NSAIDs and Gout

Question 1

Aspirin

Answer 1

Irreversibly inhibits platelet COX
Lasts 8-10 days (life of plt)
Decreases incidence of TIA, unstable angina, coronary artery thrombosis with MI, thrombosis after CABG
contraindicated in pt with hemophilia

Question 2

Celecoxib

Answer 2

selective COX-2 inhibitor
less GI irritation but may cause rashes
interacts with warfarin

Question 3

Meloxicam

Answer 3

COX 2 selective inhibitor

less selective than celecoxib

Question 4

Diconfenac

Answer 4

Nonselective COX inhibitor

Reversibly inhibits COX 1 and 2

Question 5

Ibuprofen and indomethacin

Answer 5

nonselective COX 1 and 2 ibhibitors

used to accelerate closure of patent ductus arteriosus

Question 6

Nonselective COX inhibitors (6)

Answer 6

Diclonfenac, ibuprofen, indomethacin, naproxen, ketorolac, piroxicam

Question 7

acetaminophen

Answer 7

weak COX 1 and 2 inhibitor
no anti inflammatory effects
fatal in doses >15g
increased hepatic enzymes, dizziness, excitement, disorientation

Question 8

First line drugs for gout treatment

Answer 8

NSAIDs, corticosteroids, colchicine