NSAIDS Flashcards

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

Gastric protection, maintenance of renal function, and platelet aggregation

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

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

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3
Q
  1. Give one benefit of inhibiting COX-1.
A

Prevention of platelet aggregation

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4
Q
  1. List four benefits of inhibiting

COX-2.

A

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

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

Prostaglandins

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6
Q
  1. Name two COX inhibitors that do not suppress inflammation.
A

Acetaminophen (Tylenol), ketorolac (Toradol)

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

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

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

Renal impairment, vasoconstriction, increased risk of MI & stroke

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9
Q
  1. Which COX inhibitor has an irreversible action?
A

Acetylsalicylic acid (Aspirin)

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

Reye’s syndrome

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11
Q
  1. How long does aspirin suppress platelet aggregation?
A

8 days

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12
Q
  1. Should aspirin be recommended to pregnant women?
A

No – detrimental to mother and fetus

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13
Q
  1. Give four signs of early salicylism.
A

Tinnitus, dizziness, sweating, headache

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

Asthma, allergic rhinitis, nasal polyps

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15
Q
  1. Acute poisoning with salicylates begins with hyperventilation or hypoventilation?
A

Hyperventilation

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

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

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

Sulfonamides

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

CNS, no anti-inflammatory effects.

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

Minor pathway

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

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

21
Q
  1. What drug is given for Tylenol toxicity?
A

Acetylcysteine

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

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

23
Q
  1. How long before surgery should NSAIDs be stopped?
A

1 week or 5 half-lives.

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

COX-1 inhibitors, not including aspirin or acetaminophen.

COX-2 inhibitors

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

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

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

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

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

Cardiovascular and cerebrovascular disorders. (May cause vasospasm.)

28
Q
  1. When should sumatriptan (Imitrex) be taken?
A

At the first sign of a headache.

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

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

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

Systemic fungal infections.

Live virus vaccines.