Flashcards in Analgesics Deck (103)
Prostaglandins mediate what?
Local inflammatory mediators
PGE2 sensitizes what?
Nerve endings to the action of bradykinin, histamine, and other chemical mediators
All NSIDs act how?
By inhibiting the synthesis of prostaglandins
What are the two conventional NSAIDs?
What is the "other" NSAID?
What is the life cycle of platelets?
Why is it best to discontinue NSAIDs for 2 weeks before surgery?
NSAIDs kill off platelets, so you need to allow them to regenerate before surgery
What dose of ASA is needed for analgesia?
What dose of ASA is needed for anti-pyretic?
What dose of ASA is needed for anti-inflammatory?
What dosing of ASA will kill platelets?
How/why does ASA kill platelets?
Causes irreversible inhibition of COX-1(TXA2) for the life of the platelets
What two benefits does Acetaminophen have over ASA?
No GI effects
Safe in pregnancy
What two disadvantages does Acetaminophen have compared to ASA?
No inflammatory control
No platelet inhibition (may not be an advantage...)
What is the MOA of Aspirin?
Irreversibly, non-selectively inhibits COX, reducing PG and TXA2 synthesis
What are the two common adverse effects of Aspirin?
Bleeding time doubles
What is the one hypersensitivity reaction to Aspirin?
What conditions cause Reye's Syndrome?
A child with a fever from an active viral infection taking Aspirin
What three things occur in Reye's Syndrome?
What is the rate of mortality in Reye's Syndrome?
Reye's Syndrome can occur in kids up to about what age?
Aspirin reacts with what three groups of drugs?
1. Ophthalmic/oral NSAIDS and Omega-3s
2. Aectaminophen and Cyclosporine
What is the result of an Aspirin and NSAID/Omega-3 interaction?
Hemorrhage risk - additive
What is the result of an Aspirin and Acetaminophen/cyclosporine interaction?
Nephrotoxicity - additive
What is the result of an Aspirin and Steroid interaction?
GI toxicity - additive
What are the 5 contraindications associated with Aspirin?
2.Pregnancy, esp. 3rd trimester
3. Corneal denervation/dry eye
4. NSAID/ASA induced asthma
5. Chronic GIT inflammation/active peptic ulcer
What are the two indications for Acetaminophen?
What is the MOA of Acetaminophen for the analgesic effect?
Inhibits COX and enhances 5-HT release
What is the MOA of Acetaminophen for the antipyretic effect?
Acts centrally at the hypothalamus by inhibiting PG synthetase