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Pre-reg Exam 2021 > Pain And Inflammation In MSK > Flashcards

Pain And Inflammation In MSK Flashcards

1
Q

How do NSAIDs work?

A

Inhibits COX enzymes involved in prostaglandin synthesis

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2
Q

How long does it take for NSAIDS to work?

A

Mild to moderate pain relief with first dose
Analgesic full effect takes one week
Anti inflammatory effect takes 3 weeks

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3
Q

What are the non selective cox1/cox2 inhibitors?

A 
Aspirin
Diclofenac
Ibuprofen
Indometacin
Naproxen
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4
Q

What are the selective cox 2 inhibitors?

A

Celecoxib
Etorocoxib
Parecoxib

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5
Q

What are the side effects of NSAIDs?

A 
Bronchospasm 
Hypersensitivity 
Photosensitivity with topical 
Nephrotoxicity 
Sodium and fluid retention
GI toxicity 
Cardiovascular events
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6
Q

When are NSAIDs cautioned?

A

Asthma
Renal impairment
Congestive heart failure
Hypertension

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7
Q

When are NSAIDS contraindicated?

A

History of asthma attack with NSAIDS
History of sensitivity
Pregnancy

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8
Q

Do you temporarily stop NSAIDS on sick days?

A

Yes, due to risk of AKI

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9
Q

What are the counselling points for NSAIDS?

A

Take with or after food as causes stomach irritation

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10
Q

Do you need a PPI if on NSAIDS?

A

Not always, but use in elderly and high risk NSAIDS

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11
Q

Which NSAIDS have highest GI risk?

A

Ketoprofen
Ketorolac
Piroxicam

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12
Q

Which NSAIDS have a middle risk of GI side effects?

A

Naproxen
Diclofenac
Indometacin

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13
Q

Which NSAIDs have a low risk of GI side effects?

A

Ibuprofen

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14
Q

Which NSAIDs have the lowest risk of GI side effects?

A

Selective Cox 2 inhibitors I.e. the coxibs

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15
Q

Are all NSAIDs contraindicated in severe heart failure?

A

Yes

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16
Q

Which NSAIDs have the highest CV risk?

A

High dose ibuprofen 2.4g daily
Dexibuprofen
Cox 2 selective
Diclofenac

17
Q

Why do you avoid NSAIDs especially in 3rd trimester?

A

Delays labour
Causes pulmonary hypertension in new born
Premature closure of foetal ductus arteriosus

18
Q

What are the NSAID interactions that increase the risk of AKI?

A

ACEi
Ciclosporin
Tacrolimus
Diuretics

19
Q

What are the NSAID interactions that increase the risk of bleeding?

A 
Warfarin
NOACs
Antiplatelet 
Low dose aspirin
Heparin 
SSRI
Venlafaxine
Steroid
20
Q

What are the NSAID interactions that decrease the renal excretion increasing the risk of toxicity?

A

Methotrexate

Lithium

21
Q

What are the NSAID interactions that increase the risk of hyperkalaemia?

A

Potassium sparing diuretics

22
Q

What are the NSAID interactions that increase the risk of convulsions?

A

Quinolones

Pre-reg Exam 2021 (79 decks)

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