NSAIDs

Question 1

NSAIDs MOA

Answer 1

inhibit PG synthesis by blocking COX1 (gastric mucosa, platelet aggregation) and COX2 (inflammation, fever)

Question 2

NSAIDs use

Answer 2

analgesic
anti-inflammatory
antipyretic
inhibit platelet aggregation

Question 3

NSAID SE

Answer 3

nausea/vomiting
GI ulceration
anti-coagulant
renal injury
pregnancy

Question 4

aspirin

Answer 4

rapidly absorbed
widely distributed

anticoagulant

Question 5

aspirin metabolism

Answer 5

plasma, liver

Question 6

aspirin MOA

Answer 6

irreversibly inhibits COX1 and COX2
reduce TxA2 synthesis
reduce PGI synthesis

Question 7

aspirin SE

Answer 7

hypersensitivity
GI irritation/ulcers
liver toxicity
acute renal failure
Reye's syndrome (use acetaminophen)

Question 8

aspirin OD

Answer 8

salicylism:
dizziness
nausea/vomiting
tinnitus
hyperventilation
hyperthermia

tx: emesis/lavage, alkalinize urine

Question 9

aspirin contraindications

Answer 9

hypersensitivity
peptic ulcer
children
pregnancy
elderly

Question 10

aspirin Rx interactions

Answer 10

P450 enzymes
glucuronidation
alcohol
corticosteroids
NSAIDs
oral hypoglycemics
oral anticoagulants
anti-epileptics
systemic antacids

Question 11

indomethACin use

Answer 11

acetic acid

RA
osteoarthritis
ankylosing spondylitis
acute gout

Question 12

indomethACin SE

Answer 12

closure of patent ductus arteriosis
GI ulcer
severe frontal headache
hypersensitivity

Question 13

sulindAC

Answer 13

acetic acid

prodrug

Question 14

keterolAC use

Answer 14

acetic acid

moderate/severe pain

Question 15

keterolAC SE

Answer 15

GI ulcer

don’t take for more than 5 days

Question 16

diclofenAC use

Answer 16

acetic acid

RA osteoarthritis
solar keratoses
acute pain
pts with high risk ulcers

Question 17

ibuPROfen

Answer 17

propionic acid

well tolerated
low SE

Question 18

ibuPROfen use

Answer 18

mild/moderate pain

Question 19

ibuPROfen SE

Answer 19

GI irritation

Question 20

naPROxen

Answer 20

propionic acid

long halflife (14hr)
dose: 2x/day

Question 21

ketoPROfen

Answer 21

propionic acid

short halflife
dose: 3-4x/day

Question 22

fenoPROfen

Answer 22

pripionic acid

short halflife (2hr)
dose: 3-4x/day

SE: headaches 15%

contraindication: impaired renal function

Question 23

oxaPROzin

Answer 23

propionic acid

long halflife
dose: 1x/day

Question 24

meFENamic acid

Answer 24

fenamate

analgesic
use < 1 week

SE: diarrhea 25%

contraindication: impaired renal function

Question 25

mecloFENamate

Answer 25

fenamate use: RA, osteoarthritis, mild/moderate pain SE: GI irritation

Question 26

pirOXIcam

Answer 26

oxicam ``` long halflife (50hr) dose: 1x/day ``` use: RA SE: GI irritation

Question 27

melOXIcam

Answer 27

oxicam COX2 inhibitor ``` long halflife (50hr) dose: 1x/day ``` use: RA, osteoarthritis, mild/moderate pain SE: less GI irritation, platelet aggregation

Question 28

nabumetone

Answer 28

prodrug (CYP1A2) ``` long halflife (27hr) dose: 1x/day ``` use: RA SE: Gi irritation, renal toxicity

Question 29

celecoxib

Answer 29

COX2 inhibitor metabolized by CYP2C9 halflife (11hr) dose: 2x/day use: osteoarthritis, RA, dysmenorrhea, reduce risk of colon cancer doesn't inhibit platelet aggregation fewer GI effects SE: prothrombotic contraindication: impaired renal function

Question 30

acetaminophen

Answer 30

well absorbed conjugated to glucuronide & sulfate by P450 toxicity: high doses no GI irritation

Question 31

acetaminophen use

Answer 31

``` ASA contraindication no need for anti-inflammatory bleeding disorders peptic ulcer children ```

Question 32

acetaminophen SE

Answer 32

hypersensitivity | hepatotoxicity (tx: N-acetylcysteine within 8-10hr)

Question 33

acetaminophen contraindications

Answer 33

hypersensitivity impaired liver function alcoholism

Question 34

ergot alkaloids

Answer 34

vasoconstriction SE: nausea/vomiting, leg weakness, muscle pain toxicity: ergot poisoning

Question 35

triptans

Answer 35

anti-emetic MOA: stimulate 5HT1B/D receptors SE: CNS effects, serotonin syndrome

Question 36

beta-blockers

Answer 36

MOA: vasoconstriction, decreased sympathetics SE: coronary vasospasms

Question 37

Ca2+ channel blockers

Answer 37

MOA: reduce Ca2+ influx, reduce vasospasms

Question 38

anticonvulsants

Answer 38

ion channel blockers

Question 39

angiotensin II receptor blocker

Answer 39

MOA: blocks production of angiotensin II use: high BP