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Pharmacology Exam 3 > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

Where do COX I and COX II have their effects?

A

COX I – stomach

COX II – periphery

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2
Q

What do NSAIDs block the release of?

A

Prostaglandins (PGG II)

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3
Q

What is a risk of inhibition of the COX pathway?

A

Shunting to lipoxygenase pathway causing increased allergic reactions

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4
Q

List five indications for NSAID use

A

Arthritis, gout, headache, pain syndromes, chemo

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5
Q

State three mechanisms of action of NSAIDs

A

Anti-inflammatory, antipyretic, analgesic

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6
Q

Which arachidonic acid conversion pathway do NSAIDs block?

A

COX I and II conversion

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7
Q

Explain the difference between the effect of NSAIDs and aspirin on platelets

A

NSAIDs briefly inhibit Cyclooxygenase activity, aspirin irreversibly inhibits activity

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8
Q

How is acetaminophen different from NSAIDs?

A

Acts primarily in hypothalamus to reduce prostaglandin production – Limited anti-inflammatory activity and no anticoagulation

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9
Q

How do leukotriene antagonists work?

A

Block LT receptors which mediate allergic/inflammatory reactions

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10
Q

Where do leukotriene antagonists have most of their effect?

A

On pulmonary system

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11
Q

How do corticosteroids work?

A

Bind receptors in cytoplasm, translocate to nucleus where they module genes encoding for inflammatory cytokines and interleukins

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12
Q

What medicine should be given to a newborn with a PDA?

A

NSAIDs

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13
Q

List cautions for NSAIDs

A

Renal disease (patency of renal arteriole), highly protein bound, avoid alcohol (G.I. toxicity), monitor guaiac stools, those with asthma (increased leukotrienes), and pregnancy (patent ductus arteriosus)

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14
Q

What drug can cause Rye Syndrome, and what are the signs?

A

Aspirin – in children under 16 with Varicella/flu symptoms (can cause encephalitis and seizures, death)

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15
Q

What are three signs of ASA syndrome?

A

Asthma, angioedema, nasal polyps

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16
Q

Which drug should be avoided in patients with tartrazine dye allergy?

A

Aspirin

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17
Q

Which condition does aspirin treat at high doses but exacerbate at low doses?

A

Gout

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18
Q

Why must aspirin be used cautiously in patients with PUD?

A

Causes reduction of mucus blood flow, anticoagulation, high acidity-all exacerbating PUD

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19
Q

List symptoms of an aspirin overdose

A

Tinnitus, headache, metabolic acidosis, can be fatal

20
Q

What is used for reference in treatment of aspirin overdose?

A

Done nomogram

21
Q

Why does aspirin overdose cause tinnitus?

A

Causes buildup of arachidonic acid, which is toxic to auditory nerve

22
Q

What is buffered aspirin?

A

Less harsh on stomach – coated with film that dissolves in basic media like duodenum or jejunum

23
Q

What is nabumetone?

A

NSAID causing least amount of G.I. distress (Nonacidic)

24
Q

What is oxaprozin?

A

NSAID with QD dosing

25
Q

What is Arthrotec comprised of?

A

Diclofenac and misoprostol (an NSAID and a prostaglandin)

26
Q

What is an adverse effect of indomethacin?

A

Severe frontal lobe headache

27
Q

Which NSAID is the safest to use in renal impairment?

A

Sulindac

28
Q

Which instead has the longest half life? (40-50 hours)

A

Piroxicam – should be avoided in elderly patients

29
Q

Which nonselective NSAID is the most selective of COX II?

A

Meloxicam (Mobic)

30
Q

Name the only approved IV antipyretic

A

Ibuprofen

31
Q

Name the drug used for PDA in infants?

A 
Ibuprofen lysine (NeoProfen)
Indomethacin can also be used to treat PDA
32
Q

What is Caldolor?

A

The adjunct to opioid analgesia and antipyretic (IV)

33
Q

What is the only IM NSAID?

A

Ketorlac (Toradol)

34
Q

Why is five days the max therapy for Toradol?

A

Renal and G.I. toxicity

35
Q

Name the only approved COX II specific NSAID on the market

A

Celebrex

36
Q

What drug does Celebrex have cross reactivity potential with?

A

Sulfa drugs

37
Q

Which three NSAIDs are best for patients with G.I. upset?

A

Celebrex, Nabumetone, meloxicam

38
Q

Why have several COX II inhibitors been taken off the market?

A

Linked to cardiovascular events (MI and stroke)

39
Q

Which NSAIDs have inhibitory effects on angiogenesis, and procoagulant effects?

A

COX II inhibitors

40
Q

Why could COX II inhibitors be used as adjuncts to chemotherapy?

A

Prevent angiogenesis – no blood supply to tumors

41
Q

What is acetaminophen?

A

Active metabolite of phenacetin, CNS specific for pain, headache, fever treatment

42
Q

What is used for reference in treatment of acetaminophen overdose?

A

Rumack–Matthew nomogram

43
Q

Name an interaction of acetaminophen

A

Ethanol – causes pronounced hepatotoxicity

44
Q

What is the antidote to acetaminophen overdose?

A

N-acetylcysteine (NAC)

45
Q

Describe NAC uses

A

Mucolytic in CF (Mucomyst),
potent antioxidant – nephroprotective from contrast dye toxicity
Con – smells like rotten eggs

Pharmacology Exam 3 (8 decks)

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