Flashcards in NSAIDS Deck (30):
1. What are three results of the COX-1 enzyme?
Gastric protection, maintenance of renal function, and platelet aggregation
2. What are six results of the COX-2 enzyme?
Inflammation, pain, fever, promotion of colon cancer, maintenance of renal function, vasodilation
3. Give one benefit of inhibiting COX-1.
Prevention of platelet aggregation
4. List four benefits of inhibiting
Suppress inflammation, relieve pain, reduce fever, reduce risk of colorectal cancer
5. Inhibiting cyclooxygenase (COX) interferes with the production of what?
6. Name two COX inhibitors that do not suppress inflammation.
Acetaminophen (Tylenol), ketorolac (Toradol)
7. Give four adverse effects of inhibiting COX-1.
Gastric ulceration, renal impairment, bleeding, increased risk of MI & stroke (except ASA & Tylenol)
8. Name three adverse effects of selective COX-2 inhibitors other than gastric ulceration with bleeding.
Renal impairment, vasoconstriction, increased risk of MI & stroke
9. Which COX inhibitor has an irreversible action?
Acetylsalicylic acid (Aspirin)
10. What syndrome can occur with the administration of aspirin to children who have chickenpox or influenza?
11. How long does aspirin suppress platelet aggregation?
12. Should aspirin be recommended to pregnant women?
No – detrimental to mother and fetus
13. Give four signs of early salicylism.
Tinnitus, dizziness, sweating, headache
14. List three conditions which increase the risk of hypersensitivity with salicylates.
Asthma, allergic rhinitis, nasal polyps
15. Acute poisoning with salicylates begins with hyperventilation or hypoventilation?
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.
17. An allergy to what class of drugs is a contraindication for celecoxib (Celebrex)?
18. Where does inhibition of prostaglandins occur with acetaminophen (Tylenol)?
CNS, no anti-inflammatory effects.
19. What pathway can create toxic metabolites when metabolizing large amounts of Tylenol?
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.
21. What drug is given for Tylenol toxicity?
22. Why does alcohol increase the likelihood of Tylenol toxicity?
It induces the minor pathway & alcoholics have depleted glutathione stores.
23. How long before surgery should NSAIDs be stopped?
1 week or 5 half-lives.
24. Which drugs increase the risk of stroke and myocardial infarction?
COX-1 inhibitors, not including aspirin or acetaminophen.
25. What serotonin receptors are activated by sumatriptan (Imitrex)?
5-HT (serotonin)1B/1D receptors
26. How does 5-HT activation reduce the symptoms of migraines?
Causes vasoconstriction of cranial blood vessels and suppresses release of pro-inflammatory neuropeptides.
27. What are major contraindications or cautions for the use of sumatriptan (Imitrex)?
Cardiovascular and cerebrovascular disorders. (May cause vasospasm.)
28. When should sumatriptan (Imitrex) be taken?
At the first sign of a headache.
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.