
Cox one and Cox two are responsible for the conversion of ___ into_____
Arachidonic acid into prostaglandins
Which Cox is considered to be cytoprotective Cox one or Cox two
Cox one
Which NSAID carries an increased risk for bronco spasm in people with asthma or allergic atopy
Aspirin
What are the cardinal signs of a cute inflammation
Rubor (redness) calor(heat) tumor(swelling) and dolor (pain)
Which NSAID has an increased risk for allergy in asthma
Aspirin
What is the max daily dose of acetaminophen?
4000 mg/day. Anything over can cause hepatotoxicity
