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xPharm Exam 1 > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

Aspirin

10 important things

A
  • Irreversibly blocks COX
  • Low dose (1st order elimination), High dose (0 order elimination)
  • Decreases risk of TIAs, unstable angina, cataracts and colon cancer
  • DOC for fever
  • For muscular, vascular, dental, postpartum and arthritis pain (not for visceral pain)
  • Enteric coated is best (decreases gastritis)
  • 2g or less can increase serum uric acid levels (>4g decrease levels)
  • Reye’s Syndrome in children (use tylenol instead)
  • Salicylism: tinnitus, decreased hearing and vertigo
  • Interactions: corticosteriods, spironolactone, penicillin, etc
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2
Q

Ibuprofen

5 important things

A
  • 2nd DOC for fever
  • Good for bone pain and children
  • Can decrease anti-inflammatory effect if used with ASA
  • Risk for stroke
  • Least irritant on GI
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3
Q

Naproxen

5 important things

A
  • Competes with ASA for binding sites
  • Antacids delay absorption
  • GI upset (3rd most NSAID)
  • Prolongs pro-thrombin time
  • Safest for CV risks
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4
Q

Fenoprofen

2 important things

A
  • Causes interstitial nephritis

- Not for diabetics or patients with renal dysfunction

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5
Q

Flurbiprofen

2 important things

A
  • Topical opthalmic formulation (eye inflammation)

- Monitor LFTs

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6
Q

Ketoprofen

2 important things

A
  • Inhibits both pathways (COX and Lipooxygenase)

- Better for asthmatics

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7
Q

Oxaprozin

3 important things

A
  • Once daily dosing
  • Useful in gout (don’t give for acute gout, can increase uric levels)
  • Doesn’t interfere with INR
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8
Q

Diclofenac

5 important things

A
  • More COX II selective
  • High concentrations can inhibit leukotrienes
  • Also comes in a topical preparation
  • Severe hepatic reactions (hepatitis)
  • Risk for stroke and CV death
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9
Q

Sulindac

4 important things

A
  • Prodrug (enterohepatic circulation)
  • Causes SJS
  • Increased risk of acute liver injury
  • Only NSAID that doesn’t interact with diuretics
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10
Q

Tolmetin

1 important thing

A

-Good for children (JRA)

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11
Q

Etodolac

2 important things

A
  • Selective for COX II

- Post-op analgesia

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12
Q

Meloxican

2 important things

A
  • Selective for COX II

- Causes hepatotoxicity

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13
Q

Nabumetone

2 important things

A
  • Selective for COX II

- Prodrug

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14
Q

Meclofenamate and Mefenamic Acid

2 important things

A
  • Enhance oral anticoagulation therapy

- Don’t use for more than 1 week

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15
Q

Piroxicam

3 important things

A
  • Once daily dosing
  • Very good anti-inflammatory
  • Most likely NSAID GI irritant
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16
Q

Diflusinal

3 important things

A
  • Derived from salicylic acid
  • Little anti-pyretic activity
  • For OA, RA, pain
17
Q

Indomethican

6 important things

A
  • One of the most potent inhibitors of PG synthesis
  • More effective than ASA
  • For gouty arthritis, pericarditis, and management of PDA in premature infants
  • Great amount of GI upset (2nd most NSAID)
  • Antagonizes furosemide
  • Caution in asthma, angioedema, nasal polyps, peptic ulcer, psych disorders
18
Q

Ketorolac

2 important things

A
  • IV (only 5 day mix) or PO

- Analgesic post-op

19
Q

Celecoxib

4 important things

A
  • Selective COX II inhibitor
  • Not for asthmatics or those allergic to Sulfas
  • May protect against colon cancer
  • Does not affect platelet aggregation or bleeding time
20
Q

Acetaminophen

4 important things

A
  • No anti-inflammatory properties
  • For pain and fever
  • T1/2 unaffected by renal dysfunction
  • Can cause hepatic necrosis
21
Q

Tramadol

3 important things

A
  • Binds mu receptor
  • Not a true NSAID, Opioid or Sedative
  • Can cause serotonin syndrome
22
Q

NSAIDS

8 important things

A
  • Reversible
  • Found in synovial fluid (so good for arthritis, gout, etc)
  • Not affected by food
  • Lack of response to one NSAID does not preclude response to another NSAID
  • Decrease effectiveness of thiazides (antagonize diuretics)
  • NOT for asthmatics
  • COX II inhibitors of have less ADRs
  • All induce nephrotoxicity
23
Q

GI Irritants in order

A
  • Piroxicam
  • Indomethicin
  • Naproxen
  • Sulindac
  • Diclofenac
  • Ketoprofen
  • Ibuprofen
24
Q

3 NSAIDs safe for children

A
  • Ibuprofen
  • Indomethicin
  • Tolmetin
25
Q

5 NSAIDs selective for COX II

A
  • Meloxicam
  • Etodolac
  • Nabumetone
  • Celecoxib
  • Diclofenac
26
Q

3 injectable NSAIDs

A
  • Indomethicin
  • Ketorolac
  • Ibuprofen

xPharm Exam 1 (7 decks)

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