NSAIDs

Question 1

What are the uses of NSAIDs?

Answer 1

MSK Disorders (RA and OA) 
Analgesia (post surgery and mild to moderate pain i.e. headaches)

Question 2

What are the adverse drugs reactions of NSAIDs?

Answer 2

GI disturbances (ulcers and haemorrhage)
Renal ADRs
Increases bleeding time APTT, PT
Hypersensitivity: Steven Johnson syndrome
Reye’s syndrome (swelling in liver and brain- paediatrics mostly)

Question 3

What causes NSAIDs ADRs?

Answer 3

Inhibition of COX-1

Decrease in constitutive PG synthesis

Question 4

Name some NSAIDs

Answer 4

Aspirin

Specific COX2 inhibitors: rofecoxib, celecoxib

Question 5

Name a drug that is used for fever and mild to moderate pain relief?

Answer 5

Paracetamol

Question 6

Why might it be beneficial to give NSAIDs with opiates?

Answer 6

Extends therapeutics range for treating pain

Reduces ADRs seen with opiates alone

Question 7

Why might you give NSAIDs with drug that are heavily protein bound?

Answer 7

They competitively displace the other drug and result in more free drug
Increased efficacy

*e.g. warfin

Question 8

Why are specific COX-2 inhibitors NSAIDs only used in the short term?

Answer 8

Increase CVS ADRs (stroke/MI) with long-term use

Question 9

Why might low does aspirin be beneficial (other than analgesic effect)?

Answer 9

Cardioprotective

Prophylactic for GI and breast cancer

Question 10

When prescribing paracetamol, what do you need to be wary of?

Answer 10

A pt with:
Compromised hepatic function
Alcoholics
Polypharmacy