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Flashcards in Analgesics Deck (103)
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1

Prostaglandins mediate what?

Local inflammatory mediators

2

PGE2 sensitizes what?

Nerve endings to the action of bradykinin, histamine, and other chemical mediators

3

All NSIDs act how?

By inhibiting the synthesis of prostaglandins

4

What are the two conventional NSAIDs?

Acetylsalicylic Acid
Celecoxib

5

What is the "other" NSAID?

Acetaminophen

6

What is the life cycle of platelets?

7-10 days

7

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

8

What dose of ASA is needed for analgesia?

160-325mg

9

What dose of ASA is needed for anti-pyretic?

160-325mg

10

What dose of ASA is needed for anti-inflammatory?

325-650mg

11

What dosing of ASA will kill platelets?

80-160mg

12

How/why does ASA kill platelets?

Causes irreversible inhibition of COX-1(TXA2) for the life of the platelets

13

What two benefits does Acetaminophen have over ASA?

No GI effects
Safe in pregnancy

14

What two disadvantages does Acetaminophen have compared to ASA?

No inflammatory control
No platelet inhibition (may not be an advantage...)

15

What is the MOA of Aspirin?

Irreversibly, non-selectively inhibits COX, reducing PG and TXA2 synthesis

16

What are the two common adverse effects of Aspirin?

Bleeding time doubles
Headache

17

What is the one hypersensitivity reaction to Aspirin?

Angioedema

18

What conditions cause Reye's Syndrome?

A child with a fever from an active viral infection taking Aspirin

19

What three things occur in Reye's Syndrome?

GI disturbances
Liver Degeneration
Encephalopathy

20

What is the rate of mortality in Reye's Syndrome?

35%

21

Reye's Syndrome can occur in kids up to about what age?

15

22

Aspirin reacts with what three groups of drugs?

1. Ophthalmic/oral NSAIDS and Omega-3s
2. Aectaminophen and Cyclosporine
3. Steroids

23

What is the result of an Aspirin and NSAID/Omega-3 interaction?

Hemorrhage risk - additive

24

What is the result of an Aspirin and Acetaminophen/cyclosporine interaction?

Nephrotoxicity - additive

25

What is the result of an Aspirin and Steroid interaction?

GI toxicity - additive

26

What are the 5 contraindications associated with Aspirin?

1.Hemorrhagic disorders
2.Pregnancy, esp. 3rd trimester
3. Corneal denervation/dry eye
4. NSAID/ASA induced asthma
5. Chronic GIT inflammation/active peptic ulcer

27

What are the two indications for Acetaminophen?

Mild pain
Fever

28

What is the MOA of Acetaminophen for the analgesic effect?

Inhibits COX and enhances 5-HT release

29

What is the MOA of Acetaminophen for the antipyretic effect?

Acts centrally at the hypothalamus by inhibiting PG synthetase

30

Acetaminophen only inhibits inflammation where?

Centrally - not peripherally