NSAIDs Flashcards
What is an NSAID
Non-steroidal anti-inflammatory drug
Aspirin
- under NSAID but differs because it is anti-thrombotic (blood thinner)
- irreversibly binds/inhibits COX-1 and COX-2
- low doses are selective to COX-1, you need increased doses for analgesia and anti-inflammatory effects
AE: nausea/vomiting, GI upset
Avoid: if you have GI issues, or are younger than 12 and have recently had the flu or viral illness, can cause Reye’s syndrome
Celecoxib
- ONLY COX-2 selective inhibitor on the market
- DO NOT use if pt has CV concerns
NSAID risks
- GI issues (because inhibit COX1)
- Kidney and CV issues (because inhibits cox1 and 2)
Mechanism of NSAIDs
NSAIDS work by inhibiting the cox1 and cox2 enzymes in the body- this stops the production of prostaglandins which results in less inflammation (anti-inflammatory), less pain (analgesic), and lower fever (antipyretic)
NSAIDs effect which body regions
GI
Renal (kidney)
Cardiovascular
When COX-1 is inhibited in the GI….
- peptic ulcers
- GI bleeding
Naturally occurring COX-1 in the GI does..
gastric protection
When COX 1 and 2 are inhibited in the Kidney…
- Na and water retention
- hypertension
- hemodynamic acute kidney injury
Naturally occurring COX 1 and 2 in the Kidney do…
- afferent arteriolar vasodilation
- increased sodium and water excretion
When COX 2 > COX 1 inhibition in the cardiovascular system….
- stroke
- MI
Naturally occurring COX 1 and 2 in the cardiovascular system do….
COX 1 - blood clotting and vasoconstriction
COX 2 - blood thinning, vasodilation