NSAID I Flashcards
(31 cards)
Arachadonic acid is converted via what 2 pathways? What are the products?
Cyclooxygenase (COX) 1,2 - PGs
Lipoxygenase (LO) - Leukotrienes, Histamine, Bradykinin
PGs keep things _____.
open
What are leukotrienes, histamine and bradykinins mediators of?
inflammation
what does NSAID stand for?
non-steroidal anti-inflammatory drug
99.9% of NSAIDs work how?
Block COX 1,2 pathway. Inhibits PG formation.
COX1 is primarily in the ________. COX2 is primarily in the ______.
Stomach
Periphery
When you take NSAIDs for pain, what is the downside? (Simply)
They also inhibit mucus production in the pathway because they block the COX1 pathway (stomach) too and can cause ulcerations.
What is a weird thing that MAY happen in SOME people when they takes NSAIDs? What do these people call this effect?
You could shunt all of the AA down the LO pathway and create greater levels of leukotrienes, histamine, bradykinin.
“NSAID allergy”.
Why is an NSAID allergy not really an allergy?
because there are no Abs involved here. just a shunting of chemicals.
What is the typical reaction when people report NSAID allergy? what other condition is typically present, and why is this not shocking?
Angioedema from the inflammatory chemicals (tx-Epi).
Asthma - asthmatics overproduce leukotrienes (which is one of the inflammatory chemicals).
What other drug causes angioedema? Why?
ACE inhibitor that causes an over production of bradykinin.
NSAIDs are arranged by _____. They are very _____ _____.
families
Person-specific.
What are the 6 families?
- Propionic Acids
- Acetic Acid
- Fenamates (Anthranilic Acid)
- Oxicams
- Salicylic Acid
- Non-Acidic Agens
What are the NSAID indications (5)?
- Arthritic dz
- Gout
- HA
- Pain syndromes
- Chemotherapy adjunct
What are the 3 effects of NSAIDs?
Anti-inflammatory
Antipyretic (only if you have fever)
Analgesic
Why is ASA the best anticoagulant? How little is required?
It IRREVERSIBLY inhibits platelet aggregation for the life of the platelet.
If we had a choice, we would want all NSAIDs to block only COX__.
2 - the periphery
Acetaminophen is very specific for the _____ NS…meaning it is highly ___philic, and a good/crappy peripheral anti-inflammatory agent and an excellent/crappy HA and fever reducer.
central
lipophilic
crappy peripheral anti-inflammatory agent
excellent HA and fever reduver
What is the abbreviation for acetaminophen?
APAP - para-acetylaminophenol
Is Tylenol a good anticoagulant?
NO.
In general, NSAIDS are not/highly PPB.
HIGHLY!
LT antagonists have most effects on the ______ system.
pulmonary
How do Corticosteroids work? This makes them slightly/highly potent?
Modulate genes that code for inflammatory cytokines and interleukins. They block BOTH COX and LO pathways.
HIGHLY POTENT
What is the connection with NSAIDs and renal disease? HTN?
NSAIDs block PGs. PGs hold the afferent arteriole open and increase filtration. So, NSAIDS will make renal dz worse by closing the afferent arteriole and decreasing renal blood flow/GFR/CrCl. This will cause the body to retain Na/water and worsen HTN as well.
