NSAIDs

Question 0

What enzymes do NSAIDs target?

Answer 0

Lipoxygenase

Cyclooxygenase

Question 1

What are some pros and cons of NSAIDs?

Answer 1

Few side effects

Low to moderate pain

Question 2

What does cox 1 do?

Answer 2

Platelet aggregation
Vasodilation
Gastric cytoprotectin

Question 3

What does cox 2 do?

Answer 3

Induced by acute inflammation

Inhibited by glucocorticoids

Question 4

What is prostacyclin do?

Answer 4

Decreased platelet aggregation

Question 5

What does thromboxane do?

Answer 5

Platelet aggregation

Question 6

What does aspirin do?

Answer 6

Irreversibly inhibits both cox enzymes

Question 7

What are the analgesic effects of NSAIDs mediated by?

Answer 7

Prostaglandins e and g

Question 8

How are the antipyretic effects of NSAIDs mediated?

Answer 8

The hypothalamus

Question 9

What is the main adverse effect of NSAIDs?

Answer 9

Gastric bleeding by inhibiting prostaglandins and prostacyclins which help build the mucosa

Question 10

What effect do NSAIDs have on clotting time?

Answer 10

2x increase for 7days

Question 11

How do NSAIDs stimulate respiratory distress and electrolyte disturbances?

Answer 11

Hyperventilation
Metabolic acidosis by uncoupling oxidative phosphorylation so lactic acid accumulates
Treat with bicarbonate

Question 12

What are toxic effects of aspirin?

Answer 12

Tinnitus
Headache
Hearing loss

Question 13

How do you treat aspirin overdose?

Answer 13

Vomit
Sodium bicarbonate
Transfusion
Dialysis

Question 14

What causes aspirin hypersensitivity?

Answer 14

Nasal polyps are caused
Non immune mediated
Do to shunting of AA into the leukotriene pathway

Question 15

How do you treat aspirin allergy?

Answer 15

Epinephrine avoid peptol bismol

Question 16

What is a severe reaction to aspirin?

Answer 16

Reye’s syndrome

Question 17

What can aspirin be used for?

Answer 17

Menstraul pain
Rheumatoid arthritis
Fever
Headache

Question 18

What is important about ibuprofen?

Answer 18

Not as much GI stuff

Reversible

Question 19

What is important about indomethacin?

Answer 19

Strongest cox inhibitor
Bad GI distress
Used as last choice
Used to treat patent ductus arterosis to make it close

Question 20

What is ketorolac?

Answer 20

IV
Can replace morphine
Combined with opioids

Question 21

What is celecoxib?

Answer 21

Selective cox 2 inhibitor

But increases heart attack and stoke

Question 22

What is acetaminophen?

Answer 22

Not an NSAID 
Not many issues
Low therapeutic index
A metabolite is a free radical
Do not take with alcohol

Question 23

How do you treat acetaminophen overdose?

Answer 23

N-acetylcysteine

Only effective under 24 hrs