๐Ÿ’Š370: Analgesics + Antipyretics Flashcards Preview

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Flashcards in ๐Ÿ’Š370: Analgesics + Antipyretics Deck (17)
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1
Q

What is the mechanism of action of COX inhibitors?

A

Shift Arachidonic Acid to be turned into more leukotrienes

๐ŸšจASTHMA pts- May have bad rxns

2
Q

What is the impact of COX-1 on the body?

A
  1. Stomach: promotes PGE2+PGI2 = Gastroprotective = โฌ‡๏ธ gastric acid secretion, โฌ†๏ธ bicarb+mucus secretion, maintains submucosal blood flow
  2. Platelets: prompts TXA2 โžก๏ธ stimulates platelet aggregation
  3. Kidneys: promotes PGE2+PGI2 โžก๏ธ stimulates renal vasodilation and blood flow (protective)
3
Q

What are the effects of COX2 on the body?

A
  1. Tissue injury: promotes PGE2 โžก๏ธ contributes to pain + inflammation
  2. Brain: promotes prostaglandins โžก๏ธ mediates fever + pain perception
  3. Bronchial smooth muscle: relaxed by PGE1+PGE2+ PGI1
  4. Colon: promotes prostaglandins โžก๏ธ promotes colorectal cancer***
  5. Uterus: PGE1+PGE2+PGEF2a promotes contractions at term
4
Q

What is the distinction between COX1 and COX2?

A

COX1 = GOOD, found in tissues constitutive

COX2 = BAD, inducible at sites of injury BUT good for kidneys

5
Q

What are the 1st Generation NSAIDs?

A
  1. Aspirin (ASA)
  2. Ibuprofen
  3. Naproxen (Aleve)
  4. Ketorolac (Toradol)
6
Q

Can aspirin be used for children 18years and under?

A

NO!! Risk of REYEโ€™s SYNDROME

= encephalopathy, fatty liver, high risk postviral illness

7
Q

What are symptoms of salicylism?

A
  1. Tinnitus
  2. Sweating
  3. Headache
  4. Dizziness

= Hugh doses of ASA (uncommon)

8
Q

What is a prototype of a 2nd generation NSAID?

A

Celecoxib (Celebrex)

โ€œ-coxibโ€

9
Q

What is the mechanism of action for coxibs?

A

Selectively inhibit COX2 over COX1

Used to suppress pain and inflammation

10
Q

What has the highest risk of CV events out of all NSAIDs?

A

2nd Gen = coxibs

11
Q

What are prototypes of Topical NSAIDS?

A
  1. Voltearen Emulgel (OTC)

2. Pennsiad (Rx)

12
Q

What is the mechanism of action for Acetaminohen?

A

Inhibition of COX in CNS, NOT peripheral

**no anti-inflammatory activity

13
Q

What are side effects of Acetaminophen?

A
  1. Acute liver failure (MAX 4g/day, 3G/day for chronic use, 2.0-2.6 for chronic alcohol use/liver dmg)
14
Q

What is the antidote to acetaminophen?

A

Acetylcysteine (IV/PO)

= Repletes Glutathione stores

15
Q

Uremia

A
  1. Renal function declines to 10%
  2. Uremic toxins accumulate
  3. Sudden (trauma, shock, toxins) OR chronic (HTN, diabetes)
  4. Reversible or irreversible

Treatment: drug or dialysis

16
Q

What is Glomerular Filtration Rate (GFR)?

A

Flow rate of filtered fluid through the kidney

Difficult to measure precisely

17
Q

What is Creatinine Clearance (CrCl)?

A

Volume of blood cleared of creatinine per unit time

Approximates GFR