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Pharmacology > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

t/f: NSAIDs are used in the treatment of neuropathic pain

A

false. NSAIDs are used in the tx of nociceptive pain

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2
Q

t/f: NSAIDs target the ascending sensory pathway

A

true

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3
Q

t/f: stimulus from ascending sensory pathway go to the cerebral cortex

A

true

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4
Q

t/f: only the C fibers are non-myelinated

A

true. only C fibers are non myelinated, making them very slow

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5
Q

t/f: the fastest nerve fibers are the A-delta fibers

A

false. the fastest are the A-alpha fibers

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6
Q

describe the mechanism of fever

A

antigen => leukocytes => pyrogen CK => hypothalamic thermoreg center => brain stem thermoreg center => PG => peripheral vasoconstriction

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7
Q

t/f: NSAIDs are analgesic, antipyretic, anti-inflammatory drugs

A

true

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8
Q

t/f: the main thermostat of the body is the brain stem

A

true

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9
Q

COX -1 functions

A
  • gastric cytoprotection
  • platelet aggregation
  • renal sodium/water balance
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10
Q

t/f: inhibition of COX-1 will cause gastric bleeding, decrease blood clotting, increase Na+/water (increase swelling)

A

true

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11
Q

t/f: COX-1 receptors are always expressed, while COX-2 receptors are inducible, rapidly regulated, and only expressed during inflammation

A

true

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12
Q

activation of COX-2 results in __ in prostaglandins that mediate pain and inflammation

A

increase

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13
Q

t/f: adverse effects from inhibiting COX receptors occurs when COX-1 is also inhibited

A

true. AEs can be reversed by selective inhibition of COX-2

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14
Q

where are COX-3 receptors found

A

in the brain

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15
Q

t/f: COX-3 receptors are constitutively expressed in the brain and are responsible for central regulation of fever and pain

A

true

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16
Q

the benefit of NSAIDs over steroids is that they don’t cause ___

A

endocrine problems and many AEs

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17
Q

t/f: ASA is a non-selective COX inhibitor

A

true

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18
Q

t/f: ibuprofen is a selective COX-2 inhibitor

A

false. it is a non-selective COX inhibitor

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19
Q

t/f: naproxen sodium is a selective COX-2 inhibitor

A

false. it is a non-selective COX inhibitor

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20
Q

3 main non-selective COX inhibitors

A
  1. ASA
  2. ibuprofen
  3. naproxen sodium
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21
Q

2 main selective COX-2 inhibitors

A
  1. celecoxib

2. meloxicam

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22
Q

t/f: all NSAIDs are COX inhibitors

A

true

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23
Q

t/f: ibuprofen and naproxen are both propionic acid derivatives and mixed COX1/COX2 inhibitors

A

true

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24
Q

t/f: ASA causes reversible acetylation of COX1/COX2

A

false. it causes IRREVERSIBLE acetylation of COX1/COX2

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25
Q

ASA will cause decrease in ___

A
  1. decrease cytoprotection (increase GI bleeding)
  2. decrease thromboxin synthesis (decrease platelet aggregation)
  3. decrease PG synthesis (decrease infl response)
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26
Q

t/f: low dose of ASA can be used in the prevention of CVD

A

true (due to decreased platelet aggregation)

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27
Q

t/f: AEs of ASA include: hypersensitivity, tinnitus, headaches, N/V, renal failure, and higher bleeding time

A

true

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28
Q

t/f: new platelets will have to be restored to reverse platelet effects of ASA

A

true (because it’s irreversible)

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29
Q

t/f: local hemostatic measures are sufficient to control bleeding in pts on ASA

A

true

30
Q

t/f: ASA can be administered during last trimester of pregnancy

A

false.

31
Q

pts on ASA who have GI bleeding, ulcers, and perforation should take which drugs for cytoprotection?

A
  • proton pump inhibitors (PPI)

- misoprostol

32
Q

t/f: ASA in high doses can lead to increased thyroid activity

A

false. DECREASE thyroid activity

33
Q

t/f: ASA can be given to asthmatic patients

A

false. should avoid (can develop bronchoconstriction)

34
Q

t/f: ASA can be given to someone with hypertension

A

false. ASA can cause edema which increases BP

35
Q

t/f: ASA can be given to someone with renal failure

A

false. ASA causes decrease GFR

36
Q

name all drug interactions for NSAIDs

A
  • antihypertensives (ACE inhibitors, beta blockers)
  • diuretics
  • corticosteroids
  • cyclosporine
37
Q

interaction between NSAIDs and corticosteroids leads to ___

A

GI bleeding

38
Q

t/f: giving NSAIDs to a pt on ACE inhibitors will cause decreased BP

A

false. it will cause increase BP

39
Q

t/f: celecoxib is a selective cox-2 inhibitor

A

true

40
Q

t/f: meloxicam is a selective cox-2 inhibitor

A

true

41
Q

t/f: NSAIDs can be given to pts with asthma

A

false. can cause bronchoconstriction

42
Q

t/f: NSAIDs can be given to pts with hypertension or heart failure

A

false.

43
Q

can you give NSAIDs with ASA

A

no! NSAIDs block ASA’s inhibition of platelet aggregation (thus more clotting)

44
Q

t/f: NSAIDs enhance the cardioprotective effect of ASA

A

false. NSAIDs BLOCK the cardioprotective effect of ASA

45
Q

what does NSAIDs/ASA drug interaction increase the risk of?

A

thromboembolism

46
Q

what is the dose direction for giving NSAIDs with ASA?

A

ibuprofen (non-selective COX NSAID) 30-120 min AFTER ASA

47
Q

t/f: acetaminophen has a higher affinity for COX-1

A

false. higher affinity for COX-3

48
Q

t/f: acetaminophen irreversibly inhibits COX-3

A

false. it reversibly inhibits COX-3

49
Q

t/f: acetaminophen has anti-inflammatory properties

A

false.

50
Q

t/f: acetaminophen is an NSAID

A

false. it does not have anti-inflammatory properties

51
Q

acetaminophen gets metabolized by CYP2E1 to form ___

A

NAPQI

52
Q

max allowed daily dose of acetaminophen

A

4000 mg/day

53
Q

t/f: a lower dose of acetaminophen should be taken if its not taken with a meal

A

true. not taken with food means overwhelming liver which can cause liver toxicity

54
Q

t/f: allopurinol is a co-analgesic used in the tx of gout

A

true

55
Q

t/f: ergots and triptans are co-analgesics used in the tx of headache

A

false. co-analgesics used in the tx of migraine

56
Q

t/f: adalimumab (humira) is a co-analgesic used to tx rheumatoid arthritis

A

true

57
Q

t/f: Gabapentin/ pregabalin are considered anticonvulsants and analgesics

A

false. they are anticonvulsants and CO-analgesics

58
Q

t/f: Lidocaine is considered an anticonvulsant and co-analgesics

A

true

59
Q

name 2 tricyclic anti-depressants that are co-analgesics

A
  • amitryptiline

- venlafaxine

60
Q

t/f: acetaminophen is an analgesic and antipyretic

A

true

61
Q

tx for mild/moderate pain

A

acetaminophen

62
Q

tx for moderate to severe pain

A

NSAIDs

63
Q

tx for moderate to severe pain for someone with AEs/DI to NSAIDs

A
  • celecoxib
  • acetaminophen +codeine
  • acetaminophen + oxy/tramadol
64
Q

tx for severe pain

A
  • acetaminophen +codeine

- acetaminophen + oxy/tramadol

65
Q

t/f: acetaminophen is an NSAID and COX inhibitor

A

false. it is NOT an NSAID but it is a COX inhibitor

66
Q

t/f: odontogenic oral pain is associated with infection and involves pulp or periodontium

A

true

67
Q

t/f: tx of odontogenic oral pain includes dental procedure + NSAIDs+ABX

A

true

68
Q

tx of odontogenic oral pain after extraction is __

A

NSAIDs +/- ABX

69
Q

differential dx for odontogenic oral pain is

A

elimination of pain by local anesthesia

70
Q

t/f: non-odontogenic tooth pain is caused by referred pain

A

true

71
Q

t/f: pain due to non-odontogenic causes is eliminated by LA

A

false. non-odontogenic pain is NOT eliminated by LA

Pharmacology (17 decks)

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