NSAIDs Flashcards
NSAIDS
Adverse Effects:
- heart burn
- ______
- renal impairment
- ________ cardiovascular events
- Bleeding
• ______ platelet aggregation
• drug interaction with warfarin, alcohol - Pregnancy - Cat. D
- Asthma - ↑ risk of _____ bronchospasm
ulcers
increased
inhibit
acute
- any NSAID can cause it
- ↑ risk of underlying kidney disease
- ↓ BF (elderly, dehydration, HF)
- ↑ Na+ and H20 retention → edema
- caution in high risk cardiovascular pts
*renal impairment
MOA:
- Irreversible platelet inhibition
- clot prevention
- discontinue 1 week before surgeries
Adverse effects:
- GI distress
- Tinnitus (ototoxicity)
- Reyes syndrome (not used in children under 12)
- Pregnancy category D
Aspirin
Patient teaching for Aspirin
- inform ______
- discontinue _ week before surgeries
- keep away from ________
- take with food
dentist
1
children
Overdose treatment (antidote) for Aspirin
Charcoal
Gastric lavage
Overdose treatment (antidote) for acetaminophen
Acetylcysteine
MOA:
- analgesic (pain reliever)
- antipyretic (prevent/reduce fever)
AVE:
- liver damage
• ↑ w/ alcohol use
Acetaminophen (Tylenol)
Cox2 inhibitor
increased risk of CV events
Celecoxib
Cox2 inhibitor
*Can cause premature closing of ductus
increased risk of CV events - may be pro-thrombotic
Celecoxib
Inflammation
Pain
Fever
Decreased platelet aggregation
COX-2
Therapeutic Actions
– both centrally and peripherally
– results from inhibition of PG synthesis in inflamed tissues; - - mild to moderate pain; much less than produced by opioids
Analgesia
Therapeutic Actions
fever, heat stroke, inc. temp are hypothalamic problems releasing interleukins
Antipyretic action
Therapeutic Actions
PGs in inflammation lead to vasodilation and inc. vascular permeability; inhibition of PGs by NSAIDS attenuates inflammation; inhibit leukotriene pathway
Anti-inflammatory action
Therapeutic Actions
– inhibits platelet aggregation
Antiplatelet action
Ibuprofen (Advil, Motrin) – treatment of muscle pain; Interactions – warfarin, phenytoin, sulfonamides, cephalosporins, lithium
Indomethacin (Indocin) - Used for treatment of acute gout attacks
Ketorolac (Toradol) – powerful analgesic, short term use only (< 5 days); IV followed by PO if needed
Meloxicam (Mobic) – pain of osteoarthritis, musculo-skeletal;
Naproxen (Naprosyn, Aleve) – musculoskeletal pain, longer half-life so less frequent dosing
Non-selective NSAIDS
