analgesic- antipyretic-anti-inflm and related drugs

Question 1

what conditions are treated by ANA, NSAIDS, and acetaminophen?

Answer 1

Bursitis
Dysmenorrhea
Fibromyalgia
Gout
Migraine
Osteoarthritis
RA
Juvenile RA

Question 2

what are some Analgesic–antipyretic–anti-inflammatory drug group

Answer 2

ASA, NSAIDS, tylenol, drugs used to prevent or treat gout and migraines

Question 3

NSAIDs are very hard on what organ?

Answer 3

the kidneys

Question 4

what is COX 1?

Answer 4

enzyme that stimulates physiologic prostaglandins. Gi protection, renal protection, relaxes smooth muscle tone and regulates prlatelet aggregation

Question 5

what is COX 2?

Answer 5

enzyme that stimulates pathologic prostaglandins causing inflm and leukocytosis, activation of white blood cells to release inflm cytokines

Question 6

where do nonselective and selective NSAIDs inhibit?

Answer 6

selective- COX 2

nonselective- COX 1

Question 7

what is primary dysmenorrhea?

Answer 7

most common type of dysmenorrhea that is due to the production of prostaglandins -causing uterine contractions. If excessive prostaglandins are produced, the woman may have excessive pain or dysmenorrhea with her menstrual cycle. Prostaglandins can also cause headaches, nausea, vomiting and diarrhea.

Question 8

treatment for dysmenorrhea?

Answer 8

NSAIDs (prostaglandin inhibitor) and extended cycle oral contraceptive (prevents excessive growth of uterine lining)

Question 9

Medication for dysmenorrhea may involve two complementary strategies: ______

Answer 9

decreasing prostaglandin production and hormonal alteration

Question 10

what is the half life of NSAIDs generally?

Answer 10

can range from 1-12 hours

Question 11

are NSAIDS heavily bound to plasma proteins? what %?

Answer 11

yes. 60-90%

Question 12

virtually all NSAIDS can cause __ and __

Answer 12

dyspepsia (stomach upset) and GI toxicity including ulceration.

Question 13

all except that nonactylated salicilates can effect what hemodynamically?

Answer 13

bleeding time. reversible except for aspirin which lasts to life oft he platelet.

Question 14

COX 1 is formed in ___

Answer 14

all tissues and cells, especially platelets, endothelial cells, GI tract, and kidneys

Question 15

COX -2 is present ___

Answer 15

brain, bone, kidneys, GI tract and female reproductive system

Question 16

what kinds of meds effectively block prostaglandin formation?

Answer 16

Aspirin, NSAIDs and acetaminophen inactivate cyclooxygenases,

Question 17

MOA of aspirin?

Answer 17

Acts both centrally and peripherally to block pain impulses
Act on hypothalamus to decrease temperature and reset thermostat
Prevents prostaglandins from increasing pain and edema
Antiplatelet effects by preventing synthesis of throboxane A2

Question 18

MOA of NSAIDS?

Answer 18

Act peripherally to block pain impulses
Act on hypothalamus to decrease temperature and reset thermostat
Prevents prostaglandins from increasing pain and edema
Antiplatelet effects bind reversibly with platelet COX-1 (shorter acting than aspirin)

Question 19

indications for use of NSAIDS and aspirin?

Answer 19

Treat mild-moderate pain (may be combined with oral opioid)
Anti-inflammatory
Antipyretic
Antiplatelet - low dose cardioprotective
Celecoxib used to treat familial adenomatous polyposis
NSAIDs may be used for eye disorders – (but can cause dry eye)

Question 20

contraindications for NSAIDS and aspirin?

Answer 20

GI disorders
Hypersensitivity
Renal disease
Aspirin is contraindicated for children in presence of viral infection due to association with Reye’s Syndrome
Celecoxib contraindicated if allergic to sulfonamides

Question 21

example of propionic acid derivative?

Answer 21

ibuprogen

Question 22

example of acetic acid derivative? SE of these?

Answer 22

indomethacin (induced) and sulindac (clinoril). Potentially serious adverse effects include GI ulcer-ation, bone marrow depression, hemolytic anemia, mental con-fusion, depression, and psychosis.

Question 23

what are some concerns reg: Celebrex?

Answer 23

concerns about iincreased risk of adverse cardiovascular events such as MI and stroke with COX-2 inhibitors.

Question 24

what are some drugs used to treat gout and hyperuricemia?

Answer 24

Allopurinol (Zyloprim)
Colchicine
Probenecid (Benemid)
Sulfinpyrazone (Anturan)

Question 25

drugs to treat migraines?

Answer 25

triptans, ergot preparations

Question 26

what are ergotamines

Answer 26

they narrow and constrict blood vessels in the brain. not clear on how it stops migraines.

Question 27

when is ergotamine contraindicated?

Answer 27

ischemic heart disease, pregnant or breastfeeding

Question 28

what is feverfew?

Answer 28

natural health product used for migraines

Question 29

what is the only drug of choice for pain or fever in children?

Answer 29

tylenol

Question 30

use in older adults- things to watch out for?

Answer 30

higher incidence of OA, watch for GI bleeding, dose carefully

Question 31

use in pt with renal impairment- things to look out for?

Answer 31

Acetaminophen, ASA, and other NSAIDs can cause or aggravate renal impairment

Question 32

use in pt with hepatic impairment- things to watch out for?

Answer 32

the effects of NSAIDs on liver function and the effects of hepatic impairment on most NSAIDs are largely unknown, dose carefully