Santanam 2

Question 1

MOA for NSAIDS

Answer 1

inhibit COX1 and COX2

Question 2

which NSAIDS inhibit both COX1 and COX2

Answer 2

non-selective - aspirin

traditional NSAIDS

Question 3

which NSAIDS inhibit only COX2

Answer 3

selective

Question 4

what are 3 common therapeutic actions of NSAIDS

Answer 4

antipyretics
analgesics
anti-inflammatory

Question 5

common side effects associated with NSAIDS

Answer 5

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

Question 6

MOA for aspirin

Answer 6

irreversible inhibitor of cyclo-oxygenase

-acetylates the enzyme

Question 7

aspirin does not interact with what receptors in the brain

Answer 7

opioid

Question 8

small doge 325-650 mg of aspirin has what effects

Answer 8

analgesic/antipyretic: DECREASE PLATLET AGGREATION

Question 9

middle dose 4-6 g of aspirin has what effects

Answer 9

anti-inflammatory: ANITPYRETIC ANTIPHYLYEGIC

Question 10

large dose 10-30g of aspirin has what effect

Answer 10

fatal dose: ANTI-INFLAMMATORY

Question 11

what is low dose aspirin used for

Answer 11

• decrease incidence of transient ischemic attacks

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

Question 12

what are side effects for aspirin

Answer 12

GI pain
bleeding
ulcers
tinnitis

Question 13

when do you not give aspirin to children

Answer 13

when they have viral infection

get Reye’s disease

Question 14

NSAID: propionic acid

Answer 14

ibuprofen

naproxen

Question 15

MOS for Ibuprofin and naproxen

Answer 15

competitive, reversible active-site inhibitor of COX1 and 2

Question 16

When is Ibuprofin and Naproxen used

Answer 16

mild to moderate pain
antipyretic
symptoms of rheumatoid and osteoarthritis
dysmenorrhea

Question 17

commercial name of Ibuprofin

Answer 17

Advil and Motrin

Question 18

what is Avidl and Mortin used for

Answer 18

acute migraine attacks

Question 19

commercial name for Naproxen

Answer 19

Aleve

Question 20

Naproxen used for

Answer 20

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

Question 21

what is a warning for prolonged use of Naproxen

Answer 21

increase risk of stroke/heart attack

Question 22

NSAID: heteroarylacetic acid

Answer 22

ketorolac

Question 23

what is ketorolac used for

Answer 23

seasonal allergy

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

Question 24

how is Ketorolac administered

Answer 24

IM
IV
oral

Question 25

what is the adverse reactions for Ketorolac

Answer 25

GI bleeding bleeding hepatic

Question 26

special instruction dosing for Ketorolac

Answer 26

lower dose in - patients under 110 pounds - great than 65 years - someone with elevated creatinine levels

Question 27

what are contraindications for Ketorolac

Answer 27

DON'T use in - history of peptic ulcer - before surgery - with aspirin or NSAID - renal diseae - with probenecid - active bleeding - during labor/lactation

Question 28

NSAID: phenylacetic acid

Answer 28

Diclofenac

Question 29

Uses of Diclofenac

Answer 29

``` rheumatoid osteoarthritis ankylosing spondylitis primary dysmenorrhea ophthalmic- postoperative pain and inflammation following cataract surgery ```

Question 30

what drugs make up Arthrotec? what is it used for

Answer 30

diclofenac misoprostol - patients with risk of gastric and duodenal ulcers

Question 31

who should not be given arthrotec

Answer 31

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

Question 32

NSAIDS: indole derivatives

Answer 32

indomethacin

Question 33

what are oral uses for Indomethacin

Answer 33

acute gouty arthritis rheumatoid and osteo arthritis tendinitis ankylosing spondylitis

Question 34

what is the IV use for Indomethacin

Answer 34

nonsurgical repair of patent ductus arteriosus by decreasing PGE levels

Question 35

what toxicity does Indomethacin have

Answer 35

renal

Question 36

how is Indomethacin given to pateint

Answer 36

3 doses given at 12-24 hour intreval | if urine output is

Question 37

what are the side effects of Indomethacin

Answer 37

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

Question 38

what are contraindications for Indomethacin

Answer 38

hyperbilirubinemia | renal failure

Question 39

which drug is the selective COX-2 inhibitor

Answer 39

Celecoxib

Question 40

what is Celecoxib used for

Answer 40

rheumatoid and osteo arthritis

Question 41

Celecoxib has what FDA warning

Answer 41

increased stroke and heart attack with high dose for prolonged time

Question 42

what is the drug drug interactions with Celecoxib

Answer 42

- metabolized by P450 CYP2C9 | - Fluconazole: inhibits CYP2C9

Question 43

what are adverse effects of Celecoxib

Answer 43

GI pain | nausea

Question 44

NSAIDS should not be used in what patients

Answer 44

last trimester pregnant women

Question 45

what effect does NSAIDS have on pregnancy

Answer 45

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

Question 46

Use and selection of NSAID guidlines

Answer 46

do not combine NSAIDS | change dose or type

Question 47

generally speaking what is the most common side effect for NSAIDS

Answer 47

GI pain | ulceration

Question 48

what is a common renal side effect with NSAID

Answer 48

fluid (water and salt) retention - enhances ability of ADH - decrease K secretion

Question 49

which NSAID has the highest renal failure

Answer 49

Indomethacin

Question 50

does the kidney produce prostaglandins

Answer 50

yes

Question 51

role of PGI2 and PGE2 in renal

Answer 51

increase GFR and renal blood flow

Question 52

role of PGE2 in renal

Answer 52

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

Question 53

what effect does NSAIDS have on kindey

Answer 53

- decrease renal blood flow and glomerular filteration rate | - increase tubular reabsorption of water, Cl, Na

Question 54

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

Answer 54

hyperkalemia

Question 55

what impact does PGE2 have on the collecting tubes

Answer 55

inhibits ADH

Question 56

what hormone does PGI2 and PGE2 release in renal

Answer 56

renin

Question 57

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

Answer 57

Acetaminophen (NOT AN NSAID)

Question 58

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

Answer 58

antipyretic analgesic different: weak anti-inflammatory agent

Question 59

what does Acetaminophen do to platelet function

Answer 59

does not altar

Question 60

what is a drug drug interaction for Acetaminophen

Answer 60

alcohol

Question 61

what are 2 adverse effects of Acetaminophen

Answer 61

``` hepatic toxicity (acute) renal toxicity (chronic) ```

Question 62

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

Answer 62

active rheumatoid arthritis not responding to NSAIDS

Question 63

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

Answer 63

- inhibition of function and maturation of T cells | - inhibits phagocytosis by macrophages

Question 64

how is Gold sodium thiomalate administered

Answer 64

IM

Question 65

what are some adverse effects of Gold sodium thiomalate

Answer 65

chrysiasis and mucosal lesions | proteinuria and glomerulonephritis