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Block 10 Neuro & Psych > NSAIDs > Flashcards

Flashcards in NSAIDs Deck (17)
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1

NSAIDs

ASPIRIN
Anti-inflammatory
Analgesic
Anti-pyretic

2

Mediators of Acute Inflammation

Histamine
Bradykinin
PGs
Leukotrienes

3

Mediators of Chronic Inflammation

*IL-1- MO + lymph activation
*TNFa- induction, PGs
*IL-6- induction, differentiation, fever
IL-2- induction, differentation
IFNs- activation of cytotoxic lymphocytes, antimicrobial
Chemokines

4

Aspirin (NSAID) MOA

=NON selective, IRReversible COX Inhibitor, prevent metabolism of arachidonic acid to PGs and Thromboxanes.

5

Aspirin Use

Analgesia, Antipyretic, Anti-inflammatory- musculoskeletal disorders.
Other- anti-thrombotic (angina, ischemic attacks)

6

Aspirin Adverse Rxn

GI upset and bleeding (erosive)
Tinnitus, decr hearing
Vertigo
Ince uric acid
Anti-platelet
REYES SYND (post viral + aspirin = swelling of liver and brain)

7

Aspirin Pharm

rapid absorbed
in synovial fluid
CYP 450
renal excretion

8

Acetaminophen Pharm

rapid absorption
uniform distribution
hepatic microsomal metabolism
complete excretion

9

Acetaminophen MOA

= NSAID, weak COX inhibitor
anti-pyretic!

10

Acetaminophen Use

FEVER
+ good for pts who can't take aspirin
-ok for peptic ulcers
-ok for pregnancy
-no effect on platelets

11

Acetaminophen Adverse Rxn

skin rash (allergy)
HEPATOTOXICITY via oxidative stress

12

Acetaminophen OD

common
Supportive therapy
1. gastric lavage
2. N-acetylcysteine to replenish hepatic glutathione)

13

List of common NSAIDs

Ibuprofen - good
Diclofenac - good
Naproxen- 14hr 1/2 life
Piroxicam - 57hr 1/2 life + anti inflamm
Indomethacin – more toxic + anti inflamm
Flurbiprofen- ocular/oral + anti inflamm
Ketorolac - post surgery pain

14

COX1

- Expressed in most tissues
- Constitutively active
- Necessary for cytoprotection in GI tract

15

COX2

- Produces prostanoid mediators of inflammation
- Induced in inflammatory cells
- Component of the pain response

16

COX-2 Inhibitors

Celecoxib (Celebrex)
more SELECTIVE for COX2
short half life ~1hr
(+) fewer GI rxn
(+) low platelet effect

17

Celecoxib Adverse Rxn

CARDIO- MI, htn, edema
CNS- headache, fever
GI- diarrhea, nausea
RESP- URI, cough