Pharm NSAIDs part I

Question 1

what are the cox 2 selective NSAIDs

Answer 1

celecoxib

Question 2

what are the non-narcotic analgesics

Answer 2

acetaminophen (tylenol)

Question 3

what NSAIDs are propionic acids

Answer 3

ibuprofen, naproxen

Question 4

what NSAIDs are indoleacetic acids

Answer 4

indomethacin, etodolac

Question 5

what NSAIDs are herteroaryl acetic acids

Answer 5

ketoralac

Question 6

3 major beneficial properties of NSAIDs

Answer 6

anti inflammatory
analgesic
anti-pyretic

Question 7

All NSAIDs inhibit what

Answer 7

cyclooxygenase, enzyme needed to make PGs

Question 8

prostacyclin works where

Answer 8

endothelium
kidney
platelets
brain

Question 9

thromboxane A2 works where

Answer 9

platelets, vascular smooth muscle cells, macrophages, kidney

Question 10

PG D2 works where

Answer 10

mast cells, brain, airways

Question 11

PG E2 works where

Answer 11

brain, kidney, vascular smooth muscle, platelets

Question 12

PG F2 works where

Answer 12

uterus, airways, vascular smooth muscle, eyes

Question 13

how is aspirin unique

Answer 13

irreversibly inhibits COX enzymes

Question 14

which PG sensitizes pain nerve endings

Answer 14

PGE2

Question 15

What PG are important mediators of erythema and edema

Answer 15

PGE2 and PGI2

Question 16

PG effect on apoptosis

Answer 16

inhibit it

Question 17

PG role in GI

Answer 17

PGI2 inhibits gastric acid secretion

PGE2 and PGF2 stimulate synthesis of protective bicarb and mucus in stomach and small intestine

Question 18

aspirin effects on platelet aggregation

Answer 18

irreversibly inhibits it

Question 19

what occurs with higher doses of aspirin

Answer 19

inhibit PGI2 in endothelial cells which is a vasodilator and inhibitor of platelet aggregation

Question 20

NSAID effects on renal function

Answer 20

decrease renal blood flow and rate of glomerular filtration

Question 21

conditions assoc with NSAID induced acute kidney injury

Answer 21

volume depletion from emesis, diarrhea, sepsis or hemorrhage
medications like diuretics, ACEI, ARBS, calcinuerin inhibitors
cirrhosis
CHF
nephrotic syndrome
hyperCa
chronic kidney disease
Renal a stenosis
older age

Question 22

CI to aspirin use

Answer 22

in children or adolescents with chicken pox or influenza because of Reyes syndrome
and patients with gout

Question 23

What is recommended for NSAID use for chronic Tx

Answer 23

non aspirin because it is associated with more side effects and GI effects

Question 24

what are NSAIDs used to Tx chronically

Answer 24

RA, osteoarthritis, SLE, seronegative spondyloarthropathy, arthralgia, myalgia

Question 25

what NSAID is used for anti platelet effects

Answer 25

baby aspirin

Question 26

what is used to induce closer of PDA

Answer 26

indomethacin

Question 27

what is used for high risk pregnancy women HTN with preeclampsia

Answer 27

baby aspirin

Question 28

long term aspirin protects against what cancer

Answer 28

colorectal CA

Question 29

what type of elimination occurs with aspirin at high doses

Answer 29

zero order

Question 30

low does aspirin has what PK for elimination

Answer 30

first order

Question 31

CNS actions aspirin are from what

Answer 31

salicylic acid

Question 32

HS reaction to aspirin is higher it what patients

Answer 32

asthma nasal polyps chronic urticaria

Question 33

salicylic acid toxicity Sx

Answer 33

``` tinnitus nausea vomiting hyperventialation HA confusion and dizziness ```

Question 34

Tx for aspirin overdose

Answer 34

lavage with charcoal and IV bicarb

Question 35

what NSAIDs shoul dbe avoided in third trimester

Answer 35

all

Question 36

uses ibuprofen, narpozen and ketoprofen

Answer 36

analgesia of acute tendinitis, bursitis, primary dysmenorrhea, RA, OA, ankylosing spondylitis, acute gouty arthritis

Question 37

which propionic acid NSAIDs have longer half lives

Answer 37

naproxen and oxaprozin

Question 38

why is indomethacin not commonly used for therapy as analgesic or antipyretic

Answer 38

side effects

Question 39

uses indomethacin

Answer 39

RA, OA, ankylosing spondylitis, acute gout | suppress uterin contractions in preterm labor and stimulate closure PDA in neonate

Question 40

alternative for opoinds IM or IV or PO for postoperative analgesia

Answer 40

ketorolac

Question 41

Cox 2 expression

Answer 41

induced at sites of inflammation, local target for anti-inflammatory Tx

Question 42

major difference acetominophen to aspirin

Answer 42

little anti inflammatory activity

Question 43

acute overdose acetopminophen

Answer 43

hepatotoxicity | depletion of glutathione and accumulation of a metabolite that produces hepatic necrosis

Question 44

Sx of hepatotoxicity from acetominophen overdose

Answer 44

nausea, vomtiing, anorexia, abdominal pain for first 2 days | then 2-4 days increase liver enzymes and bilirubin which can lead to fatal liver damage

Question 45

Tx acteominophen hepatotoxicity

Answer 45

gastric lavage within 4 hours ingestion, supportive measures and administreation of N acetylcysteine (drug that restores glutathione)