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Flashcards in NSAIDS Deck (30):
1

1. What are three results of the COX-1 enzyme?

Gastric protection, maintenance of renal function, and platelet aggregation

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2. What are six results of the COX-2 enzyme?

Inflammation, pain, fever, promotion of colon cancer, maintenance of renal function, vasodilation

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3. Give one benefit of inhibiting COX-1.

Prevention of platelet aggregation

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4. List four benefits of inhibiting
COX-2.

Suppress inflammation, relieve pain, reduce fever, reduce risk of colorectal cancer

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5. Inhibiting cyclooxygenase (COX) interferes with the production of what?

Prostaglandins

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6. Name two COX inhibitors that do not suppress inflammation.

Acetaminophen (Tylenol), ketorolac (Toradol)

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7. Give four adverse effects of inhibiting COX-1.

Gastric ulceration, renal impairment, bleeding, increased risk of MI & stroke (except ASA & Tylenol)

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8. Name three adverse effects of selective COX-2 inhibitors other than gastric ulceration with bleeding.

Renal impairment, vasoconstriction, increased risk of MI & stroke

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9. Which COX inhibitor has an irreversible action?

Acetylsalicylic acid (Aspirin)

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10. What syndrome can occur with the administration of aspirin to children who have chickenpox or influenza?

Reye’s syndrome

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11. How long does aspirin suppress platelet aggregation?

8 days

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12. Should aspirin be recommended to pregnant women?

No – detrimental to mother and fetus

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13. Give four signs of early salicylism.

Tinnitus, dizziness, sweating, headache

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14. List three conditions which increase the risk of hypersensitivity with salicylates.

Asthma, allergic rhinitis, nasal polyps

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15. Acute poisoning with salicylates begins with hyperventilation or hypoventilation?

Hyperventilation

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16. How does ibuprofen (Motrin, Advil) alter the action of aspirin?

Blocks ASA access to COX-1 receptors. on platelets, preventing ASA from inhibiting platelet aggregation. Give ibuprofen 2 hrs after aspirin.

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17. An allergy to what class of drugs is a contraindication for celecoxib (Celebrex)?

Sulfonamides

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18. Where does inhibition of prostaglandins occur with acetaminophen (Tylenol)?

CNS, no anti-inflammatory effects.

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19. What pathway can create toxic metabolites when metabolizing large amounts of Tylenol?

Minor pathway

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20. What is the maximum recommended dosage of Tylenol per day for nondrinkers? Patients who drink or have liver disease? Patients with malnutrition?

4 g per day. 2 g per day for drinkers or liver disease. 3 g per day for patients with malnutrition.

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21. What drug is given for Tylenol toxicity?

Acetylcysteine

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22. Why does alcohol increase the likelihood of Tylenol toxicity?

It induces the minor pathway & alcoholics have depleted glutathione stores.

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23. How long before surgery should NSAIDs be stopped?

1 week or 5 half-lives.

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24. Which drugs increase the risk of stroke and myocardial infarction?

COX-1 inhibitors, not including aspirin or acetaminophen.
COX-2 inhibitors

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25. What serotonin receptors are activated by sumatriptan (Imitrex)?

5-HT (serotonin)1B/1D receptors

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26. How does 5-HT activation reduce the symptoms of migraines?

Causes vasoconstriction of cranial blood vessels and suppresses release of pro-inflammatory neuropeptides.

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27. What are major contraindications or cautions for the use of sumatriptan (Imitrex)?

Cardiovascular and cerebrovascular disorders. (May cause vasospasm.)

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28. When should sumatriptan (Imitrex) be taken?

At the first sign of a headache.

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29. What restrictions are placed on patients receiving intra-articular injections with glucocorticoids? How long may the pain from the injection last?

Restrict movement for 1-2 days. Pain should only last 1-2 days.

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30. What disease process is a contraindication for glucocorticoids? What vaccines?

Systemic fungal infections.
Live virus vaccines.