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Ocular Pharmacology > NSAIDS > Flashcards

NSAIDS Flashcards

1
Q

TXA2 causes what 2 things?

A

broncho-constriction and platelet aggregation

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2
Q

TXA2 is the antagonist to which prostaglandin?

A

PGI2

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3
Q

what are the properties of PGE2 and PDF2a?

A

pro-inflammatory - increase bradykinin, histamine and sensitize nerves to pain

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4
Q

what are 3 things that PGE2 can cause?

A

vasodilation, edema, and hyperthermia

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5
Q

why is it not a good idea to “self-prescribe” large doses of omega 3?

A

flaxseed oil reduces platelet aggregation (if on ASA = bleeding) and can also cause ileus (intestine block) and thyroid problems

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6
Q

what is the oil you may ingest if you want to raise omega 6 levels and create pro-inflammatory PG’s?

A

evening primrose oil

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7
Q

which COX enzyme is involved in prostacyclin production as well as O2 radicals?

A

COX2

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8
Q

which COX is the one that creates pain and fever?

A

COX2

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9
Q

COX1 has effects on what structures/cells?

A

GI, vasculature, platelets, macrophages, and kidneys

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10
Q

which prostaglandin decreases acid secretion?

A

PGI2

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11
Q

having high levels of which substance decreases your pain tolerance by sensitizing pain fibers (allodynia)?

A

PGE2, PGF2a, LT’s, and substance P

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12
Q

Aspirin is the number one choice to treat which disease?

A

rheumatoid arthritis

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13
Q

what dose of aspirin do you need to treat low intensity pain in periphery?

A

160-325mg

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14
Q

which NSAID has an equivalent pain relief as an equal dose of morphine? why is that a good thing?

A

ketorolac tromethamine - it is non-addictive

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15
Q

which NSAID has the least amount of GI toxicity?

A

ibuprofen/motrin

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16
Q

what analgesic is the most commonly used for suicide?

A

acetaminophen - liver toxicity

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17
Q

at what dose/concentration will there be an overdose with aspirin? how do you treat it?

A

10-30 grams = dialysis

18
Q

who is susceptible to getting Reye’s syndrome?

A

children (under age 15) taking ASA or salicylates to reduce fever in viral infections = chicken pox

19
Q

what are the symptoms/adverse reactions in Reye’s syndrome?

A

GI distress, liver dies and encephalopathy

20
Q

which topical NSAID is indicated for corneal pain and uveitis?

A

nepanfenac (ilevro QD)

21
Q

which topical NSAID is a pro-drug and is only active once hydrolyzed in AC?

A

Diclofenac (volaren)

22
Q

how does cyclosporin-A’s mechanism differ from NSAID’s/ASA?

A

it reduces type 1 helper T cells (that create IL2, IL4, IFN-g, TNFa) - inhibits mast cell degranulation

23
Q

Restasis (cyclosporin-A) is indicated for what ocular condition?

A

keratoconjunctivis sicca (KCS)

24
Q

The inhibitory pathway for inflammation is activated through the use of what?

A

steriods

25
Q

what is the name of the annexin protein which inhibits PLA2 activity?

A

lipocortin (lipomodulin)

26
Q

what is arachidonate acid responsible for?

A

generating leukotrienes (responsible for cell signaling and lead to infiltration of tissues by immune cells)

27
Q

what is the role of acetyl transferase in the inflammatory pathway?

A

converts Lyso-PAF to PAF

28
Q

what fruit is the biggest source of plant based omega 3?

A

kiwi

29
Q

what type of enzyme is COX1?

A

constitutive enzyme - involved in PG and TXA2 production

30
Q

what type of enzyme is COX2?

A

inducible enzyme - involved in PG and prostacyclin production (generates pro-inflammatory PGs and O2 radicals)

31
Q

what is allodynia?

A

hyper-sensitized state of pain

32
Q

what are examples of natural opiates?

A

morphine and codeine

33
Q

bradykinin, potassium ions, NE, and histamine stimulate what type of fibers?

A

pain fibers

34
Q

what are the 7 common adverse effects of narcotics?

A

nausea/vomiting, miosis, flushing/itching, sedation, constipation, respiratory depression and dependence

35
Q

what drug can cause irreversible inhibition of COX1?

A

aspirin

36
Q

NSAIDS vs. steroids - which has HPA axis effects?

A

steroids

37
Q

do NSAIDS or narcotic analgesics have a ceiling effect?

A

NSAIDS

38
Q

a pregnant patient has a headache - what drug should you suggest she take?

A

acetaminophen

39
Q

allergic conjunctivitis is an indication for which topical NSAID?

A

Ketorolac

40
Q

post-operative inflammation is the only indication for this topical NSAID?

A

Bromfenac (prolensa)

41
Q

IMP (intraoperative miosis prevention), PO (pos-op inflammation), and CME are the indications for this drug?

A

Flurbiprofen (Ocufen)

Ocular Pharmacology (10 decks)

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