Pharm NSAIDs part I Flashcards Preview

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Flashcards in Pharm NSAIDs part I Deck (45)
1

what are the cox 2 selective NSAIDs

celecoxib

2

what are the non-narcotic analgesics

acetaminophen (tylenol)

3

what NSAIDs are propionic acids

ibuprofen, naproxen

4

what NSAIDs are indoleacetic acids

indomethacin, etodolac

5

what NSAIDs are herteroaryl acetic acids

ketoralac

6

3 major beneficial properties of NSAIDs

anti inflammatory
analgesic
anti-pyretic

7

All NSAIDs inhibit what

cyclooxygenase, enzyme needed to make PGs

8

prostacyclin works where

endothelium
kidney
platelets
brain

9

thromboxane A2 works where

platelets, vascular smooth muscle cells, macrophages, kidney

10

PG D2 works where

mast cells, brain, airways

11

PG E2 works where

brain, kidney, vascular smooth muscle, platelets

12

PG F2 works where

uterus, airways, vascular smooth muscle, eyes

13

how is aspirin unique

irreversibly inhibits COX enzymes

14

which PG sensitizes pain nerve endings

PGE2

15

What PG are important mediators of erythema and edema

PGE2 and PGI2

16

PG effect on apoptosis

inhibit it

17

PG role in GI

PGI2 inhibits gastric acid secretion
PGE2 and PGF2 stimulate synthesis of protective bicarb and mucus in stomach and small intestine

18

aspirin effects on platelet aggregation

irreversibly inhibits it

19

what occurs with higher doses of aspirin

inhibit PGI2 in endothelial cells which is a vasodilator and inhibitor of platelet aggregation

20

NSAID effects on renal function

decrease renal blood flow and rate of glomerular filtration

21

conditions assoc with NSAID induced acute kidney injury

volume depletion from emesis, diarrhea, sepsis or hemorrhage
medications like diuretics, ACEI, ARBS, calcinuerin inhibitors
cirrhosis
CHF
nephrotic syndrome
hyperCa
chronic kidney disease
Renal a stenosis
older age

22

CI to aspirin use

in children or adolescents with chicken pox or influenza because of Reyes syndrome
and patients with gout

23

What is recommended for NSAID use for chronic Tx

non aspirin because it is associated with more side effects and GI effects

24

what are NSAIDs used to Tx chronically

RA, osteoarthritis, SLE, seronegative spondyloarthropathy, arthralgia, myalgia

25

what NSAID is used for anti platelet effects

baby aspirin

26

what is used to induce closer of PDA

indomethacin

27

what is used for high risk pregnancy women HTN with preeclampsia

baby aspirin

28

long term aspirin protects against what cancer

colorectal CA

29

what type of elimination occurs with aspirin at high doses

zero order

30

low does aspirin has what PK for elimination

first order

31

CNS actions aspirin are from what

salicylic acid

32

HS reaction to aspirin is higher it what patients

asthma
nasal polyps
chronic urticaria

33

salicylic acid toxicity Sx

tinnitus
nausea
vomiting
hyperventialation
HA confusion and dizziness

34

Tx for aspirin overdose

lavage with charcoal and IV bicarb

35

what NSAIDs shoul dbe avoided in third trimester

all

36

uses ibuprofen, narpozen and ketoprofen

analgesia of acute tendinitis, bursitis, primary dysmenorrhea, RA, OA, ankylosing spondylitis, acute gouty arthritis

37

which propionic acid NSAIDs have longer half lives

naproxen and oxaprozin

38

why is indomethacin not commonly used for therapy as analgesic or antipyretic

side effects

39

uses indomethacin

RA, OA, ankylosing spondylitis, acute gout
suppress uterin contractions in preterm labor and stimulate closure PDA in neonate

40

alternative for opoinds IM or IV or PO for postoperative analgesia

ketorolac

41

Cox 2 expression

induced at sites of inflammation, local target for anti-inflammatory Tx

42

major difference acetominophen to aspirin

little anti inflammatory activity

43

acute overdose acetopminophen

hepatotoxicity
depletion of glutathione and accumulation of a metabolite that produces hepatic necrosis

44

Sx of hepatotoxicity from acetominophen overdose

nausea, vomtiing, anorexia, abdominal pain for first 2 days
then 2-4 days increase liver enzymes and bilirubin which can lead to fatal liver damage

45

Tx acteominophen hepatotoxicity

gastric lavage within 4 hours ingestion, supportive measures and administreation of N acetylcysteine (drug that restores glutathione)