Naproxen

Question 1

Brand Name

Answer 1

Naprosyn

Question 2

Broad Category

Answer 2

Analgesic / Antipyretic / NSAID

Question 3

Pharm class

Answer 3

Propionic acid derivative / Nonselective NSAID

Question 4

MOA

Answer 4

Nonselective COX inhibition preventing the substrate arachidonic acid from binding to the active site, thus blocking synthesis of prostaglandins

Question 5

Indications

Answer 5

Pain / Inflamation
Fever
decrease opioid requirements perioperative

Question 6

PO dosing

Answer 6

250 - 500 mg

Question 7

GI effects

Answer 7

Gastropathy
GI bleeding

Question 8

Renal effects

Answer 8

sodium water retention
Reversible impairment of GFR

Question 9

Hematologic effects

Answer 9

increased bleeding due to inhibition of thromboxane synthesis

Question 10

Contraindications

Answer 10

Asthma / Samters triad
Hypersensitivity
Gestation after 30 weeks (premature PDA closure)
GI ulcer / hemorrhage

Question 11

Precautions or avoidance

Answer 11

Renal / Hepatic disease
Orthopdeics (inhibit bone formation)

Question 12

Drug - Drug interactions

Answer 12

Albumin-bound drugs:
- competitively displace albumin-bound drugs (warfarin, phenytoin, valproic acid) increasing risk for toxicity)

Decreases renal clearance of lithium and digoxin

Increases risk of ulcers with: corticosteroids and ASA

Question 13

Metabolism

Answer 13

Hepatic
- CYP2C9 (primarily)
- glucuronidation

Question 14

Elimination

Answer 14

Renal

Question 15

Vd Considerations

Answer 15

Small
- hydrophilic
- remains in plasma / ECF
- highly protein bound

Question 16

Clearance Considerations

Answer 16

Reduced clearance with
- renal dysfunction
- hepatic impairment
- elderly patients

Question 17

Protein binding

Answer 17

Very high (99%)
Albumin