NSAIDs

Question 1

What is inflammation characterized by

Answer 1

Heat, Redness, Swelling, Pain, and Loss of function

Question 2

What are the 3 phases of inflammatory response

Answer 2

Transient phase, subacute phase, and chronic proliferative phase

Question 3

This phase is characterized by local vasodilation and increased capillary permeability

Answer 3

Transient phase

Question 4

This phase is characterized by infiltration of leukocytes and phagocytic cells

Answer 4

Subacute phase

Question 5

This phase is characterized in which tissue degeneration and fibrosis occur

Answer 5

Proliferative phase

Question 6

Arachidonic acid metabolites are important for _____

Answer 6

Inflammation

Question 7

What are arachidonic acid metabolites mediated by

Answer 7

COX inhibitors

Question 8

The major enzymes inhibited by NSAIDS are

Answer 8

COX

Question 9

Where does COX-1 play an important role in the body

Answer 9

In Gastric mucosa, Kidney, Platelets, and Vascular endothelium

Question 10

Where does COX-2 play an important role in the body

Answer 10

The brain and Kidney

Question 11

This COX is always present without causing inflammation; mediates homeostatic functions

Answer 11

COX-1

Question 12

This COX is inducible (off and on) and its byproduct mediates inflammation, pain, and fever

Answer 12

COX-2

Question 13

What are the 5 different types of NSAIDS

Answer 13

Salicylates, Propionic Acid Derivatives, Enolic Acids, Arylacetic Acid Derivatives, and Selective COX-2 inhibitors

Question 14

Salicylates are highly bound to what plasma protein

Answer 14

Albumin

Question 15

What are the adverse effects of Salicylates

Answer 15

Gastric irritation and micro bleeding

Question 16

This is a rare and potentially fatal pediatric illness defined as acute noninflammatory encephalopathy with fatty liver failure; caused by aspirin use in children

Answer 16

Reye Syndrome

Question 17

What drug is “safer for children” and avoids Reyes syndrome

Answer 17

acetaminophen

Question 18

Why is aspirin good and bad

Answer 18

Good for CV situations, but bad because it will inhibit the COX enzyme for life (10 days)

Question 19

What is the main drug of propionic acid derivative

Answer 19

Ibuprofen

Question 20

What percentage of ibuprofen is bound to plasma proteins

Answer 20

99%

Question 21

What are the 2 main drugs of aryl acetic acid derivatives

Answer 21

Indomethacin and Ketorolac

Question 22

Widely used arylacetic acid derivative but toxicity often limits its use

Answer 22

Indomethacin

Question 23

A potent analgesic but a moderate anti-inflam

Answer 23

Ketorolac

Question 24

Where is ketorolac routinely used

Answer 24

in the ER

Question 25

This drug is similar to opioids if you deliver it IM

Answer 25

Ketorolac

Question 26

Enolic acid drugs

Answer 26

Piroxicam and Meloxicam

Question 27

This NSAID can be better tolerated than aspirin or indomethacin and has a long half life (once a day)

Answer 27

Piroxicam

Question 28

What additive does Piroxicam do

Answer 28

Inhibits migration of neutrophils

Question 29

What are some adverse effects of Piroxicam

Answer 29

Gastric irritation and microbleeding

Question 30

Most NSAIDs can _____ (increase or decrease) the anticoagulant effect of WARFARIN

Answer 30

INCREASE

Question 31

All NSAIDs can blunt the diuretic actions of

Answer 31

Thiazides

Question 32

NSAIDS may enhance the toxicity of _____ (a cancer drug)

Answer 32

Methotrexate

Question 33

COX-2 Inhibitor

Answer 33

Celecoxib, Refecoxib, and Valdecoxib

Question 34

Is Acetaminiphen a COX inhibitor

Answer 34

NO

Question 35

what percentage of acetaminophen is bound to proteins

Answer 35

20-50% (drug-drug interactions are less severe)

Question 36

This is a byproduct of a very reactive modified acetaminophen; it is very toxic

Answer 36

NAPQI

Question 37

What is the antidote for APAP overdose

Answer 37

N-acetyl-cysteine (replenishes GSH)