NSAIDS Flashcards

1
Q

Non selective NSAIDS

A
Aspirin
Diclofenac
Ibuprofen
Indomethacin
Ketorolac
Piroxicam
Tolmetin
Acetaminophen (not NSAID)
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2
Q

COX-2 Selective

A

Celecoxib
Etoricoxib
Meloxicam (not as selective)

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3
Q

What happens when you inhibit COX

A

Decreased PGs and TXA

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4
Q

Which COX is constitutive

A

1

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5
Q

Where is COX-2 constitutive

A

Kidney

Brain

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6
Q

What naturally induces COX-2

A

Growth factors
Tumor promoters
Cytokines

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7
Q

What effects do NSAIDs have

A

Antipyretic
Analgesic
Anti-inflammatory

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8
Q

Blocking which COX can cause GI damage

A

1

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9
Q

What does endothelial COX-2 activation lead to

A

Vascular Prostacyclin

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10
Q

What sensitizes nerve endings to pain

A

PGE2

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11
Q

NSAIDs or opioid better for inflammatory pain

A

NSAIDs

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12
Q

What is responsible for fever

A

COX-2 –> PGE2

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13
Q

What are NSAIDs useful for treating

A

RA
OA
Gout

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14
Q

DOC closing ductus arteriosis

A

Indomethacin

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15
Q

DOC gout Sx

A

Indomethacin

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16
Q

Why can Celecoxib cause HS reactions

A

Sulfonamide

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17
Q

What happens if you give child with viral fever, Aspirin

A

Reye’s

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18
Q

What do you give child with viral fever

A

Acetaminophen/Ibuprofen

19
Q

Contraindication

A

Pregnancy

Aspirin is Category D

20
Q

DOC OA and pregnancy

A

Acetaminophen

21
Q

Tx for Colon cancer

A

Aspirin

22
Q

Give for niacin flushing

A

Aspirin

23
Q

Tx GI ulceration from COX-1 inhibition

A

Misoprostol
PPIs
H2 blockers

24
Q

Lowest risk of GI ulceration

A

Celecoxib

25
Q

Highest risk of GI ulceration

A

Piroxicam

26
Q

Why are there CVS AEs with NSAIDs

A

Imbalance of TXA2 and PGI2

27
Q

Higher CV risk but lower GI effects

A

COX-2 inhibitors

28
Q

What are the CVS AE of NSAIDs

A

Vasoconstriction
Platelet aggregation
Thrombosis

29
Q

Renal AE of NSAIDs

A

Decreased RBF
AIN
Analgesic nephropathy

30
Q

What happens with decreased PGE2

A

Sodium and water retention (Decreased GFR)

31
Q

What happens with decreased PGI2

A

Hyperkalemia and ARF

32
Q

What is the most common cause of AIN

A

NSAIDs and ABX

33
Q

What is the effect of chronic NSAID use

A

Analgesic nephropathy and papillary necrosis

34
Q

Aspirin effect on uric acid

A

Low dose reduces secretion

High dose inhibits reabsorption

35
Q

What is seen in Aspirin HS

A

Rhinitis
Edema
Asthma

36
Q

Why does Aspirin HS occur

A

Excess LT synthesis

37
Q

Which NSAIDs are irreversible

A

Aspirin/Salicylates

38
Q

What happens with Aspirin induced uncoupling of oxidative phosphorylation

A
Increased CO2 and respiration
Hyperventilation (resp centre at high doses)
Resp paralysis (toxic levels)
39
Q

How does Aspirin/Salicylates increase BT

A

Decreased TXA2 in platelets but unaffected PGI2 levels

40
Q

What kind of elimination does Aspirin undergo

A

Zero order

41
Q

What can chronic Aspirin use cause

A

Hepatic injury

42
Q

What is Salicylism

A

HA
Confusion
Tinnitus
Dizziness

43
Q

Acid/Base effects of Aspirin

A

Resp alk

Metab acid