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Pharmacyology 3 > NSAIDs > Flashcards

NSAIDs Flashcards

1
Q

Propionic acid derivatives

A

ibuprofen

naproxen

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2
Q

Ibuprofen/naproxen uses

A
  • analgesic
  • anti-pyretic
  • anti-inflammatory
  • fewer side effects than aspirin, less toxic
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3
Q

Ibuprofen/naproxen inhibition

A

reversible and competitive only

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4
Q

ibuprofen/naproxen has specific approval for what?

A

dysmenorrhea

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5
Q

Adverse effects of ibuprofen/naproxen

A
  • GI similar to aspirin (less severe, more potent, lower dose)
  • prolong bleeding (short term)
  • high albumin binding
  • cross sensitivity
  • prevent low dose aspirin from exerting anti-platelet effects
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6
Q

ibuprofen/naproxen is ___% protein binding

A

98%

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7
Q

Ibuprofen/naproxen and aspirin

A

take 8 hr before or 30 min after taking low dose aspirin

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8
Q

All NSAIDs can cause what?

A

renal toxicity/failure

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9
Q

Ibuprofen/naproxen toxicity

A
  • tinnitus
  • N/V
  • GI bleeding
  • lethargy
  • seizures
  • coma
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10
Q

Treatment of OD ibuprofen/naproxen

A
  • activated charcoal first 2 hr
  • supportive therapy
  • monitor respirations
  • urine alkalization not effective! (because protein bound)
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11
Q

Low dose ibuprofen use

A

analgesia/anti-pyresis

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12
Q

high dose ibuprofen use

A

anti-inflammatory

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13
Q

Ibuprofen specifically approved for

A

patent ductus arteriosus

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14
Q

Naproxen additional approvals

A

Gout

migraine

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15
Q

Acetic acid derivatives

A

indomethacin

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16
Q

Indomethacin is ___ more potent than aspirin

A

10-20x

17
Q

indomethacin use

A
  • limited use for analgesia and antipyresis

- Severe inflammation (RA, gouty arthritis)

18
Q

indomethacin side effects

A
  • severe HA, vertigo, confusion
  • seizures
  • serious GI problems
19
Q

Selective COX2 inhibitor

A

Celecoxib

20
Q

Most inflammation effects are due to ___

A

COX2

21
Q

Celecoxib is equal to naproxen for what?

A

osteoarthritis and RA

22
Q

Celecoxib is poorer than naproxen for what?

A

acute pain

23
Q

DI celecoxib

A
  • may inhibit CYP2D6

- slow metabolism of tricyclic and SSRI

24
Q

Adverse effects of celecoxib

A
  • edema
  • GI (less than with ibu/nap)
  • increased risk of MI
25
Q

Who cannot use celecoxib?

A

allergy to sulfonamides

pregnancy

26
Q

Components of MI risk in celecoxib

A
  • TX/PGI imbalance

- inhibition of renal COX and loss of renal PG

27
Q

BBW celecoxib and all NSAIDs

A

MI risk

28
Q

COX2 inhibitors increase what?

A

Tx
platelet aggregation
risk of thrombosis, MI,storke

29
Q

APAP

A

acetyl para-amino phenol

30
Q

How dose APAP work?

A

don’t know!

inhibit COX and PG synthesis

31
Q

APAP used for

A

analgesic
antipyresis
- CNS for relaxation, drowsiness, euphoria

***no anti-inflammatory

32
Q

APAP side effects vs aspirin

A
  • No GI effects
  • No hematologic effects
  • No CV effects
  • No respiratory effects
  • No acid/base effects
  • No association with Reye’s
33
Q

What is used in place of aspirin in children?

A

APAP

34
Q

Max of APAP recommended

A

4g/day

35
Q

Adverse effects of APAP

A
  • cross sensitivity with aspirin
  • hepatic damage!!
  • alcohol increase liver damage
  • skin rash, drug fever
  • chronic abuse –> nephrotoxicity
36
Q

OD toxicity APAP

A
  • GI distress: 24h
  • hepatotoxicity: usually reversible
  • jaundice 24-48h
37
Q

High APAP depletes ____

A

glucuronic acid

- hepatotoxicity

38
Q

Treatment OD APAP

A
  • supportive therapy
  • remove drug promptly (charcoal 4hr)
  • vomiting/gastric lavage (4h)
  • after 4 hour: N-acetyl-cysteine
  • time and concentration dependent windows
39
Q

N-acetyl-cysteine

A
  • reverse toxicity
  • restore endogenous glutathione
  • react with NAPQI (AC*) toxic metabolite

Pharmacyology 3 (12 decks)

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