NSAIDs and Antihistamines

Question 1

Inflammation

Answer 1

normal, protective response to tissue injury caused by physical trauma, noxious chemicals, microbiological agents

Question 2

Nonselective COX Inhibitors: Salicylates examples

Answer 2

aspirin

Question 3

Nonselective COX Inhibitors: Non-Salicylates examples

Answer 3

ibuprofen, ketoprofen, diclofenac, ketorolac

Question 4

COX2 Inhibitor example

Answer 4

Celecoxib

Question 5

Aspirin MOA

Answer 5

irreversibly inactivates COX

inhibits prostaglandin synthesis at PGE2

Question 6

Low dose of Aspirin (<300mg)

Answer 6

inhibit platelet aggregation

Question 7

SE of Aspirin

Answer 7

GI irritation
prolongs bleeding- cant have before surgery
blocks PGE2 and PGF2a that stops protective mucous secretions of stomach
Reye Syndrome

Question 8

Countering SE of Aspirin

Answer 8

take with food and water

antacids

Question 9

Reye Syndrome

Answer 9

fatal hepatitis with cerebral edema

aspirin during viral infections

Question 10

Ibuprofen/ Ketoprofen MOA

Answer 10

inhibits COX

Question 11

Diclofenac

Answer 11

formed in combination with misoprostol

0.1% used in post op eye inflammation

Question 12

Ketorolac

Answer 12

used to treat seasonal allergic conjunctivitis

Question 13

Celecoxib

Answer 13

inhibits COX2
used for osteoarthritis, rheumatoid arthritis, acute pain
reduced risk for GI issues

Question 14

Celecoxib should not be used on…

Answer 14

patients allergic to sulfonamides

Question 15

Acetaminophen

Answer 15

analgesic and antipyretic

no anti-inflammatory effect

Question 16

Pharmacokinetics of Acetaminophen

Answer 16

made by glucuronidation and sulfation; part is hydroxylated to NAPQI- dangerous unless reacting with glutathione

Question 17

Comparing Acetaminophen with Aspirin

Answer 17

no effect on platelets

does not cause Reye Syndrome

Question 18

SE of Acetaminophen

Answer 18

large doses cause hepatic necrosis- liver failure

Question 19

Countering SE of Acetaminophen

Answer 19

acetylcysteine

Question 20

Histamines

Answer 20

lead to inflammatory responses- runny nose, anaphylactic shock

Question 21

H1 Receptors (Gq)

Answer 21

smooth muscle, endothelium, brain

Question 22

H2 Receptors (Gs)

Answer 22

Gastric Mucosa

Question 23

Triple Response of Lewis- intradermal injection of histamine

Answer 23

red spot- few mm
flare- 1 cm beyond site
wheal- 1-2 min

Question 24

First vs Second Gen H1 Receptor Antagonists

Answer 24

sedative vs nonsedative

Question 25

First Gen H1 Receptor Antagonists

Answer 25

mine and zine
sedation
lipid soluble- CNS penetration, cross BBB

Question 26

Second Gen H1 Receptor Agonists

Answer 26

Dine
non sedating or weak sedation
no drug interactions
does not cross BBB

Question 27

Promethazine

Answer 27

H1

motion sickness, morning sickness

Question 28

Cetirizine

Answer 28

H1

mast cell stabilizer and anti-inflammatory

Question 29

Cyproheptadine

Answer 29

H1

appetite stimulant

Question 30

Increase effects of antihistamines

Answer 30

MAOI

Question 31

Antihistamines with no CNS entry

Answer 31

loratadine

fexofenadine