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Pharmacology > Exam 4 - Non-opioid analgesics and anti-inflammatories > Flashcards

Exam 4 - Non-opioid analgesics and anti-inflammatories Flashcards

1
Q

Which non-opioid inhibits cyclooxygenase so prostaglandins cannot be formed and is sensitize to pain receptors to substances such as bradykinin. Also it is more effective if given before painful stimuli.

A

Aspirin - ASA - acetylsalicylic acid

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2
Q

Which non-opioid works on COX 3 in the CNS?

A

Acetaminophen

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3
Q

What 5 things does acetaminophen NOT do?

A
  1. Not anti-inflammatory
  2. Inhibit platelet aggregation (not an anticoagulant)
  3. Irritate the GI tract
  4. Cause bronchoconstriction
  5. No effect on uric acid
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4
Q

NSAIDs inhibit what 3 things?

A
  1. Inhibit prostaglandin synthesis
  2. Inhibit cyclooxygenase so that prostaglandins are not formed
  3. Inhibits cytoprotective PG as well as PG associated with inflammation
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5
Q

What are the selective/non-selective enzymes affected in NSAIDs?

A

Non-selective: COX-1 / COX-2

Selective: COX2

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6
Q

What 3 things are an indication of use for Aspirin?

A
  1. Fever
  2. salicylate for analgesia
  3. throbbing pain (due to inflammation)
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7
Q

Acetaminophen and aspirin are equally ______ and ______, but acetaminophen is less useful clinically bc it is not ____________. Acetaminophen also has no effect on ___ acid and no ______ effects

A 
efficacious
potent
anti-inflammatory
uric
anticoagulant
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8
Q

3 dental uses for NSAIDs and 5 medical uses for NSAIDs

A

Dental: pain(analgesic), fever(antipyretic), inflammation (anti-inflammatory)
Medical: osteoarthritis, RA, gouty arthritis, fever, dysmenorrhea, pain

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9
Q

5 clinical effects of Aspirin

A
  1. Analgesic (mild to mod.)
  2. Antipyretic (fever reduction- vasodilation and sweating)
  3. Anti-inflammatory -decreased erythema and swelling (ALL DENTAL PAIN)
  4. Uricosuric
  5. Antiplatelet - irreversible for life of platelet (7-10days)
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10
Q

How does high/low doses of Aspirin affect uric acid?

A 
High doses (3+g/day) = excretion of uric acid in urine (tx for gout)
Low doses (<1g/day) = uric acid retention (take probenecid to excrete uric acid/aspirin antagonizes)
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11
Q

At what dose does aspirin reduce the risk for clots?

A

81 mg

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12
Q

What are 6 general adverse side effects of aspirin?

A
  1. GI problems
  2. Bleeding
  3. Reye’s syndrome (with viral infections)
  4. Salicylism (6-10 g in adults)
  5. Hypersensitivity/allergic reactions
  6. Aspirin burn
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13
Q

What happens in Aspirin poisoning or salicylism?

A

confusion, tinnitus, dizziness, nausea, vomiting, headache, dimness of vision, hyperthermia, hyperventilation, respiratory alkalosis, renal loss of bicarb -> respiratory and metabolic acidosis -> death

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14
Q

How does aspirin affect bleeding?

A

Causes irreversible effect on platelets by reducing platelet adhesiveness/aggregation interfering with ADP which inhibits production of prothrombin causing hypoprothrombinemia

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15
Q

What are the 2 major adverse side effects of acetaminophen?

A
  1. hepatoxic

2. Increased bleeding (INR)

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16
Q

What 4 groups of people is acetaminophen contraindicated in?

A
  1. liver disease or dysfunction
  2. patients treated with drugs that are dependent of liver function
  3. alcoholics
  4. patients on warfarin
17
Q

What are 10 general side effects of NSAIDs?

A
  1. Reversible effect on blood platelets
  2. Increased risk of MI/stroke
  3. Hypertension
  4. Compromised rental function
  5. GI complications (bleeding/perforation)
  6. CNS complications
  7. Skin reactions
  8. Respiratory complications (do not use if asthmatic)
  9. Hypersensitivity
  10. Kidney damage
18
Q

How do NSAIDs affect the kidney?

A

inhibiting prostaglandins shuts down renal blood flow -> renal necrosis. (short term ok)

19
Q

Whats the dose of NSAIDs that gives anti-inflammatory effects?

A

3500 mg - for pain and arthritis. (Difficult bc chronically will lead to GI ulceration/bleeding)

20
Q

Whats the optimal analgesia dose of ibuprofen to relieve dental pain?

A

400 mg

21
Q

Whats the optimal analgesia dose of ibuprofen to chronic inflammatory pain?

A

400-800 mg 4x/day NOT exceeding 3200 mg - takes days/weeks to reach anti-inflammatory effects

22
Q

Which non-opioid analgesic gives up to 7 hours of pain relief?

A

naproxen (inflammatory dosing: less than 12 hours, peaks after 2 weeks)

Pharmacology (10 decks)

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