oral NSAIDs

Question 0

antipyretic

Answer 0

reduces fever

Question 1

3 properties of NSAIDs

Answer 1

analgesic
antiinflammatory
antipyretic

Question 2

how do NSAIDs cause GI irritation

Answer 2

• directly because they are irritating substances (food minimizes the direct irritation)
• indirectly by reducing cytoprotective prostaglandin synthesis

Question 3

COX-1 action and inhibition

Answer 3

• cox-1 converts arachidonic acid to cytoprotective prostaglandins which stimulates bicarbonate production and mucus production which protect gastric cells from gastric acid
• inhibition blocks prostaglandin formation and causes irritation

Question 4

NSAID BBWs

Answer 4

• increased risk of cardiovascular events (stroke, heart attack, etc.)
• increased risk of GI bleeding
• contraindicated in pts. allergic to aspirin

Question 5

Motrin

Answer 5

ibuprofen

-NSAID

Question 6

Naprosyn

Answer 6

naproxen

-NSAID

Question 7

Anaprox DS

Answer 7

naproxen sodium

-NSAID

Question 8

Clinoril

Answer 8

sulindac

-NSAID

Question 9

what is the therapeutic benefit from NSAIDs

Answer 9

inhibition of cox-2 which slows prostaglandin synthesis

Question 10

Feldene

Answer 10

piroxicam

-NSAID

Question 11

Voltaren

Answer 11

diclofenac sodium

• NSAID
• enteric-coated tablet: TID

Question 12

Voltaren XR

Answer 12

diclofenac sodium

• NSAID
• ER tablet: qday

Question 13

Voltaren Opthalmic

Answer 13

diclofenac sodium

• NSAID
• QID

Question 14

Pennsaid

Answer 14

diclofenac sodium 1.5% topical solution

• NSAID
• ind. for arthritis of the knee
• QID
• 40 drops/dose (10 at a time and rub in) X 4 doses/day = 160drops/day
• contains DMSO

Question 15

DMSO

Answer 15

dimethyl sulfoxide

• percutaneous absorption enhancer
• tastes like garlic

Question 16

Voltaren Gel

Answer 16

diclofenac sodium 1% topical gel (QID)

• NSAID
• ind. for arthritis joint pain
• dosing card: 2g or 4g
• upper extremities: 2g/dose = 8g max/24hr
• lower extremities: 4g/dose = 16g max/24hr
• contains alcohol USP as a PEA

Question 17

PAE

Answer 17

percutaneous absorption enhancer

Question 18

Cataflam

Answer 18

diclofenac potassium

• NSAID
• ind. ONLY for moderate pain
• tablet: TID

Question 19

Celebrex

Answer 19

celecoxib

• NSAID
• specific cox-2 inhibitor
• structurally similar to sulfonamides; DON’T take if allergic to sulfonamides

Question 20

Mobic

Answer 20

meloxicam

• NSAID
• more cox-2 selective so less GI irritation

Question 21

nabumetone

Answer 21

• NSAID

- more cox-2 selective so less GI irritation

Question 22

etodolac

Answer 22

• NSAID

- more cox-2 selective so less GI irritation

Question 23

indomethacin

Answer 23

-NSAID

Question 24

oxaprozin

Answer 24

-NSAID

Question 25

ketorolac

Answer 25

- NSAID - ONLY ind. for acute pain (not inflammation or chronic pain) - causes higher incidence of GI bleeding and ulceration - tablet: 5 days MAX (#20) - NO REFILLS

Question 26

Sprix

Answer 26

ketorolac nasal spray (QID) - NSAID - 5 single day spray bottle (1spray/nostril/dose X 4 doses/day = 8 sprays/bottle) - must discard spray bottle within 24hr after first spray (can't guarantee accurate dose after) - REFRIGERATE in pharmacy, single day bottle can be at RT for 24hr

Question 27

ketoprofen

Answer 27

-NSAID

Question 28

aspirin

Answer 28

-NSAID

Question 29

Cambia

Answer 29

diclofenac potassium - NSAID - ind. ONLY for tx of migraines - powder for oral solution: 50mg packet - mix with 60mL of water and drink as single dose

Question 30

Solaraze Gel

Answer 30

diclofenac sodium 3% topical gel - NSAID - ind. for actinic keratosis - BID

Question 31

actinic keratosis

Answer 31

- a.k.a. AK | - precancerous rough patches of skin caused by UV light

Question 32

other drugs ind. for AK that are not NSAIDs

Answer 32

Zyclara cream | Aldara cream

Question 33

Zyclara cream

Answer 33

imiquimod 3.75% cream - ind. for AK - qday x 2weeks, skip two weeks, repeat

Question 34

Aldara Cream

Answer 34

imiquimod 5% cream - ind. for AK and genital warts - BIW X 16 weeks

Question 35

pt. couseling for Zyclara and Aldara

Answer 35

- may want to wear gloves and make sure to put directly on affected spots - avoid UV light, may increase sensitivity to sunburn

Question 36

Zipsor

Answer 36

diclofenac potassium capsule - NSAID - ind. for moderate pain - QID

Question 37

Flector Patch

Answer 37

diclofenac epolamine - NSAID - ind. for pain due to strains, sprains, and bruises - BID: place directly over injury

Question 38

Vimovo

Answer 38

naproxen, esomeprazole - NSAID, PPI - ind. for prevention of NSAID-induced stomach ulcers in pts. needing NSAIDs long-term - BID - take on an EMPTY stomach, 30min-1hr before meals

Question 39

Cytotec

Answer 39

misoprostol - prostaglandin - ind. for the prevention of NSAID-induced ulcers in pts. taking NSAIDs long-term - can be taken with NSAIDs to minimize GI irritation, but most pts. take Arthrotec since it contains misoprostol - BBW: do not take during pregnancy (abortifacient)

Question 40

Cytotec MOA

Answer 40

- it is a cytoprotective prostaglandin that stimulates mucus and bicarbonate production and protects gastric cells from gastric acid - this action prevents the indirect GI irritation of NSAIDs

Question 41

abortifacient

Answer 41

induces abortion

Question 42

Mefeprex

Answer 42

mifepristone - abortifacient and antiprogestin - ind. for the termination of pregnancy: only effective within the first 7 weeks of pregnancy - misoprostol is taken a few days after the mifepristone to start contractions (embryo is expelled because of thinned uterus)

Question 43

antiprogestin

Answer 43

blocks progesterone receptors in the uterus; lining of uterus thins without progesterone so embryo cannot remain implanted