NSAIDs Flashcards
reversible inhibitor of COX1/2
Ibuprofen (tNSAID)
should be avoided in hepatic dysfucnction?
acetaminophen
COX-1 inhibitor side effects (3)
GI ulceration
Bleeding
Renal dysfunction
COX-2 inhibitor side effects (2)
renal dysfunction delayed labor increased thrombosis (endothelial cells)
Safest otc med for pain in patients with ulcers?
acetaminophen (cox1/2 irreveresible)
celebrex is not otc
safest treatment for patients taking oral anticoagulants
acetaminophen
lowest GI risk NSAID?
Ibuprofen (antiCOX2>COX1)
lowest CV risk NSAID?
Naproxen (antiCOX1>COX2)
Celecoxib side effects? (celebrex)
reduce PGI2 antithrombic effect (COX2 mediated) so increased risk of clots
best treatment for patient non-responsive to acetaminophen who has significant CV risk?
naproxen with omeprezole
greater cox-2 activity means
increased CVS risk
ibuprofen>naproxen
greater relative cox-1 activity means
increased GI risk
naproxen>ibuprofen>celebrex
what is the potentially biggest danger of celebrex?
sulfonamide sensitivity
what is the primary reason for making drugs that selectively inhibit COX2?
lower the risk of GI toxicity associated with cox-1 agents
what makes acetaminophen unique from other NSAIDs?
no anti-inflmmatory effect (only works in CNS)
Why acetaminophen no anti-inflammatory effect?
peroxide formation inhibits activity at site of inflammation
major concern of acetaminophen?
hepatotoxicity
-
treatment overdose acetaminophen?
n-acetylcysteine -
safest drug to treat msk pain in patients with kidney dysfunction?
actaminophen
relative to ibuprofen, agents that inhibit cox2 preferentially over cox1 will cause higher incidence of?
clotting related disorders
aspirin clinical use
pain of inflammatory origin
antiplatelet effects
high dose –> anti-inflammatory
aspirin at low dose?
cox1 selective –> decreased tendency for clotting
tinnitis associated wtih mild ________ toxicity?
aspirin
aspirin anti-platelet effect via?
TXA2
severe aspirin toxicity (3)
hyperthermia
metabolic acidosis
coma
Fever?
COX-2
Inflammation?
COX-2
Protection of GI?
COX-1
Vasodilation of kidney?
COX-1 and COX-2
Activation of platelet aggregation
COX-1
Contraction of uterine SM
COX-2
Opening of DA?
COX-2
What is Ketorolac?
tNSAID (rev cox1/2) in IM/IV
Dyspepsia and gastric ulceration is a concern with NSAID (COX1) what can we do to help?
PPIs omeprazoel
Why are we concerned for patients with bleeding disorders when taking NSAIDs?
Reversible COX1/2
COX-1 inhibition - inhibits platelet aggregation (but only for 2 days)
COX-2 inhibition - inhibits endothelial anti-platelet aggregation –> increased clot
balance between the two
if taking aspiring - take NSAID 1 HOUR later
