NSAIDS (Nonsteroidal Anti-Inflammatory Drugs)

Question 1

Renal Actions of Prostaglandins (PGs) - 4

Answer 1

1. Increased renal blood flow
2. Decreased ADH induced H2O reabsorption
3. Decreased chloride reabsorption in Loop of Henle
4. Increased renin release

Question 2

Two most important PGs for Renal

Answer 2

PGE2 and PGI2

Question 3

What is the main toxicity w/ aspirin/salicylate overdose?

Answer 3

Acid/Base issues

Question 4

Effects of aspirin/salicylate overdose (high therapeutic range) toxicity (3)

Answer 4

Respiratory alkalosis due to stimulation of respiratory center in CNS (adults, high therapeutic doses)

Toxic levels:
1. Uncoupling of oxidative phosphorylation –> metabolic acidosis due to high metabolic and drug acid load
2. Depress respiratory centers
THUS combined metabolic and respiratory acidosis

Question 5

Aspirin - Class

Answer 5

NSAID; salicylic acid derivative

Question 6

Aspirin - MOA

Answer 6

Irreversibly acetylates and inactives COX-1 and COX-2

Question 7

Aspirin - Tx (5 points)

Answer 7

Anti-inflammatory, antipyretic, analgesic
Prevention of cardiovascular disease
Benefit in colon cancer

Question 8

Aspirin - Toxicity (4 points)

Answer 8

Tinnitus
Low dose blocks actions of probenecid
High dose uricosuric (blocks urate reabsorption) –> increased risk of renal urate stones
Overdose uncouples oxidative phosphorylation –> metabolic and respiratory acidosis

Question 9

Aspirin - Toxicity Tx

Answer 9

Give HCO3- to alkalinize urine –> shifts HA to H+ and A-

A- cannot diffuse out of tubules –> ion trapping