Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

#Pharmacotherapeudics > Pain Overview and COX inhibitors (2) > Flashcards

Pain Overview and COX inhibitors (2) Flashcards

1
Q

Why do NSAIDs cause GI ulcers?

A

NSAIDs inhibit COX-1, inhibiting prostaglandins which increases gastric secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Eicosanoids include _______ and ______ which mediate what?

A

Prostaglandins
Leukotrienes

mediate inflammatory rxn (vasodialtion, vasc permeability, platelete agregation, leukocyte chemotaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

For acute mild/moderate pain use _______ or ______ first.

A

NSAIDs

APAP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Fore severe acute pain use ______ 1st

A

opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Visceral pain 1st line for severe and 2nd line

A

opioids for severe, add adjuvants TCA or AED

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Inflamm pain 1st line

A

apa or nsaids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

neuropathic pain 1st line central

A

clonidine or baclofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

peripheral neuropathic pain 4

A

TCA/AED
Lidocaine
SSRI/SNRI
Long acting opioid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic functional pain 1st line

A

TCA or Tramadol

2nd line SSRI/SNRI or pregabalin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what are MOAIs?

A

Nonsteroidal anti-iflam

Inhibit COX to stop prostoglandin synth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 main clinical results of MOA

A

antipyretic, analgesia, anti-inflam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Asprin is an MOA with _____ inhibition

A

irreversible acetylation of active site

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ibuprofen is an MOA with _____ inhibition

A

competative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

NSAIDs are analgesic and are most effective when ________ is involved

A

inflammation

bc inhib prostaglandin synthesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

3 indications for NSAIDs

A

MSK/joint dz (sprains, gout, arthritis, rheum)
analgesic for mild-mod pain releif of HA, dysmenorrhea, sunburn
sympt releif of fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Misoprostol is a …..

A

PGE analog used to treat NSAID induced GI damage (PPI also effective(used for GERD))

17
Q

contraindications of misoprostol

A

pregnancy

18
Q

Don’t use NSAIDs in pts with _________, _______, ________, or ________

A

GI ulcers
cardiac dz
renal dz (edema and hypercalemia)
asthma

19
Q

Asprin is the prototype of traditional _______(drugs) (4 effects)

A

NSAIDs

inhibits COX: anti-coag, antipyretic, analgesic, anti-inflamm

20
Q

Asprin can lead to ________ poisoning (list 7 sx)

A

salicylism

causes NV, hypervent, HA, confusion, delerium, convulsions, acidosis

21
Q

Asprin is NOT recommended for children <12 b/c they may develop….

A

Reye’s syndrome

post viral infxn, admin of asprin leads to hepatitis and cerebral edema that can be fatal

22
Q

Asprin should not be taken with (6)

A

heparin or oral anticoag -bleeding
probenecid or sulfinpyrazone- dec urate excretion(gout pt)
antacids -dec rate of absorption
ibuprofen - inc clotting

23
Q

Diflunisal is a derivative of _____. It’s more potent than ______ but has no _____ activity

A 
salicyclic acid (but no risk of poisoning)
more potent than asprin
no antipyretic activity bc doesnt cross BBB
24
Q

Name the 6 classes of NSAIDs

A 
Propionic acid
indoleacetic acids
oxicoms
phenylbutazone
fenamates
salicyclates
25
Q

Name the propionic acid NSAIDs

A

Ibuprofen

26
Q

propionic acid NSAIDs all possess 3 activities but have less intense effects on _____

A

anti-inflam, analgesic, anipyritic

less intense GI effects than asprin

27
Q

Indoleacetic acid NSAIDs are good for tx of _________; these are very potent anti-inflamms but Sfx limit use, including dec effectiveness of ___ drugs

A

arthritis

dec effect of CV drugs

28
Q

Etodolac has less ___ issues but more _____ issues

A

less GI issues

more kidney issues (esp w/digoxin, lithium, MTX)

29
Q

Diclofenac approved for ___, ___, and ______.

and a ______ preparation is available

A

RA, OA, and ank sponylitis

opthalmic prep

30
Q

Nabumatone (3)

A

prodrug
as potent as asprin for RA and OA
fewer sf

31
Q

Piroxicam and meloxicam (3)

A

COX2 sel at low doses, nonsel at high doses

GI ADRs

Interferes with lithium excretion(bipolar pt)

32
Q

Mefenamic acid and Meclofenamate (2)

A

no advantages over other NSAIDs

severe diarrhea and hemolytic anemia

33
Q

Phenylbutazone (3)

A

powerful antiinflam

limited use bc agranulocytosis and aplastic anemia, GI, fluid retention

displaces warfarin, oral hypoglycemic, and sulfonamides from protein binding

34
Q

Ketotolac

A

GOOD for inflam pain (pyrrolizine carboxylic acid derivative)

this is the ONLY injectable NSAID (IM or IV)

High rate of GI bleed 5 day max use
dec dose in elderly and kidney pts; cleared more slowly

35
Q

COX 2 inhibitors

A

fewer sfx, fewer gi bleed, still need caution for heart and kidney

celecoxib - black box warning!!! Inc MI and stroke risk

36
Q

celecoxib

A

BLACK BOX WARNING - Inc MI and Stroke

#Pharmacotherapeudics (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions