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POD exam 4 > Santanam 2 > Flashcards

Santanam 2 Flashcards

1
Q

MOA for NSAIDS

A

inhibit COX1 and COX2

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2
Q

which NSAIDS inhibit both COX1 and COX2

A

non-selective - aspirin

traditional NSAIDS

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3
Q

which NSAIDS inhibit only COX2

A

selective

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4
Q

what are 3 common therapeutic actions of NSAIDS

A

antipyretics
analgesics
anti-inflammatory

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5
Q

common side effects associated with NSAIDS

A
  • GI ulcers
  • bleeding
  • PGE2 inhibited in kidney (fluid retention)
  • cross sensitivity with aspirin
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6
Q

MOA for aspirin

A

irreversible inhibitor of cyclo-oxygenase

-acetylates the enzyme

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7
Q

aspirin does not interact with what receptors in the brain

A

opioid

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8
Q

small doge 325-650 mg of aspirin has what effects

A

analgesic/antipyretic: DECREASE PLATLET AGGREATION

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9
Q

middle dose 4-6 g of aspirin has what effects

A

anti-inflammatory: ANITPYRETIC ANTIPHYLYEGIC

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10
Q

large dose 10-30g of aspirin has what effect

A

fatal dose: ANTI-INFLAMMATORY

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11
Q

what is low dose aspirin used for

A
  • decrease incidence of transient ischemic attacks

- risk reduction of preeclampsia in women ( begin late first tirmester)

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12
Q

what are side effects for aspirin

A

GI pain
bleeding
ulcers
tinnitis

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13
Q

when do you not give aspirin to children

A

when they have viral infection

get Reye’s disease

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14
Q

NSAID: propionic acid

A

ibuprofen

naproxen

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15
Q

MOS for Ibuprofin and naproxen

A

competitive, reversible active-site inhibitor of COX1 and 2

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16
Q

When is Ibuprofin and Naproxen used

A

mild to moderate pain
antipyretic
symptoms of rheumatoid and osteoarthritis
dysmenorrhea

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17
Q

commercial name of Ibuprofin

A

Advil and Motrin

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18
Q

what is Avidl and Mortin used for

A

acute migraine attacks

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19
Q

commercial name for Naproxen

A

Aleve

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20
Q

Naproxen used for

A

same as Ibuprofen with greater anti-inflammatory
acute gout
ankylosing spondylitis

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21
Q

what is a warning for prolonged use of Naproxen

A

increase risk of stroke/heart attack

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22
Q

NSAID: heteroarylacetic acid

A

ketorolac

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23
Q

what is ketorolac used for

A

seasonal allergy

  • recovery from cataract surgery
  • excellent analgesic
  • only NSAID approved for postoperative pain (moderate to severe)
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24
Q

how is Ketorolac administered

A

IM
IV
oral

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25
Q

what is the adverse reactions for Ketorolac

A

GI bleeding
bleeding
hepatic

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26
Q

special instruction dosing for Ketorolac

A

lower dose in

  • patients under 110 pounds
  • great than 65 years
  • someone with elevated creatinine levels
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27
Q

what are contraindications for Ketorolac

A

DON’T use in

  • history of peptic ulcer
  • before surgery
  • with aspirin or NSAID
  • renal diseae
  • with probenecid
  • active bleeding
  • during labor/lactation
28
Q

NSAID: phenylacetic acid

A

Diclofenac

29
Q

Uses of Diclofenac

A 
rheumatoid
osteoarthritis
ankylosing spondylitis 
primary dysmenorrhea
ophthalmic- postoperative pain and inflammation following cataract surgery
30
Q

what drugs make up Arthrotec? what is it used for

A

diclofenac
misoprostol
- patients with risk of gastric and duodenal ulcers

31
Q

who should not be given arthrotec

A

pregnant women

-liver problem pple ( monitor transaminases during first 8 weeks)

32
Q

NSAIDS: indole derivatives

A

indomethacin

33
Q

what are oral uses for Indomethacin

A

acute gouty arthritis
rheumatoid and osteo arthritis
tendinitis
ankylosing spondylitis

34
Q

what is the IV use for Indomethacin

A

nonsurgical repair of patent ductus arteriosus by decreasing PGE levels

35
Q

what toxicity does Indomethacin have

A

renal

36
Q

how is Indomethacin given to pateint

A

3 doses given at 12-24 hour intreval

if urine output is

37
Q

what are the side effects of Indomethacin

A

GI pain: take with food
displacement of bilirubin from albumin
decrease urine output

38
Q

what are contraindications for Indomethacin

A

hyperbilirubinemia

renal failure

39
Q

which drug is the selective COX-2 inhibitor

A

Celecoxib

40
Q

what is Celecoxib used for

A

rheumatoid and osteo arthritis

41
Q

Celecoxib has what FDA warning

A

increased stroke and heart attack with high dose for prolonged time

42
Q

what is the drug drug interactions with Celecoxib

A
  • metabolized by P450 CYP2C9

- Fluconazole: inhibits CYP2C9

43
Q

what are adverse effects of Celecoxib

A

GI pain

nausea

44
Q

NSAIDS should not be used in what patients

A

last trimester pregnant women

45
Q

what effect does NSAIDS have on pregnancy

A

inhibit uterine motility
induce bleeding in last trimester
premature closure of ductus arteriouss

46
Q

Use and selection of NSAID guidlines

A

do not combine NSAIDS

change dose or type

47
Q

generally speaking what is the most common side effect for NSAIDS

A

GI pain

ulceration

48
Q

what is a common renal side effect with NSAID

A

fluid (water and salt) retention

  • enhances ability of ADH
  • decrease K secretion
49
Q

which NSAID has the highest renal failure

A

Indomethacin

50
Q

does the kidney produce prostaglandins

A

yes

51
Q

role of PGI2 and PGE2 in renal

A

increase GFR and renal blood flow

52
Q

role of PGE2 in renal

A

inhibit Cl- absorption in thick ascending limb of loop of Henle

53
Q

what effect does NSAIDS have on kindey

A
  • decrease renal blood flow and glomerular filteration rate

- increase tubular reabsorption of water, Cl, Na

54
Q

what is most likely to occur in NSAID use in elderly, diabetics, pple with diminished renal function

A

hyperkalemia

55
Q

what impact does PGE2 have on the collecting tubes

A

inhibits ADH

56
Q

what hormone does PGI2 and PGE2 release in renal

A

renin

57
Q

When people are allergic to asprin what medicine do they use instead

A

Acetaminophen (NOT AN NSAID)

58
Q

what are similair activities of Acetaminophen and aspirin, how is Acetaminophen different

A

antipyretic
analgesic
different: weak anti-inflammatory agent

59
Q

what does Acetaminophen do to platelet function

A

does not altar

60
Q

what is a drug drug interaction for Acetaminophen

A

alcohol

61
Q

what are 2 adverse effects of Acetaminophen

A 
hepatic toxicity (acute)
renal toxicity (chronic)
62
Q

Gold Salts and Auranofin & Gold sodium thiomalate are used for what

A

active rheumatoid arthritis not responding to NSAIDS

63
Q

What is the mechanism of action for gold salts auranofin and gold sodium thiomalate

A
  • inhibition of function and maturation of T cells

- inhibits phagocytosis by macrophages

64
Q

how is Gold sodium thiomalate administered

A

IM

65
Q

what are some adverse effects of Gold sodium thiomalate

A

chrysiasis and mucosal lesions

proteinuria and glomerulonephritis

POD exam 4 (6 decks)

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