NSAIDS

Question 1

Misoprostol

Answer 1

prostaglandin E1 analogue that has antiulcer effects in pts on long term aspirin or NSAID therapy for RA

Question 2

aspirin triad

Answer 2

aspirin sensitivity, asthma, nasal polyps

Question 3

Salicylism

Answer 3

chronic salicylate intoxication, results from therapy with high doses, greater than 100mg for 2 days or longer

Question 4

ASA dose for RA OA or other inflammatory condition in adults

Answer 4

2.4-3.6

Question 5

diflusinal should not be used to treat:

Answer 5

fever, should not be used as an antipyretic

Question 6

Black box warning of NSAIDS

Answer 6

may cause increase risk of serious CV thrombotic events, myocardial infarction, and stroke

Question 7

salicylates may cause moderate to severe….

Answer 7

noncardiogenic pulmonary edema by increasing alveolar capillary membrane permeability

Question 8

daily doses of ASA 3-4g may decrease….

Answer 8

hematocrit and plasma iron concentrations and reduce erythrocyte life span

Question 9

use of salicylates in children with varicella infections has an increased risk of developing….

Answer 9

Reye’s syndrome… vomiting, headaches, belligerence, delirium and coma
take acetaminophen instead

Question 10

lethal dose of salicylate in children

Answer 10

4g

Question 11

little toxicity 
mild tox
severe
lethal 
(adults)

Answer 11

150mg
150-300
300-500
over 500

Question 12

common toxic SE in adults

Answer 12

tinnitus and hearing loss

Question 13

common toxic SE in children

Answer 13

hyperventilation and CNS effects

(metabolic acidosis and respiratory alkalosis is present

Question 14

what is given to enhance salicylate elimination during toxic state

Answer 14

IV sodium bicarbonate and furosemide – diuretic

Question 15

diflusinal

Answer 15

derivative of salicylic acid
not hydrolyzed to salicylate in vivo so not considered a true salicylate
analgesic and anti inflammatory but NOT antipyretic
reversibly inhibits cyclooxygenase enzyme

Question 16

acetic acid 
propionic acid 
enolic acid 
anthranilic acid 
alkanone derivatives

Answer 16

cox 1 and 2 inhibitors

both analagesic and antipyretic inhibition

Question 17

which NSAIDS aren’t used for RA or OA

Answer 17

ketorolac

mefenamic acid

Question 18

tx for juvenile RA

Answer 18

tolmetin

naproxen

Question 19

Indomethacin

Answer 19

aggravate depression
NSAIDS cross BBB
strong headaches, also with ketorolac
used to close ductus arteriosus, as well as ibuprofen

Question 20

NSAID cardio SE

Answer 20

fluid retention and peripheral edema

Question 21

tolmetin

Answer 21

autoimmune hemolytic anemia

type 2 drug allergy

Question 22

Why do renal SE effects occur in kidney with NSAIDS

Answer 22

inhibits cox 2

inhibits renal prostaglandin production and might lead to renal decompensation

Question 23

effect on K and Na

Answer 23

hyperkalemia

hypernatremia

Question 24

papillary necrosis

Answer 24

irreversible type of renal injury that has occurred with NSAIDS

Question 25

celecoxib

Answer 25

cox 2 inhibitor
anti inflammatory, analgesic, antipyretic
inhibits prostaglandin synthesis via inhibition of cox 2
should not be used in pts with allergic type reactions to sulfonamides

Question 26

should not give more than …. of acetaminophen

Answer 26

4000 mg or 2000mg for alcoholics