NSAIDs

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

Answer 8

Question 9

Which of the 7 important NSAIDs belongs to salicyclate class?

Answer 9

Aspirin

Question 10

Which of the 7 important NSAIDs belongs to Propionic class?

Answer 10

Ibuprofen

Naproxen

Question 11

How do you identify NSAIDs in the propionic class?

Answer 11

They have “pro” in their name somewhere

Question 12

Which of the 7 important NSAIDs belongs to Acetic Acid Class?

Answer 12

Indomethacin

Ketorolac

Diclofenac

Question 13

How do you recognize NSAIDs in the acetic acid class?

Answer 13

They have “ac” in their name, usually toward the end of the name

Question 14

Which of the 7 important NSAIDs belongs to Sulfonic Acid Class?

Answer 14

Celecoxib

Question 15

How do you identify NSAID in sulfonic acid class?

Answer 15

Have “coxib” in name

Question 16

Tylenol is not an NSAID, but it often does similar things as NSAIDs. What class of drug is tylenol?

Answer 16

Aminophenol class

Question 17

What are the clinical uses for all NSAIDs (3)?

Answer 17

Analgesia

Antipyresis

Anti-inflammation

Question 18

What are the specific clinical uses of aspirin?

Answer 18

Pain

Fever

Antithrombosis

Question 19

What are the clinical uses for acetaminophen? (2)

Answer 19

Pain

Fever

Question 20

What are the clinical uses for ibuprofen, naproxen, and celecoxib?

Answer 20

Arthritis

Gout

Primary Dysmenorrhea

Question 21

What are the specific clinical uses of indomethacin?

Answer 21

Closing physiologic heart shunt in newborns

Question 22

What is the clinical use for diclofenac?

Answer 22

Kidney stone pain

Question 23

What are the specific clinical uses of ketorolac?

Answer 23

Post-surgery analgesia

Question 24

What effect does acetaminophen have for analgesia when acting in the presence of arachidonic acid?

Answer 24

It increases endogenous canabinoid production –> reduced pain sensitization

Question 25

Describe the structure of the COX enzyme

Answer 25

The active site is buried deep inside the protein and is reachable by a tunnel that opens out in the ER membrane. It acts like a funnel guiding the arachidonic acid into the enzyme for processing.

Question 26

How does aspirin interact with the COX enzyme to modify its functionality?

Answer 26

The aspirin enters the tunnel to the catalytic site and covalently binds (**IRREVERSIBLE)** to the active site via binding to Ser530, blocking the action of the enzyme and thus leading to decreased platelet activation and anti-thrombosis. Platelets don't have DNA so once aspirin binds to COX enzymes they are unable to synthesize new COX

Question 27

Complete this table.

Answer 27

Question 28

How do other NSAIDs react with COX enzymes?

Answer 28

They **REVERSIBILY** bind to COX thorugh Tyr and Arg residues

Question 29

How does celecoxib react with COX1 / COX2?

Answer 29

The COX2 catalytic site is slightly wider than COX1 so it does not fit in COX1 but does fit in COX2 for **REVERSIBLE** inhibition.