NSAIDS

Question 1

Effects of PGs

Answer 1

Vascular SM - vasodilate
GI SM - Contract
Secretory cells - Produce more mucous and bicarb
Kidney cells - Increase renal blood flow/diuresis
Uterus - Contribute to contractions
Inflammatory cells - Chemotaxis and induce inflam

Question 2

Effects of Leukotrienes

Answer 2

Chemotaxis, vasoconstriction, bronchospasms, increased vascular permeability

Question 3

Effects of prostacyclin

Answer 3

Vasodilate and inhibit platelet agg

Question 4

Effects of Thromboxane

Answer 4

Vasoconstrict and promote platelet agg

Question 5

Therapeutic uses of Aspirin

Answer 5

Reduce pain, fever, inflammation, coagulation (in low doses)

Question 6

Side effects of Aspirin

Answer 6

Gastic irritation, renal dysfunction, bleeding, hypersensitivity and bronchospasms

Question 7

Contraindications of Aspirin

Answer 7

Children under 12 with a viral DZ, pregnant, the chronically renal insufficient, patients already taking oral anticoagulants

Question 8

Overdose and treatment of Aspirin

Answer 8

Sweating, vomiting, fever, respiratory alkalosis but metabolic acidosis, tinitus, ultimately renal failure and death
Treat w/ gastric lavage, charcoal, bowel irrigation and sodium bicarb

Question 9

Uses of traditional NSAIDs

Answer 9

Reduce pain, inflammation, fever

Question 10

Side effects of tNSAID

Answer 10

similar to aspirin but usually better tolerated and less side effects. Reversible effect on platelets

Question 11

Therapeutic effects of Acetaminophen

Answer 11

Reduced pain, fever, but not good for inflammation other than in some osteoarthritis

Question 12

Side effects of acetaminophen

Answer 12

Mild increase in hepatic enzymes and some dizziness/excitement/disorientation in supratherapeutic doses

Question 13

Overdose and treatment of acetaminophen

Answer 13

Diarrhea, abdominal pain, hepatotoxicity
Result of over producing hepatotoxic metabolite once all the P2 pathways are inhibited. Ethanol induces the toxic pathway and damages the liver at the same time.
Treat with supportive treatment and N-acetylcysteine

Question 14

Therapeutic effects of Celecoxib

Answer 14

Reduce inflammation, pain, fever. Use to reduce GI side effects in certain categories of patients.

Question 15

Side effects of Celecoxib

Answer 15

Renal side effects similar to aspirin and tNSAID, but lower risk of ulcer and doesn’t prolong bleeding unless patient also on warfarin (inhibit war metabolism). Possible hypersensitivity from sulfa moiety.