NSAIDS 2 Flashcards

1
Q

What is the name of Aspirin?

A

ASA

Acetylsalicylic acid

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2
Q

7 uses of aspirin?

A
Anaglesia
Anti-inflammatory 
Anti-pyuretic
MI prophylaxis
Colon Cancer
Uricosuria prophylaxis
Anticoagulation
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3
Q

What is uricosuria?

A

an agent that cause excretion of uric acid, so inhibits gout at HIGH doses only

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4
Q

What dose of aspirin for gout prophylaxis?

A

5mg/day

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5
Q

What are the 3 contraindications for aspirin use?

A
  • Bleeding disorders
  • Tartrazine (yellow) dye allergy
  • ASA syndrome
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6
Q

What is ASA syndrome?

A

Asthma
Angioedema
Nasal polyps

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7
Q

Use ASA cautiously in patients with what GI disease? Why?

A

Peptic Ulcer Disease

  • Reduced mucosal blood flow
  • Anticoagulation
  • High acidity
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8
Q

Who should NOT receive aspirin?

A

patients under 16 for Variecella or flu-like syndrome due to risk of Rye Syndrome

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9
Q

What is Rye Syndrome?

A

encephalitis, seizures, death

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10
Q

Use ASA cautiously in patients with what organ issues?

A

Renal disease

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11
Q

Adverse effects of ASA?

A

GI upset

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12
Q

Signs of ASA overdose?

A

Tinnitus

Metabolic Acidosis

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13
Q

Treatment of ASA overdose?

A

Done Nomogram

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14
Q

Why does tinnitus occur?

A

Arachadonic acid causes toxicity to the auditory nerve

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15
Q

What is buffered ASA?

A

high in sodium, acidity buffered down and pH increased. Less harsh on the stomach

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16
Q

What is enteric coated ASA?

A

Film that dissolves in basic media, delaying ASA release until the med reaches the duodenum (higher pH). Less harsh on the stomach

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17
Q

Patients on ASA should monitor what?

A

Gum bleeding

Bruising

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18
Q

How can you reduce ASA side effects?

A

Food may decrease GI irritation

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19
Q

Pregnancy risk factor and ASA?

A

X, premature closure of ductus arteriosis

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20
Q

Which NSAIDS are GI friendly?

A
  • Celecoxib (most)
  • Nabumetone
  • Meloxicam
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21
Q

Why is Nabumetone special? (2 reasons)

A

Less GI distress, non-acidic

May compete with Cox-II selective NSAID

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22
Q

Why is Oxaprozin special?

A

Long half life, good for rheumatoid & osteoarthritis. Caution in elderly though (it can accumulate and they have bad kidneys)

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23
Q

What is Arthrotec? Pregnancy risk?

A

Diclofenac + Misoprostol

NSAID + mucus secreting agent

PREGANCY X

24
Q

What is the main use for Naproxen?

A

musculoskeletal injuries

25
Q

Name the NSAID that starts with E

A

Etodolac

26
Q

What is the main use of Indomethacin

A

IV dosage for closure of patent ductus arterioles

27
Q

What forms does Ibuprofen come in?

A

IV PO

OTC RX

28
Q

What is the Ibuprofen IV called?

A

Ibuprofen Lysine

Caldolor

29
Q

What is the ibuprofen Lysine used for?

A

close PDA in premature babies

30
Q

What is Caldolor used for?

A

Analgesia

Anti-pyretic

31
Q

What are the IV pain NSAIDS?

A

Caldolor

Ketorloac

32
Q

What are the IV anti-pyretics?

A

Caldolor

33
Q

Why is Ketorloac special?

A

Low grade narcotic

Renal & GI toxic, so maximum 5 day therapy

34
Q

What is the Adverse Effect of Indomethacin?

A

Severe frontal lobe headaches

35
Q

Who should use Sulindac?

A

Really compromised patients

36
Q

Why is Piroxicam special?

A

Long half life

NOT good in elderly patients

37
Q

Why is Meloxicam is specia?

A

Long T1/2

Most Cox-II selectiveof the non-selectives

38
Q

Name the NSAID that starts with K

A

Ketoprofen

39
Q

Name the selective NSAIDS

A

Celecoxib
Rofecoxib
Valdecoxib

40
Q

These selective NSAIDS select for what?

A

COX-II

41
Q

Use with caution in patients with what for celecoxib?

A

Sulfa allergies, contains a sulfa-moiety

42
Q

Who should not be prescribed Celecoxib

A

History of MI / unstable angina

43
Q

What is the brand name of Celecoxib?

A

Celebrex

44
Q

Why cardiac issues with cox-II specific NSAIDS?

A
  • Procoagulant

- Inhibit angiogenesis (so unable to bypass clotts)

45
Q

Who MAY benefit from cox-II specific NSAIDS?

A

cancer patients (tumors need blood supply)

46
Q

Acetaminophen is also called what acronym?

A

APAP

47
Q

What is APAP?

A

active metabolite of phenacetin

48
Q

Why was phenacetin pulled?

A

Too much met-hemoglobinemia (Hgb can’t carry O2)

49
Q

What is the philicty of APAP? Why is this important?

A

Lipophilic

Highly CNS specific with little effects on the periphery

50
Q

Indications for APAP?

A

HA

Fever

51
Q

How does APAP effect platelets?

A

It does not

52
Q

What does APAP interact with?

A

Alcohol

53
Q

How is APAP metabolized?

A

Liver

54
Q

How do you grade APAP toxicity?

A

Rumack- Matthew Nomogram

55
Q

APAP toxicity antidote?

A

N-Acetylcysteine (Mucomyst)

56
Q

Why give Mucomyst before contrast dyes?

A

Dyes = oxidative stress = nephrotoxicity, mucomyst protects renal (anti-oxidant)

57
Q

Why not use leukotriene receptor blockers for angioedema?

A

Only come PO and pt can’t swallow