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Year2 MSK exam 1 > Pharm NSAIDs part I > Flashcards

Pharm NSAIDs part I Flashcards

1
Q

what are the cox 2 selective NSAIDs

A

celecoxib

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2
Q

what are the non-narcotic analgesics

A

acetaminophen (tylenol)

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3
Q

what NSAIDs are propionic acids

A

ibuprofen, naproxen

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4
Q

what NSAIDs are indoleacetic acids

A

indomethacin, etodolac

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5
Q

what NSAIDs are herteroaryl acetic acids

A

ketoralac

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6
Q

3 major beneficial properties of NSAIDs

A

anti inflammatory
analgesic
anti-pyretic

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7
Q

All NSAIDs inhibit what

A

cyclooxygenase, enzyme needed to make PGs

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8
Q

prostacyclin works where

A

endothelium
kidney
platelets
brain

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9
Q

thromboxane A2 works where

A

platelets, vascular smooth muscle cells, macrophages, kidney

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10
Q

PG D2 works where

A

mast cells, brain, airways

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11
Q

PG E2 works where

A

brain, kidney, vascular smooth muscle, platelets

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12
Q

PG F2 works where

A

uterus, airways, vascular smooth muscle, eyes

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13
Q

how is aspirin unique

A

irreversibly inhibits COX enzymes

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14
Q

which PG sensitizes pain nerve endings

A

PGE2

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15
Q

What PG are important mediators of erythema and edema

A

PGE2 and PGI2

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16
Q

PG effect on apoptosis

A

inhibit it

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17
Q

PG role in GI

A

PGI2 inhibits gastric acid secretion

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

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18
Q

aspirin effects on platelet aggregation

A

irreversibly inhibits it

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19
Q

what occurs with higher doses of aspirin

A

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

20
Q

NSAID effects on renal function

A

decrease renal blood flow and rate of glomerular filtration

21
Q

conditions assoc with NSAID induced acute kidney injury

A 
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
22
Q

CI to aspirin use

A

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

23
Q

What is recommended for NSAID use for chronic Tx

A

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

24
Q

what are NSAIDs used to Tx chronically

A

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

25
Q

what NSAID is used for anti platelet effects

A

baby aspirin

26
Q

what is used to induce closer of PDA

A

indomethacin

27
Q

what is used for high risk pregnancy women HTN with preeclampsia

A

baby aspirin

28
Q

long term aspirin protects against what cancer

A

colorectal CA

29
Q

what type of elimination occurs with aspirin at high doses

A

zero order

30
Q

low does aspirin has what PK for elimination

A

first order

31
Q

CNS actions aspirin are from what

A

salicylic acid

32
Q

HS reaction to aspirin is higher it what patients

A

asthma
nasal polyps
chronic urticaria

33
Q

salicylic acid toxicity Sx

A 
tinnitus
nausea
vomiting
hyperventialation
HA confusion and dizziness
34
Q

Tx for aspirin overdose

A

lavage with charcoal and IV bicarb

35
Q

what NSAIDs shoul dbe avoided in third trimester

A

all

36
Q

uses ibuprofen, narpozen and ketoprofen

A

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

37
Q

which propionic acid NSAIDs have longer half lives

A

naproxen and oxaprozin

38
Q

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

A

side effects

39
Q

uses indomethacin

A

RA, OA, ankylosing spondylitis, acute gout

suppress uterin contractions in preterm labor and stimulate closure PDA in neonate

40
Q

alternative for opoinds IM or IV or PO for postoperative analgesia

A

ketorolac

41
Q

Cox 2 expression

A

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

42
Q

major difference acetominophen to aspirin

A

little anti inflammatory activity

43
Q

acute overdose acetopminophen

A

hepatotoxicity

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

44
Q

Sx of hepatotoxicity from acetominophen overdose

A

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

45
Q

Tx acteominophen hepatotoxicity

A

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

Year2 MSK exam 1 (26 decks)

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