Smooth Muscle Prostaglandins Part 1

Question 1

____________________ are chemical mediators found in most body tissues that regulate cell functions and promote the inflammatory response

Answer 1

prostaglandins

Question 2

what are the 5 types of prostaglandins

Answer 2

1. PGD2 2. PGE2 3. PGF2 4. PGI2 5. thromboxane A2

Question 3

where is PGD2 located?

Answer 3

1. airways 2. brain 3. mast cells

Question 4

where is PGE2 located ?

Answer 4

1. brain 2. kidneys 3. platelets 4. vascular smooth muscle

Question 5

where is PGF2 located?

Answer 5

1. airways 2. eyes 3. uterus 4. vascular smooth muscle

Question 6

where is PGI2 located

Answer 6

1. brain 2. endothelium 3. kidneys 4. platelets

Question 7

where si thromboxane A2 located?

Answer 7

1. kidneys 2. macrophages 3. platelets 4. vascular smooth muscle

Question 8

effects of PGD2

Answer 8

bronchoconstriction

Question 9

effects of PGE2

Answer 9

1. bronchodilation 2. gastroprotection 3. increases activity of GI sm. muscle 4. increase sensitivity to pain 5. increase body temperature 6. vasodilation

Question 10

effects of PGF2

Answer 10

1. increases activity of GI smooth muscle 2. bronchoconstriction 3. increases uterine contraction

Question 11

effects of PGI2

Answer 11

1. decrease platelet aggregation 2. gastroprotection 3. vasodilation

Question 12

effects of Thromboxane A2

Answer 12

1. increase platelet aggregation 2. vasoconstriction

Question 13

prostaglandin synthesis comes from the precursor ________________________

Answer 13

arachadonic acid

Question 14

in prostaglandin synthesis, physiologic prostaglandins originate from _________________, and pathologic prostaglandins originate from ______________

Answer 14

COX-1; COX-2

Question 15

which prostaglandin synthesis pathway plays a role in pain and inflammation, is inducible, and is only in circulation in response to a condition?

Answer 15

COX-2

Question 16

MOA of NSAIDS (asprin, ibuprofen, and tylenol)

Answer 16

inhibit COX1 and COX2

Question 17

NSAIDS (asprin, ibuprofen and tylenol) tx ____________________, but do not ___________________

Answer 17

sx; tx the underlying disorder

Question 18

__________________ is a peripheral and central analgesic, but __________________ is only a peripheral analgesic

Answer 18

ASA; ibuprofen

Question 19

uses of NSAIDs (asprin, ibuprofen, and tylenol)

Answer 19

1. analgesic 2. antipyretic 3. anti-inflammatory

Question 20

_______________ binds irreversibly to plt COX-1, and ____________ bind reversibly to plt COX-1

Answer 20

ASA; NSAIDs

Question 21

What is the antiplt effects of asprin

Answer 21

1. prevents the synthesis of thromoxane A2 2. inhibits platelet aggregation 3. effects last for the lifetime of the plt (7-10 days)

Question 22

what is the antiplt effects of non-asprin NSAIDs?

Answer 22

1. anti-plt effects only last while the drug is present in the blood (~4.5 half lifes) 2. plt fx returns after 4 half lives

Question 23

Asprin and all NSAIDS (except tylenol and COX-2 specific drugs) have what effects on plts?

Answer 23

1. inhibit plt aggregation 2. interfere with blood coagulation 3. increase the risk of bleeding

Question 24

which drug is the prototype anti-prostaglandin drug

Answer 24

asprin

Question 25

T/F: asprin is nephrotoxic at high doses

Answer 25

TRUE

Question 26

asprin effects in the kidneys

Answer 26

1. constricts renal arteries and arterioles 2. decreases the bloodflow to the kidneys 3. decreases GFR 4. increases the retention of salt and water

Question 27

which anti-prostaglandin drug is safer in regards to GI bleeds? (NSAIDS or ASA?)

Answer 27

NSAIDS

Question 28

__________________ is effective in the tx of mild to moderate pain of the skin, muscles, joints, and other connective tissue

Answer 28

ASA

Question 29

prostaglandins normal fx in the kidney

Answer 29

1. increases blood flow via VD at times of decreased blood flow 2. counters the VC effects of local vasoconstrictors (epi, AngII)

Question 30

__________________ is a propionic acid derivative medication that inhibits prostaglandin synthesis

Answer 30

Ibuprofen

Question 31

___________________ is a selective COX 2 inhibitor

Answer 31

celecoxib

Question 32

what meds are widely used over asprin due to having less Gastric irritation and GI upset

Answer 32

NSAIDs (ibuprofen and celecoxib)

Question 33

half life of celecoxib

Answer 33

11 hours

Question 34

celecoxib (compared to asprin) has less ________________, no _______________ effects, and can potentiate ______________________.

Answer 34

Gastric irritation; antiplt; pre-existing HTN

Question 35

T/F: celecoxib is not protein bound

Answer 35

false; celecoxib is highly protein bound

Question 36

what labs should be monitored if a pt is taking ibuprofen or celecoxib regularly

Answer 36

BUN/Cr due to possible renal damage

Question 37

if pt has liver or renal damage, but needs to be prescribed a cox inhibitor like ibuprofen or celecoxib, what changes would you make to the dose?

Answer 37

decrease it

Question 38

what route is celecoxib available in?

Answer 38

PO only

Question 39

route that asprin is available in?

Answer 39

1. P.O: enteric coated, chewable 2. PR

Question 40

T/F: asprin is available in liquid form

Answer 40

false; unstable in liquid

Question 41

route that Ibuprofen is available in?

Answer 41

PO: tablet, chewable, capsule, oral suspension, oral drops

Question 42

advantage of tylenol over other COX inhibitors

Answer 42

does not cause: N/V, GI bleeding, or disrupt coagulation

Question 43

tylenol is equal to asprin in its ______________&_____________ effects, but lacks ________________ effects

Answer 43

analgesic; antipyretic; anti-inflammatory

Question 44

what routes is tylenol available in?

Answer 44

1. P.O: tablet, liquid 2. PR 3. IV

Question 45

which med is marketed OTC with many analgesic and cold remedies, and is also prescribed with codeine, hydrocodone, oxycodone, and percocet to enhance analgesic effects

Answer 45

tyelnol

Question 46

C/I for NSAIDs (asprin, ibuprofen, and tylenol)

Answer 46

1. PUD 2. GI or other bleeding d/o 3. hypersensitivity rxn (cross rxn with ASA and NSAIDs) 4. impaired renal fx 5. children with flu/chicken pox 2/2 reye's syndrome 6. alcoholics 7. asthmatics

Question 47

__________________ can be given to children for fever and/or pain but until at least 2 years of age

Answer 47

acetaminophen

Question 48

what med is safe to give children for fever, but not until at least 6 mo of age

Answer 48

ibuprofen

Question 49

what medication is c/i in children <12 years of age

Answer 49

asprin 2/2 reyes syndrome and rapidly progressive encephalopathy after acute viral illness

Question 50

__________________ is a safe COX inhibitor for the elderly in recommended doses as long as do not have liver damage or abuser of etoh

Answer 50

acetaminophen