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Flashcards in NSAIDs Deck (39):
1

Aspirin is unique among the NSAIDs for its ability to ______.

decrease clotting

2

Celecoxib is unique among the NSAIDs because it ______.

doesn't have any gastric side effects

3

The COX1 pathway in platelets turns arachidonic acid into ______.

thromboxane

4

Eicosanoids are ________.

signaling molecules made from oxidizing 20-carbon fatty acids

5

List some of the effects of prostaglandins from the COX 1 pathway.

- GI: decreased acid production and increased mucous/bicarb secretion; increase smooth muscle contractions
- Platelets (TXA2): pro-aggregatory effect
- Kidneys: increased renal blood flow

6

On vascular endothelial cells, prostaglandins work to _________.

cause vasodilation and anti-clotting

7

COX1 is ___________, while COX2 is ________.

constitutively functioning; dependent of stimuli for induction

8

Acetaminophen does not function in the periphery, only in the ______. Thus it is not an anti-inflammatory.

CNS (on COX2, to be specific)

9

Glucocorticoids inhibit _____ and stimulate ______, thus leading to a strong anti-inflammatory effect.

COX; annexins (which inhibit phospholipase A, the enzyme that makes arachidonic acid)

10

Ketorolac is ________, as is Celebrex.

prescription only

11

The antiplatelet effect of aspirin is ______, while the antiplatelet effect of other NSAIDs is _______.

4 - 7 days; 2 days

12

If you have to recommend a tNSAID, for GI patients ______ is better, while for cardio patients ______ is better.

ibuprofen; naproxen

13

Celecoxib (Celebrex) is a ________ inhibitor.

selective COX2

14

Celecoxib is great for _________.

patients who cannot tolerate high doses of NSAIDs due to GI tract

15

Selective COX2 inhibitors have ________ effect on platelets.

no (because platelets are mediated by COX1)

16

What is inhibited by NSAIDs to induce analgesia?

Inhibition of COX-2 at site of inflammation

17

The antipyretic effect of NSAIDs is mediated by ______.

inhibition of COX-2 in the hypothalamus

18

The anti-inflammatory effect of NSAIDs occurs through _______.

inhibition of COX-2 at sites of inflammation

19

NSAIDs inhibit thrombogenesis by ______.

inhibiting COX-1 in platelets

20

Which isoform of COX is present in the stomach, and what does it do?

COX-1, and it produces PGE which decreases acid/pepsin secretions and increase mucous/bicarb secretions

21

Which isoform of COX is present in the kidneys?

Both!

22

Inhibiting ______ leads to bleeding problems, while inhibiting ______ leads to thrombosis.

COX-1 in platelets; COX-2 in vascular endothelial cells

23

The traditional NSAIDs are _______ and include the following drugs: _________.

reversible inhibitors of COX-1 and COX-2; ibuprofen, ketorolac, and naproxen

24

Acetaminophen does not _________, but does inhibit ______.

COX-1 or COX-2 in the peripheral system; COX-2 in the CNS, leading to antipyretic effect and analgesia

25

Celecoxib (Celebrex) is a ________.

selective reversible inhibitor of COX-2

26

Aspirin (acetyl salicylic acid) is an _________.

irreversible inhibitor of COX-1 and COX-2

27

________ mediates platelet aggregation.

Thromboxane A2 (produced by the COX-1 pathway)

28

In the kidneys, NSAIDs cause _______.

vasoconstriction and fluid retention

29

Celebrex is great for __________.

patients at risk of GI bleeds (still has renal risk)

30

Recommended maximum doses of acetaminophen are ______ for those without liver disease and ______ for those with.

4000 mg / day; 2000 mg/day (because alcohol induces CYP2E1)

31

Low-dose aspirin is essentially ______.

platelet COX-1 selective, thus it is antithrombotic

32

In the kidneys, PGE2 and PGI2 ________.

increase renal blood flow

33

In vascular smooth muscle, PGE2 and PGI2 lead to _______ while TXA2 leads to _______.

vasodilation; vasoconstriction

34

The anti-thrombotic enzyme on vascular endothelial cells is ______.

COX-2

35

Leukotrienes lead to _________.

vasoconstriction, bronchoconstriction, vascular permeability, and chemotaxis for phagocytic cells

36

The lowest GI-risk NSAID is _______ and the highest is ______.

ibuprofen; naproxen

37

The lowest CV-risk NSAID is ________ and the highest is _______.

naproxen; ibuprofen

38

Aspirin overdose first leads to _____ and then _______.

respiratory alkalosis; metabolic acidosis

39

Acetylsalicylic acid is rapidly hydrolyzed by _____.

esterases

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