NSAIDs Flashcards
aspirin
(salicylate) irreverisble COX1 and COX2 inhibitor
low dose aspirin - coagulation
inhibits TXA2 production (antithrombogenic) from platelets and maintains PGI2 production (antithrombogenic) from endothelial cells to result in a decreased coagulable state
high dose asprin - coagulation
inhibits both TXA2 production (antithrombogenic) from platelets and PGI2 (prothrombogenic) from endothelial cells to result in these factors canceling out
salsalate
(salicylate) competative inhibitor of COX enzymes for mild fever, inflammation, pain
diflunisal
(salicylate) competative inhibitor of COX enzymes
more potent than aspirin
cannot cross the BBB so cannot inhibit pyogenic effects of prostaglandin production
side effects of NSAIDs
gastric distress (nausea, vomiting), GI bleeding, acute renal failure in patients with underlying kidney failure/MI, increased bleeding, Reye’s syndrome, gout in susceptible individuals
Reye’s syndrome
contraindication seen only in aspirin administration
results in liver failure encephalopathy
contraindicated in kids with febrile viral infection
ibuprofen
rapid onset of action, ideal for fever and acute pain
naproxen
safest NSAID
rapid onset of action, long serum half-life (14hrs = twice daily dosing)
indomethacin
potent anti-inflammatory, high toxicity; used to close patent ductus arteriosus
keterolac
mainly used as IV analgesic as a replacement for opioid analgesics
oxaprozin
slow onset (~6hrs) long serum half life (50-60 hrs = once daily dosing)
diclofenac
relatively selective for COX-2, associated with increased risk of MI/stroke
celecoxib
selective COX2 inhibitor that lacks gastric side effects of COX1 inhibition
leads to heart attack and stroke
