NSAIDS Flashcards
TXA2 causes what 2 things?
broncho-constriction and platelet aggregation
TXA2 is the antagonist to which prostaglandin?
PGI2
what are the properties of PGE2 and PDF2a?
pro-inflammatory - increase bradykinin, histamine and sensitize nerves to pain
what are 3 things that PGE2 can cause?
vasodilation, edema, and hyperthermia
why is it not a good idea to “self-prescribe” large doses of omega 3?
flaxseed oil reduces platelet aggregation (if on ASA = bleeding) and can also cause ileus (intestine block) and thyroid problems
what is the oil you may ingest if you want to raise omega 6 levels and create pro-inflammatory PG’s?
evening primrose oil
which COX enzyme is involved in prostacyclin production as well as O2 radicals?
COX2
which COX is the one that creates pain and fever?
COX2
COX1 has effects on what structures/cells?
GI, vasculature, platelets, macrophages, and kidneys
which prostaglandin decreases acid secretion?
PGI2
having high levels of which substance decreases your pain tolerance by sensitizing pain fibers (allodynia)?
PGE2, PGF2a, LT’s, and substance P
Aspirin is the number one choice to treat which disease?
rheumatoid arthritis
what dose of aspirin do you need to treat low intensity pain in periphery?
160-325mg
which NSAID has an equivalent pain relief as an equal dose of morphine? why is that a good thing?
ketorolac tromethamine - it is non-addictive
which NSAID has the least amount of GI toxicity?
ibuprofen/motrin
what analgesic is the most commonly used for suicide?
acetaminophen - liver toxicity
at what dose/concentration will there be an overdose with aspirin? how do you treat it?
10-30 grams = dialysis
who is susceptible to getting Reye’s syndrome?
children (under age 15) taking ASA or salicylates to reduce fever in viral infections = chicken pox
what are the symptoms/adverse reactions in Reye’s syndrome?
GI distress, liver dies and encephalopathy
which topical NSAID is indicated for corneal pain and uveitis?
nepanfenac (ilevro QD)
which topical NSAID is a pro-drug and is only active once hydrolyzed in AC?
Diclofenac (volaren)
how does cyclosporin-A’s mechanism differ from NSAID’s/ASA?
it reduces type 1 helper T cells (that create IL2, IL4, IFN-g, TNFa) - inhibits mast cell degranulation
Restasis (cyclosporin-A) is indicated for what ocular condition?
keratoconjunctivis sicca (KCS)
The inhibitory pathway for inflammation is activated through the use of what?
steriods
what is the name of the annexin protein which inhibits PLA2 activity?
lipocortin (lipomodulin)
what is arachidonate acid responsible for?
generating leukotrienes (responsible for cell signaling and lead to infiltration of tissues by immune cells)
what is the role of acetyl transferase in the inflammatory pathway?
converts Lyso-PAF to PAF
what fruit is the biggest source of plant based omega 3?
kiwi
what type of enzyme is COX1?
constitutive enzyme - involved in PG and TXA2 production
what type of enzyme is COX2?
inducible enzyme - involved in PG and prostacyclin production (generates pro-inflammatory PGs and O2 radicals)
what is allodynia?
hyper-sensitized state of pain
what are examples of natural opiates?
morphine and codeine
bradykinin, potassium ions, NE, and histamine stimulate what type of fibers?
pain fibers
what are the 7 common adverse effects of narcotics?
nausea/vomiting, miosis, flushing/itching, sedation, constipation, respiratory depression and dependence
what drug can cause irreversible inhibition of COX1?
aspirin
NSAIDS vs. steroids - which has HPA axis effects?
steroids
do NSAIDS or narcotic analgesics have a ceiling effect?
NSAIDS
a pregnant patient has a headache - what drug should you suggest she take?
acetaminophen
allergic conjunctivitis is an indication for which topical NSAID?
Ketorolac
post-operative inflammation is the only indication for this topical NSAID?
Bromfenac (prolensa)
IMP (intraoperative miosis prevention), PO (pos-op inflammation), and CME are the indications for this drug?
Flurbiprofen (Ocufen)
