NSAIDs

Question 1

What are the antipyretic, anti-inflammatory, and analgesic properties of aspirin?

Answer 1

Aspirin has all three types of activity

Question 2

What are the antipyretic, anti-inflammatory, and analgesic properties of acetaminophen?

Answer 2

Acetaminophen is anti-pyretic and analgesic only

Question 3

What are the antipyretic, anti-inflammatory, and analgesic properties of ibuprofen and naproxen?

Answer 3

Both are effect anti-pyretics, analgesics, and anti-inflammatorys

Question 4

What are the antipyretic, anti-inflammatory, and analgesic properties of Indomethaxin, Etodolac, and Ketorolac?

Answer 4

Indomethacin - is used as an anti-inflammatory

Etodolac - used as an anti-inflammatory and analgesic

Ketorolac - used as a post-op analgesic

Question 5

What are the antipyretic, anti-inflammatory, and analgesic properties of celecoxib?

Answer 5

Celecoxib is anti-inflammatory, because it inhibits inflammation induced COX-2

Question 6

What are the clinical uses of aspirin?

Answer 6

Anti-inflammatory, prevent thromboembolism, dysmenorrhea, closure of PDA, preeclampsia, colorectal cancer

Question 7

What are the clinical uses of naproxen and ibuprofen?

Answer 7

Analgesic - bursitis, tendinits, dysmenorrhea

Anti-inflammatory - arthritis (rheumatoid, ankylosing, gouty)

Question 8

What are the clinical uses of Indomethacin, etodolac, and ketorolac?

Answer 8

Indomethacin - osteoarthritis, gouty arthritis, ankylosing spondylitis, rheumatoid arthritis, and closure of PDA

Etodolac - Post-op analgesia, osteoarthritis, and rheumatoid arthritis

Ketorolac - post-op analgesia

Question 9

Describe the action of aspirin on platelets and COX-1 or COX-2.

Answer 9

Aspirin irreversibly binds COX-1 and COX-2. In platelets this inhibits the production of TXA2 prolonging bleeding time by inhibiting platelet aggregation.

Question 10

Describe the zero-order kinetics of aspirin.

Answer 10

Aspirin is cleared at low-doses by first-order kinetics. At higher-doses (arthritis Tx) it suffers zero-oreder kinetics. Half-life is greatly increased, and toxicity may result from small increases in dosing.

Question 11

Describe the ADRs of aspirin

Answer 11

GI ulcers, prolonged bleeding, hypersensitivity, and Reye’s syndrome

Question 12

Describe the ADRs of ibuprofen and naproxen?

Answer 12

GI ulcers, prolonged bleeding, but less so than aspirin

Question 13

Describe the ADRs of indomethacin, etodolac, ketorolac.

Answer 13

Indomethacin - low toxicity –> GI ulcers and frontal headache

Etodolac - less incidence of GI irritation

Ketorolac - avoid use > 5 days d/t GI irritation

Question 14

Describe the ADRs of celecoxib?

Answer 14

Lower incidence of GI bleed and prolonged bleeding

Question 15

Describe how acetaminophen differs from other NSAIDs

Answer 15

Low anti-inflammatory action, but strong analgesic and anti-pyretic effect. Overdose can cause hepatotoxicity (Tx with N-acetylcysteine)