NSAIDS 2

Question 1

What is the name of Aspirin?

Answer 1

ASA

Acetylsalicylic acid

Question 2

7 uses of aspirin?

Answer 2

Anaglesia
Anti-inflammatory 
Anti-pyuretic
MI prophylaxis
Colon Cancer
Uricosuria prophylaxis
Anticoagulation

Question 3

What is uricosuria?

Answer 3

an agent that cause excretion of uric acid, so inhibits gout at HIGH doses only

Question 4

What dose of aspirin for gout prophylaxis?

Answer 4

5mg/day

Question 5

What are the 3 contraindications for aspirin use?

Answer 5

• Bleeding disorders
• Tartrazine (yellow) dye allergy
• ASA syndrome

Question 6

What is ASA syndrome?

Answer 6

Asthma
Angioedema
Nasal polyps

Question 7

Use ASA cautiously in patients with what GI disease? Why?

Answer 7

Peptic Ulcer Disease

• Reduced mucosal blood flow
• Anticoagulation
• High acidity

Question 8

Who should NOT receive aspirin?

Answer 8

patients under 16 for Variecella or flu-like syndrome due to risk of Rye Syndrome

Question 9

What is Rye Syndrome?

Answer 9

encephalitis, seizures, death

Question 10

Use ASA cautiously in patients with what organ issues?

Answer 10

Renal disease

Question 11

Adverse effects of ASA?

Answer 11

GI upset

Question 12

Signs of ASA overdose?

Answer 12

Tinnitus

Metabolic Acidosis

Question 13

Treatment of ASA overdose?

Answer 13

Done Nomogram

Question 14

Why does tinnitus occur?

Answer 14

Arachadonic acid causes toxicity to the auditory nerve

Question 15

What is buffered ASA?

Answer 15

high in sodium, acidity buffered down and pH increased. Less harsh on the stomach

Question 16

What is enteric coated ASA?

Answer 16

Film that dissolves in basic media, delaying ASA release until the med reaches the duodenum (higher pH). Less harsh on the stomach

Question 17

Patients on ASA should monitor what?

Answer 17

Gum bleeding

Bruising

Question 18

How can you reduce ASA side effects?

Answer 18

Food may decrease GI irritation

Question 19

Pregnancy risk factor and ASA?

Answer 19

X, premature closure of ductus arteriosis

Question 20

Which NSAIDS are GI friendly?

Answer 20

• Celecoxib (most)
• Nabumetone
• Meloxicam

Question 21

Why is Nabumetone special? (2 reasons)

Answer 21

Less GI distress, non-acidic

May compete with Cox-II selective NSAID

Question 22

Why is Oxaprozin special?

Answer 22

Long half life, good for rheumatoid & osteoarthritis. Caution in elderly though (it can accumulate and they have bad kidneys)

Question 23

What is Arthrotec? Pregnancy risk?

Answer 23

Diclofenac + Misoprostol

NSAID + mucus secreting agent

PREGANCY X

Question 24

What is the main use for Naproxen?

Answer 24

musculoskeletal injuries

Question 25

Name the NSAID that starts with E

Answer 25

Etodolac

Question 26

What is the main use of Indomethacin

Answer 26

IV dosage for closure of patent ductus arterioles

Question 27

What forms does Ibuprofen come in?

Answer 27

IV PO | OTC RX

Question 28

What is the Ibuprofen IV called?

Answer 28

Ibuprofen Lysine | Caldolor

Question 29

What is the ibuprofen Lysine used for?

Answer 29

close PDA in premature babies

Question 30

What is Caldolor used for?

Answer 30

Analgesia | Anti-pyretic

Question 31

What are the IV pain NSAIDS?

Answer 31

Caldolor | Ketorloac

Question 32

What are the IV anti-pyretics?

Answer 32

Caldolor

Question 33

Why is Ketorloac special?

Answer 33

Low grade narcotic | Renal & GI toxic, so maximum 5 day therapy

Question 34

What is the Adverse Effect of Indomethacin?

Answer 34

Severe frontal lobe headaches

Question 35

Who should use Sulindac?

Answer 35

Really compromised patients

Question 36

Why is Piroxicam special?

Answer 36

Long half life NOT good in elderly patients

Question 37

Why is Meloxicam is specia?

Answer 37

Long T1/2 | Most Cox-II selectiveof the non-selectives

Question 38

Name the NSAID that starts with K

Answer 38

Ketoprofen

Question 39

Name the selective NSAIDS

Answer 39

Celecoxib Rofecoxib Valdecoxib

Question 40

These selective NSAIDS select for what?

Answer 40

COX-II

Question 41

Use with caution in patients with what for celecoxib?

Answer 41

Sulfa allergies, contains a sulfa-moiety

Question 42

Who should not be prescribed Celecoxib

Answer 42

History of MI / unstable angina

Question 43

What is the brand name of Celecoxib?

Answer 43

Celebrex

Question 44

Why cardiac issues with cox-II specific NSAIDS?

Answer 44

- Procoagulant | - Inhibit angiogenesis (so unable to bypass clotts)

Question 45

Who MAY benefit from cox-II specific NSAIDS?

Answer 45

cancer patients (tumors need blood supply)

Question 46

Acetaminophen is also called what acronym?

Answer 46

APAP

Question 47

What is APAP?

Answer 47

active metabolite of phenacetin

Question 48

Why was phenacetin pulled?

Answer 48

Too much met-hemoglobinemia (Hgb can't carry O2)

Question 49

What is the philicty of APAP? Why is this important?

Answer 49

Lipophilic | Highly CNS specific with little effects on the periphery

Question 50

Indications for APAP?

Answer 50

HA | Fever

Question 51

How does APAP effect platelets?

Answer 51

It does not

Question 52

What does APAP interact with?

Answer 52

Alcohol

Question 53

How is APAP metabolized?

Answer 53

Liver

Question 54

How do you grade APAP toxicity?

Answer 54

Rumack- Matthew Nomogram

Question 55

APAP toxicity antidote?

Answer 55

N-Acetylcysteine (Mucomyst)

Question 56

Why give Mucomyst before contrast dyes?

Answer 56

Dyes = oxidative stress = nephrotoxicity, mucomyst protects renal (anti-oxidant)

Question 57

Why not use leukotriene receptor blockers for angioedema?

Answer 57

Only come PO and pt can't swallow