E2: NSAIDS Flashcards
(40 cards)
What are the 5 mediators of acute inflammation?
Histamine, serotonin, bradykinin, PGs, and leukotrienes
What role does histamine play in acute inflammation?
Vasodilation and increase vascular permeability
**strong vascular permeability
What role does serotonin play in acute inflammation?
- some vasodilation
- increase vascular permeability
What role does bradykinin play in acute inflammation?
Vasodilation, increase vascular permeability, and pain
**most response for pain response
What role do prostaglandins play in acute inflammation?
Vasodilation, increase vascular permeability, chemotaxis, and pain
**strong vasodilation and chemotaxis
What role do leukotrienes play in acute inflammation?
Increase vascular permeability and chemotaxis, both strong
What are the 3 things that cyclooxygenase may produce?
PGs, thromboxane, and prostacyclin
What is the MOA of Aspirin?
No selective, irreversible inhibitor of COX1 and COX2
Which COX enzyme is inducible?
COX2: produces prostacyclin
** COX1 is not inducible and produces thromboxane
Does aspirin cross the placental and BBB?
Readily crosses the placental barrier and slowly crosses the BBB
What are the 4 main effects of aspirin?
Analgesia
Antipyretic
Anti inflammatory
Antiplatelet
What are the uses of aspirin?
- Mild to moderate pain
- antipyretic
- anti inflammatory
- MI and thrombosis prophylaxis
- Long term use decreases colon cancer
What are the adverse effects of aspirin?
-Respiratory alkalosis, then metabolic and respiratory acidosis
Aspirin should be avoided in patients with what conditions?
- Hypoprothrombinemia
- vitamins K deficiency
- hemophilia
- severe hepatic damage
- PUD
What effect does aspirin have on Uric acid?
- Low doses of aspirin actually decreases uric acid excretion and elevates plasma urate concentration
- at large doses aspirin enhances uric acid and lowers the plasma urate levels
Why should you avoid aspirin in asthmatics?
-it can cause aspirin asthma due to increased leukotriene synthesis (which causes bronchoconstriction)
What are the adverse effects of aspirin on the kidneys?
-Renal damage, acute renal failure, interstitial nephritis
Why should aspirin be avoided in children?
-Risk of Reye’s syndrome (cerebral edema in children with viral infection, give Tylenol)
What are the general effects of nonecetylated salicylates?
- Effecitve anti-inflammatory
- salicylic acid is the active drug
- Less effective analgesics than aspirin and no irreversible COX inhibition
What is the MOA of NSAIDs?
- Specific reversible inhibitors of COX2 enzymes
- Nonspecific reversible inhibitors of COX1 and COX2 enzymes
What kind of drug is Celecoxib?
An NSAID that is a selective and reversible COX2 inhibitor
-Has the potential to cause less gastropathy and risk of GI bleeding, since GI protective PGs are produced by COX1
What are the adverse effects of Celecoxib?
GI disturbances including ulceration and bleeding, increased risk of CVD
What are the contraindications of Celecoxib?
GI disease, asthma, breast feeding, pregnancy, renal failure
What is the MOA of ibuprofen?
Nonspecific reversible inhibitors of COX1 and COX2
