NSAIDs & Acetaminophen

Question 1

Aspirin

Answer 1

Effect:

• inhibit platelet aggregation
• Nonselective COX inhibitor

Use:

• Cardioprotective, low dose
• Kawasaki disease, high dose
• fever reducer
• rheumatoid arthritis
• osteoarthritis
• gout
• ankyloses
• spondilitis
• dysmenorrhea
• colon cancer
• niacin tolerability

Adverse:

• anti-uricosuric
• hepatic injury, high dose
• salicylate intoxication
• gastrointestinal
• cardiovascular
• renal
• NERD

Mechanism of Action:

• inhibit COX = inhibit prostaglandin, prostacyclin & thromboxane synthesis
• COX-1 inhibition = GI damage (gastric epithelial cells)
• COX-2 inhibition = anti-inflammatory actions (kidney & brain)

Question 2

Diclofenac
Ibuprofen
Indomethacin
Ketorolac
Naproxen
Piroxicam

Answer 2

Effect:
- Nonselective COX inhibitor

Use:

• rheumatoid arthritis
• osteoarthritis
• gout
• ankyloses
• spondilitis
• dysmenorrhea
• colon cancer
• niacin tolerability

Adverse:

• gastrointestinal
• cardiovascular
• renal
• NERD

Mechanism of Action:

• inhibit COX = inhibit prostaglandin, prostacyclin & thromboxane synthesis
• COX-1 inhibition = GI damage (gastric epithelial cells)
• COX-2 inhibition = anti-inflammatory actions (kidney & brain)

Ind. = Closure of ductus arteriosus

Question 3

Celecoxib
Meloxicam
Rofecoxib
Valdecoxib

Answer 3

Effect:
- COX-2 selective inhibitor

Use:

• rheumatoid arthritis
• osteoarthritis
• gout
• ankyloses
• spondilitis
• dysmenorrhea
• colon cancer
• niacin tolerability

Adverse:

• rash (celecoxib)
• gastrointestinal
• cardiovascular
• renal
• NERD

Mechanism of Action:

• inhibit COX = inhibit prostaglandin, prostacyclin & thromboxane synthesis
• COX-1 inhibition = GI damage (gastric epithelial cells)
• COX-2 inhibition = anti-inflammatory actions (kidney & brain)

Rof. & Val. = * WITHDRAWN *