NSAIDS Exam 4

Question 1

What are NSAIDS commonly used for?

Answer 1

temporary management of pain

Question 2

What 3 things we use NSAIDS for?

Answer 2

Anti-pyretic, analgesic and anti-inflammatory

Question 3

What is the MOA for NSAIDs

Answer 3

Depress eicosanoids action, inhibiting action of prostaglandins and thromboxane

Question 4

NSAIDS inhibit?

Answer 4

COX-1 and COX-2

Question 5

Two pathways of Arachidonic Acid?

Answer 5

Leukotrienes

Eicosanoids

Question 6

What enzyme creates leukotrienes?

Answer 6

5-lipoxygenase

Question 7

What enzyme creates PGs?

Answer 7

Cyclooxygenase

Question 8

Both NSAIDs and glucocorticoids inhibit?

Answer 8

COX-2

Question 9

Where is COX-1 found?

Answer 9

in all cells especially stomach “housekeeper”

Question 10

Where is COX-2 found?

Answer 10

in all inflammatory cells, kidney, lungs

Question 11

COX-1 is a major product of what?

Answer 11

thromboxane

Question 12

Aspirin works on what pathway?

Answer 12

COX-1, COX-2, and Lipoxygenase

Question 13

MOA of corticosteroids?

Answer 13

1. increase Lipocortin, inhibiting PLA

2. Block expression of inflammatory genes

Question 14

MOA of Leukotriene inhibitors?

Answer 14

block leukotriene activity

Question 15

MOA of 5-ASA?

Answer 15

inhibits COX-1, COX-2, lipoxygenase.

Question 16

MOA of Zileuton (Zyflo CR)

Answer 16

inhibits lipoxygenase

Question 17

MOA of Zafirulask (Accolate) and Montelukast (Singulair)?

Answer 17

block LT receptors

Question 18

Used to treat asthma and seasonal allergies

Answer 18

Zafirlukast and montelukast

Question 19

Used to treat IBD

Answer 19

5-ASA

Question 20

What is unique about aspirin?

Answer 20

irreversibly inhibits

Question 21

NSAIDs blocking the Cox pathway could cause what?

Answer 21

shunting to LT synthesis

Question 22

What dose does NSAIDs inhibit COX?

Answer 22

low doses 200mg

Question 23

What dose dose NSAIDs produce anti-inflammatory effects?

Answer 23

larger doses (600-800mg)

Question 24

T/F Aspirin is less potent than NSAIDs?

Answer 24

True

Question 25

At what dose does Aspirin reduce platelet aggregation?

Answer 25

<100mg

Question 26

What dose does aspirin provide analgesic and antipyretic effects?

Answer 26

up to > 200mg

Question 27

What dose does aspirin provide anti-inflammatory effects>

Answer 27

> 800mg (risk of gastric intolerance)

Question 28

How does NSAIDs provide anti-inflammatory effects @ high doses?

Answer 28

blocks ATP-binding site on IkK to prevent it from phosphorylating IkB and activating NFkB

Question 29

DOC for antipyresis?

Answer 29

Acetominophen

Question 30

DOC for analgesia?

Answer 30

Acetaminophen

Question 31

DOC for primary dysmenorrhea?

Answer 31

Ibuprofen

Question 32

DOC for inhibiting parturition?

Answer 32

Indomethacin

Question 33

DOC for preventing GI polyps and cancer?

Answer 33

Daily aspirin for > 10 yrs

Question 34

DOC for inflammation?

Answer 34

ALL NSAIDs work equally

Question 35

What diseases are NSAIDs used for?

Answer 35

osteoarthritis, Rheumatoid arthritis, ankylosing spondylitis, muscle soreness and joint pain

Question 36

SDE of Aspirin?

Answer 36

Tinnitus

Question 37

What can interfere with aspirin anti-platelet effects?

Answer 37

NSAIDs such as ibuprofen

Question 38

What dose is needed for anti-inflammatory effects in arthritis?

Answer 38

150-300mg/L

Question 39

What drug carries a risk for MI?

Answer 39

Diclofenac (Voltaren) | Coxib drugs

Question 40

SDE of Indomethacin?

Answer 40

CNS side effect esp. in elderly

Question 41

What drug doesn't interfere with anti-platelet effect of aspirin?

Answer 41

Celecoxib (COX-2 inhibitors)

Question 42

Used to treat arthritis, dysmennorhea, post surgical pain

Answer 42

Celecoxib

Question 43

ADR of aspirin?

Answer 43

hypersensitivity: rhinoconjunctitivs, angioedema, uricaria

Question 44

ADR of NSAIDs

Answer 44

``` Increased Bp Nephrotoxicity GI ulceration and bleeding CNS reaction NSAIDS C/I in preggo/lactation ```

Question 45

Which NSAIDs can be used in pregnancy and lactation?

Answer 45

Acetaminophen

Question 46

What is the biggest worry of taking Acetaminophen?

Answer 46

hepatic toxicity

Question 47

What causes acetaminophen toxicity?

Answer 47

NAPQI (N-acetyl- benzoquinoneimine)

Question 48

What is the antidote for acetaminophen toxicity?

Answer 48

N-acetylcysteine

Question 49

T/F Gout is a metabolic disease

Answer 49

True

Question 50

Gout drug used to stop formation of urate?

Answer 50

Allopurinal

Question 51

What does Allopurinal inhibit?

Answer 51

Xanthine Oxidase

Question 52

Why does acute attacks appear after allopurinal?

Answer 52

due to urate shunting into the tissues

Question 53

What is a alternative to Allopurinal?

Answer 53

Febuxostat

Question 54

MOA of Colchicine?

Answer 54

binds tubulin preventing polymerization. Inhibits leukocyte migration

Question 55

SDE of Colchicine?

Answer 55

diarrhea, abdominal pain, alopecia, neutropenia

Question 56

MOA of Uricase?

Answer 56

breaks down uric acid after formation

Question 57

Uricase is a ?

Answer 57

enzyme

Question 58

Compared to aspirin, Celeboxib has no effect on what?

Answer 58

platelet aggregation and GI problems

Question 59

What is contributed to nasal polyps in adults and adult asthma?

Answer 59

Aspirin