Exam 4; Aspirin and NSAIDs Flashcards Preview

AU14 Pharmacology > Exam 4; Aspirin and NSAIDs > Flashcards

Flashcards in Exam 4; Aspirin and NSAIDs Deck (38):
1

What are the four major effects NSAIDs

analgesic
anti-pyretic
anti-inflammatory
anti-platelet (decrease in clotting

2

What is the clinical use for aspirin and NSAIDs at low doses

aches and pains
inhibition of clotting

3

What is the clinical use for aspirin and NSAIDs at high doses

pain/arthritis

4

What is the chemistry behind aspirin

salicylic acid + acetyl group → acetylsalicylic acid

5

What is the pharmacokinetics behind acetylsalicylic acid

its a weak acid that is more readily absorbed in a weak acid like the stomach)

6

acetylsalicylic acid is dissociated in the plasma to what, which can have what effects

into salicylic acid which strongly binds to plasma proteins which then can displace other proteins and drugs

7

What is the mechanism behind aspirin

it inhibits prostaglandin metabolism by inhibiting the enzyme cyclooxygenase

8

What are the two different types of cyclooxygenase that aspirin effects

COX1; all cells have this and it regulates prostaglandin synthesis
COX2; inflammatory cells have it which is responsible for the inflammation process

9

How does aspirin affect temperature

it lowers the temperature of a fever, but only in those with fever
may act in the CNS to counteract pyrogens

10

How does aspirin affect peripheral vasculature

may cause mild peripheral vasodilation

11

The use of aspirin to treat this is potentially very dangerous

viral infection in children; could cause Reye's syndrome

12

What is the mechanism behind the analgesic effect of aspirin

decrease PG production (which are neuromodullary and may regulate pain)
has both central and peripheral effects

13

What is the mechanism being the anti-inflammatory effect of aspirin

PGs serve as vital signs for inflammation, so decreasing them decreases the signs and may also decrease immune cell migration and activity

14

What is the mechanism behind the anti-clotting effects of aspirin

ASA causes irreversible inhibition of platelet COX preventing the synthesis of thromboxane

15

What is the lethal dose of aspirin in children

4gram or 12 regular aspirin

16

What is the lethal dose of aspirin in adults

20 grams or 50-60 regular aspirin

17

What results in death from an overdose of aspirin

severe pulmonary edema

18

Which side effects are the most common when taking aspirin

GI effects; salicylic acid is a direct irritant

19

What is the mechanism behind GI upset involving aspirin

decreased mucosal production in GI
decreased bicarbonate in the GI; no longer a counter mechanism of stomach acid

20

What are two CNS effects of aspirin

tinnitus
increase respiration rate

21

In which patients is aspirin contraindicated

in patients with clotting deficiencies

22

Aspirin has a direct effect on which part of the eye

the iris, it reduces mitosis that occurs during and after eye surgery

23

How does aspirin affect the kidney

decreased kidney perfusion

24

True or False
Aspirin does not cause hypersensitivity reactions

False, it does

25

Aspirin causes this in pregnant women

inhibits labor, prolonging gestation

26

Aspirin can cause this, especially with patients with nasal polyps

bronchospasms

27

Which drug is not a NSAID because it has no anti-inflammatory or anti-platelet effects

acetaminophen

28

An OD of acetaminophen (20-30) tablets can cause what

irreversible liver damage

29

What is the mechanism behind acetaminophoen affecting the liver

most common cause of acute liver failure
reduces glutathione in the liver
will confound with an already damaged liver (like in alcoholics)

30

Which drug family are the NSAIDs

propionic acid derivatives; ibuprofen and the other "pro's"
naproxyn
fenoprofen
ketoprofen
flurbiprofen
oxaprozin
suprofen

31

What are the three NSAIDs that are acetic acid derivatives

Indomethacin
tolmetin
sulindac

32

What is the mechanism behind Indomethacin

very potent COX inhibitor

33

What are the side effects of indomethacin

thrombocytopenia
corneal opacities
plastic edema

34

What are side other NSAIDs

pyroxicam
disclofenac
bromfenac
nepafenac
etodolac
nabumeone

35

This is a selective COX2 inhibitor

celecoxib

36

What is celecoxib used to help prevent

helps prevent the GI upset that aspirin usually cause

37

2 similar drugs to celecoxib have been pulled from the market, why?

may cause in increase in MI and stroke

38

All NSAIDs at high enough doses may have what

similar effects