NSAIDs

Question 1

What is an NSAID

Answer 1

Non-steroidal anti-inflammatory drug

Question 2

Aspirin

Answer 2

• 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

Question 3

Celecoxib

Answer 3

• ONLY COX-2 selective inhibitor on the market

- DO NOT use if pt has CV concerns

Question 4

NSAID risks

Answer 4

• GI issues (because inhibit COX1)

- Kidney and CV issues (because inhibits cox1 and 2)

Question 5

Mechanism of NSAIDs

Answer 5

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)

Question 6

NSAIDs effect which body regions

Answer 6

GI
Renal (kidney)
Cardiovascular

Question 7

When COX-1 is inhibited in the GI….

Answer 7

• peptic ulcers

- GI bleeding

Question 8

Naturally occurring COX-1 in the GI does..

Answer 8

gastric protection

Question 9

When COX 1 and 2 are inhibited in the Kidney…

Answer 9

• Na and water retention
• hypertension
• hemodynamic acute kidney injury

Question 10

Naturally occurring COX 1 and 2 in the Kidney do…

Answer 10

• afferent arteriolar vasodilation

- increased sodium and water excretion

Question 11

When COX 2 > COX 1 inhibition in the cardiovascular system….

Answer 11

• stroke

- MI

Question 12

Naturally occurring COX 1 and 2 in the cardiovascular system do….

Answer 12

COX 1 - blood clotting and vasoconstriction

COX 2 - blood thinning, vasodilation