Inflammatory Drugs

Question 1

Mechanism of acetaminophen

Answer 1

reversibly inhibits cyclooxygenase, mostly in CNS, inactivated peripherally

Question 2

Use of acetaminophen

Answer 2

antipyretic, analgesic, NOT anti-inflammatory

use instead of aspirin in CHILDREN

Question 3

Toxicity of acetaminophen

Answer 3

Hepatic necrosis due to overdose

NAPQI is toxic metabolite that depletes glutathione stores

Question 4

Antidote to acetaminophen overdose

Answer 4

N-acetylcysteine which regenerates the glutathione stores

Question 5

Mechanism of aspirin

Answer 5

irreversibly inhibits cyclooxygenase (1 and 2) via acetylation
decreases synthesis of TXA2 (increase bleeding time) and prostaglandins

increased bleeding time but NO effect on PT or PTT

Question 6

Toxicity of aspirin

Answer 6

gastric ulceration, tinnitus (CN VIII)

chronic use: acute renal failure, interstitial nephritis, GI bleeding

cause respiratory alkalosis early, transitions to mixed metabolic acidosis-respiratory alkalosis

Question 7

Toxicity of aspirin in CHILDREN

Answer 7

REYE syndrome in children treated with aspirin for viral infection

Question 8

Mechanism of celecoxib

Answer 8

reversibly inhibits COX-2 found in inflammatory cells, vascular endothelium

Question 9

Use of celecoxib

Answer 9

analgesic and anti-inflammatory

rheumatoid arthritis, osteoarthritis

Question 10

Benefit of COX2 specific versus non-selective

Answer 10

spares COX1 thus:

• able to maintain gastric mucosa
• platelet function intact

Question 11

Toxicity of celecoxib

Answer 11

increased risk of thrombosis, sulfa allergy

Question 12

Name the NSAIDs

Answer 12

ibuprofen, naproxen, indomethacin, ketorolac, diclofenac

Question 13

Mechanism of NSAIDs

Answer 13

reversibly inhibits cyclooxygenase (1 and 2)

blocks prostaglandin synthesis

Question 14

Use of NSAIDs

Answer 14

antipyretic, anti-inflammatory, analgesic

Question 15

Specific use of indomethacin

Answer 15

to close the PDA

Question 16

Toxicity of NSAIDs

Answer 16

interstitial nephritis
gastric ulcer (prostaglandins protect gastric mucosa)
renal ischemia (prostaglandins dilate afferent arterioles)

Question 17

Use of aspirin

Answer 17

low dose for decreased platelet activity
intermediate dose for anti-pyretic and analgesic
high dose for anti-inflammatory