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Pharm test 3 > NSAID I > Flashcards

NSAID I Flashcards

1
Q

Arachadonic acid is converted via what 2 pathways? What are the products?

A

Cyclooxygenase (COX) 1,2 - PGs

Lipoxygenase (LO) - Leukotrienes, Histamine, Bradykinin

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2
Q

PGs keep things _____.

A

open

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3
Q

What are leukotrienes, histamine and bradykinins mediators of?

A

inflammation

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4
Q

what does NSAID stand for?

A

non-steroidal anti-inflammatory drug

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5
Q

99.9% of NSAIDs work how?

A

Block COX 1,2 pathway. Inhibits PG formation.

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6
Q

COX1 is primarily in the ________. COX2 is primarily in the ______.

A

Stomach

Periphery

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7
Q

When you take NSAIDs for pain, what is the downside? (Simply)

A

They also inhibit mucus production in the pathway because they block the COX1 pathway (stomach) too and can cause ulcerations.

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8
Q

What is a weird thing that MAY happen in SOME people when they takes NSAIDs? What do these people call this effect?

A

You could shunt all of the AA down the LO pathway and create greater levels of leukotrienes, histamine, bradykinin.
“NSAID allergy”.

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9
Q

Why is an NSAID allergy not really an allergy?

A

because there are no Abs involved here. just a shunting of chemicals.

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10
Q

What is the typical reaction when people report NSAID allergy? what other condition is typically present, and why is this not shocking?

A

Angioedema from the inflammatory chemicals (tx-Epi).

Asthma - asthmatics overproduce leukotrienes (which is one of the inflammatory chemicals).

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11
Q

What other drug causes angioedema? Why?

A

ACE inhibitor that causes an over production of bradykinin.

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12
Q

NSAIDs are arranged by _____. They are very _____ _____.

A

families

Person-specific.

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13
Q

What are the 6 families?

A
  1. Propionic Acids
  2. Acetic Acid
  3. Fenamates (Anthranilic Acid)
  4. Oxicams
  5. Salicylic Acid
  6. Non-Acidic Agens
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14
Q

What are the NSAID indications (5)?

A
  1. Arthritic dz
  2. Gout
  3. HA
  4. Pain syndromes
  5. Chemotherapy adjunct
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15
Q

What are the 3 effects of NSAIDs?

A

Anti-inflammatory
Antipyretic (only if you have fever)
Analgesic

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16
Q

Why is ASA the best anticoagulant? How little is required?

A

It IRREVERSIBLY inhibits platelet aggregation for the life of the platelet.

17
Q

If we had a choice, we would want all NSAIDs to block only COX__.

A

2 - the periphery

18
Q

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.

A

central
lipophilic
crappy peripheral anti-inflammatory agent
excellent HA and fever reduver

19
Q

What is the abbreviation for acetaminophen?

A

APAP - para-acetylaminophenol

20
Q

Is Tylenol a good anticoagulant?

A

NO.

21
Q

In general, NSAIDS are not/highly PPB.

A

HIGHLY!

22
Q

LT antagonists have most effects on the ______ system.

A

pulmonary

23
Q

How do Corticosteroids work? This makes them slightly/highly potent?

A

Modulate genes that code for inflammatory cytokines and interleukins. They block BOTH COX and LO pathways.
HIGHLY POTENT

24
Q

What is the connection with NSAIDs and renal disease? HTN?

A

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.

25
Q

What is the caution in reducing someone’s fever?

A

Fevers are a side of infection. If you continue to mask a fever without figuring out what is causing it, you are not treating the underlying infection/cancer!

26
Q

What happens when you take ASA and other PPB drugs?

A

Whichever drug cannot bind with the proteins, will have exaggerated effect as it blows in the breeze!

27
Q

Coingestion of ASA and _____ will increase GI upset and possible ulcers.

A

alcohol

28
Q

Why do you have to monitor guiac stools?

A

because you can develop ulcers and bleed into the stool

29
Q

Why shouldn’t asthmatics takes NSAIDs?

A

possible shunting effect and increased leukotrienes!

30
Q

Why shouldn’t pregnant women take NSAIDS? What is the tx for a PDA?

A

it can cause the ductus arteriosus to close!

Tx - NSAIDS

31
Q

Why would someone’s gums bleed when they brush their teeth?

A

too many NSAIDS.

Pharm test 3 (9 decks)

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