Pharm > Nsaids > Flashcards

Nsaids Flashcards

(50 cards)

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1
Q

What does NSAIDs stand for?

A

Non-steroidal anti-inflammatory drugs

NSAIDs combat inflammation but are not steroids.

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2
Q

What is the primary use of NSAIDs?

A
  • Treat acute inflammation
  • Manage chronic inflammatory conditions where corticosteroids are not indicated

Most NSAIDs are available over the counter, while some require a prescription due to lower safety profiles.

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3
Q

What are common side effects of NSAIDs?

A
  • GI upset
  • Kidney problems
  • Liver issues

GI upset is a primary reason some NSAIDs are prescription only.

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4
Q

What is the role of prostaglandins in inflammation?

A
  • Contribute to pain signaling
  • Induce fever

Prostaglandins are byproducts of the inflammatory response.

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5
Q

What initiates acute inflammation?

A

Tissue injury

Acute inflammation is a response to tissue damage.

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6
Q

What mediates chronic inflammation?

A
  • White blood cells
  • Cytokines (e.g., interleukins)
  • Tumor necrosis factor

Chronic inflammation involves a sustained immune response.

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7
Q

What are the two main pathways involved in the inflammatory response?

A
  • Cox pathway (cyclooxygenase)
  • Lox pathway (lipoxygenase)

These pathways are activated following cell damage.

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8
Q

What is arachidonic acid produced from?

A

Phospholipids in the cell membrane

Arachidonic acid is a key compound in the inflammatory process.

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9
Q

What do COX-1 and COX-2 refer to?

A
  • COX-1: Constitutive, always present
  • COX-2: Inducible, expressed in response to inflammation

COX-1 is involved in maintaining normal physiological functions, while COX-2 is associated with inflammation.

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10
Q

What is the effect of COX-2 inhibitors?

A

Target inflammation without affecting COX-1

Ideally, COX-2 inhibitors should minimize side effects related to COX-1 inhibition.

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11
Q

What is the gold standard NSAID?

A

Aspirin (acetylsalicylic acid)

Aspirin was first documented for use in 1763 and is known for its irreversible COX inhibition.

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12
Q

What is a significant risk associated with NSAIDs?

A

Cardiovascular events

Most NSAIDs carry a black box warning regarding cardiovascular risks.

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13
Q

Fill in the blank: Prostacyclin is a compound that prevents _______.

A

platelet aggregation

Prostacyclin is beneficial and released from vessel walls.

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14
Q

True or false: Aspirin is the only NSAID that irreversibly binds to COX.

A

TRUE

Other NSAIDs reversibly bind to COX enzymes.

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15
Q

What are the potential side effects of COX-1 selective NSAIDs?

A
  • Gastric irritation
  • Nephrotoxicity
  • Hepatotoxicity

COX-1 selective NSAIDs can lead to various adverse effects due to their action.

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16
Q

What is the primary mechanism of action for NSAIDs?

A

Inhibition of prostaglandin synthesis

NSAIDs primarily target the COX pathways to reduce inflammation and pain.

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17
Q

What is the effect of leukotrienes in inflammation?

A
  • Call in additional white blood cells
  • Contribute to bronchoconstriction

Leukotrienes play a significant role in asthma-like responses.

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18
Q

What is the gold standard for analgesic effects, first documented in 1763?

A

Aspirin (ASA)

Aspirin was first documented from Willowbark extracts and has been used for its analgesic properties since 1948.

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19
Q

What are the analgesic effects of aspirin primarily due to?

A
  • Inhibition of COX enzymes
  • Effects on prostaglandins

Aspirin’s pyretic effects are linked to its action on the central nervous system and peripheral blood vessels vasodilation causing precipitation of heat.

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20
Q

Aspirin causes dilation of peripheral vessels to dissipate heat, which lowers what?

A

Body temperature

This effect is part of aspirin’s role as an antipyretic.

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21
Q

True or false: Aspirin causes constriction of blood vessels in the central nervous system.

Study These Flashcards
A

TRUE

This constriction can lead to the throbbing pain associated with headaches.

22
Q

What is the primary reason most people take aspirin?

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A

Clot prevention

Aspirin is widely used for its cardiovascular benefits, including reducing the risk of ischemic heart attacks.

23
Q

What is the typical low dose of aspirin recommended for clot prevention?

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A

81 milligrams

Initially marketed as children’s aspirin, it is now referred to as low-dose aspirin.

24
Q

Aspirin can decrease the incidence of what type of cancer?

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A

Colon cancer

Regular low-dose aspirin use has been associated with a lower incidence of colon cancer.

25
What is a common **side effect** of aspirin?
GI upset ## Footnote This is due to its acidic nature and inhibition of protective prostaglandins.
26
What is the effect of aspirin on **prostaglandins** in the stomach?
Decreases production of beneficial mucus ## Footnote This can lead to an increased incidence of gastric ulcers.
27
What is the purpose of a **buffered aspirin**?
To balance out the acidic component ## Footnote Buffered aspirin may help reduce GI upset but does not prevent the inhibition of protective prostaglandins.
28
What is the **black box warning** associated with NSAIDs during pregnancy?
Avoid pregnancy ## Footnote NSAIDs can suppress prostaglandin synthesis, which is crucial for fetal kidney development leading the placenta abruptio
29
What syndrome is associated with aspirin use in children recovering from a viral illness?
Reye's syndrome ## Footnote This syndrome can lead to severe encephalopathy.
30
What is the **primary COX-2 selective inhibitor** mentioned?
Celecoxib (Celebrex) ## Footnote Celebrex has fewer GI effects compared to traditional NSAIDs.
31
What is a significant **caution** regarding Celebrex?
Sulfonamide allergy ## Footnote Celebrex is a sulfonamide and should be avoided by individuals with sulfa drug allergies.
32
What is the **cost range** for a monthly dose of Celebrex?
$150 to $300 ## Footnote The cost varies depending on whether it is the brand name or generic.
33
What is the **main use** of Ketorolac (Toradol)?
Post-surgical pain ## Footnote Ketorolac is used mainly in emergency medicine and for short-term pain relief.
34
What is the **recommended administration** for ibuprofen?
200 mg over the counter; 800 mg prescription ## Footnote Ibuprofen is widely used for its anti-inflammatory and analgesic properties.
35
What is a rare but serious side effect of ibuprofen?
Agranulocytosis Aplastic anemia - decrease in all blood cells ## Footnote This condition involves a severe drop in white blood cell count.
36
What is the effect of **prostaglandins** on the ductus arteriosus at birth?
They keep it open ## Footnote Prostaglandins are necessary for maintaining the ductus arteriosus during fetal circulation.
37
What is the **main action** of COX-2 selective inhibitors?
Provide analgesia and anti-inflammatory effects with fewer GI side effects ## Footnote They primarily target COX-2 while sparing COX-1.
38
What is the primary use of **Toradol** in pain management?
Decreased use of opioids ## Footnote Toradol is used short term and not for chronic use due to side effects.
39
What is the half-life of **Naproxen** compared to **ibuprofen**?
* Naproxen (aleve): 14 hours * Ibuprofen: 2 hours ## Footnote Naperson requires less frequent dosing, which is beneficial.
40
True or false: **Acetaminophen** is classified as an NSAID.
FALSE ## Footnote Acetaminophen is effective for pain and fever but lacks anti-inflammatory effects.
41
What are the potential fatal doses of **acetaminophen**?
Around 15 grams ## Footnote Fatality is typically due to hepatotoxicity and renal tubular necrosis.
42
List the **benefits** of glucocorticoids in the body.
* Suppress inflammation * Mobilize energy stores * Improve cognitive function * Retain salt and water ## Footnote Glucocorticoids are released during stress and inflammation. - increases annexin - decreases phospholipase - increase leukoprotease - increase IL-10 - decrease inh-nfkb
43
What are the **negative effects** of long-term glucocorticoid use?
* Suppressed immune system * Metabolic syndrome * Diabetes * Obesity * Muscle wasting * Depression * Hypertension ## Footnote Chronic use can lead to significant health issues.
44
What is the role of glucocorticoids in the treatment of **Addison's disease**?
Supplement glucocorticoids ## Footnote Patients with Addison's disease do not produce enough glucocorticoids.
45
What are **DMARDs** primarily used for?
Target joint disorders ## Footnote DMARDs can also be applied to multiple other disorders.
46
What is the mechanism of action for **non-biologic DMARDs** like **methotrexate**?
Suppresses adenosine production ## Footnote This inhibits B-cell and T-cell maturation.
47
What is the significance of **NF-kappa B** in inflammation?
Pro-inflammatory cytokine ## Footnote NF-kappa B is inhibited by glucocorticoids.
48
How can inflammation contribute to **cancer formation**?
* Sulfaporation * Mutation of genes * Oncogene activation * Angiogenesis ## Footnote Chronic inflammation can lead to cancer development.
49
What are **reactive oxygen species** and their effect on cells?
Damage cell membranes and DNA ## Footnote They cause mutations and can lead to more aggressive tumors.
50
What is the role of **anti-inflammatory therapy** in cancer treatment?
Useful adjunct to cancer therapy ## Footnote It can help control inflammation that may complicate cancer treatment.
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