Antiinflammatory Drugs Used For Rheumatic D/o

Front 1

ketorolac tromethamine(toraldol) dosage/usage

Back 1

-IV/IM injection
-short term(<5 days)
-tx of mod-severe acute pain requiring analgesia at the opioid level

Front 2

potential cross reactivity of ketorolac with ASA/NSAIDs

Back 2

pts who have exhibited asthma, rhinitis, uticaria, nasal polyps, angioedema, and bronchospasm

Front 3

COX1

Back 3

-present in virtually all cells
-constitutive (housekeeping)enzyme

Front 4

COX1 effects on stomach

Back 4

-provide gastric mucosal barrier by stimulating mucus and bicarbonate secretion and mucosal blood flow

Front 5

COX1 effects on kidney

Back 5

-PGE2 and PGI2 (prostacycline) are vasodialting PGs which provide renal homeostasis by maintaining renal blood flow and glomerular filtration

Front 6

COX1 effects on homeostasis

Back 6

platelets contain ONLY COX1
--inhibition of COX1 causes unwanted adverse effects of GI bleeding and renal insufficiency

Front 7

COX2

Back 7

-inducible form in cells experiencing inflammation
-considered constitutive in brain and kidney

Front 8

inhibition of COX2 results in ?

Back 8

-antiinflammatory, analgesic, and antipyretic actions
-may be a predisposition to thrombosis

Front 9

TXA2(produced in platelets through COX1)and PGI2(produced in vascular endothelium through COX2) are?

Back 9

vasoactive substances that balance vascular tone and the tendency towards thrombosis

Front 10

inhibition of COX2 effects on TXA2 and PGI2

Back 10

removes the PGI2 effects and allow prothrombic TXA2 actions to predominate

Front 11

COX2 specific inhibitor approved in US

Back 11

celecoxib (celebrex)

Front 12

FDA concluded that all NSAIDSs should be contraindicated in pts who are?

Back 12

immediately post-op from CABG

Front 13

COX2 inhibitors have cross reactivity with?

Back 13

-ASA/NSAIDs
-sulfa drugs(sulfonamides)

Front 14

COX2 inhibitors are contraindicated in pts with?

Back 14

ASA triad::asthmatics with rhinitis and nasal polyps who exhibit severe, potentially fatal bronchospasm after taking ASA

Front 15

clinical considerations regarding tx with COX2 inhibitors::GI

Back 15

-All NSAIDs have risk of GI toxicity
-reserve COX2 inhibitors for pts at high risk for NSAID-induced gastropathy

Front 16

Use COX2 inhibitors with great caution or not at all in pts with____,____, &_________.

Back 16

1.chronic renal failure
2.severe heart disease
3.hepatic failure

Front 17

COX2 inhibitor-induced nephrotoxicity mechanism

Back 17

-invloves both direct toxic damage to tubules and decreased renal perfusion secondary to inhibition of renal PG synthesis

Front 18

Are COX2 inhibitors less nephrotoxic than nonselective NSAIDs?

Back 18

NO (no advantage b/c COX2 plays significant role in maintaining renal blood flow in pts with compromised renal fx)

Front 19

Due to COX2 inhibitor-induced nephrotoxicity they are contraindicated in pts with? Use caution in ?

Back 19

1.advanced renal disease
2. fluid retention, HTN, or HF

Front 20

CV risk for COX2 inhibitors

Back 20

probability of greater prothrombic effect compared to nonselective NSAIDS
**all COX2 inhibitors increase risk of CV events

Front 21

celebrex is first drug to be approved for a hereditary form of colorectal CA termed?

Back 21

familial adenomatous polyposis (FAP)

Front 22

pts at low risk for GI complications should not recieve?

Back 22

a cox2 inhibitor

Front 23

for pts at increased risk of GI bleeding_____+_______or______ appears to be as least as beneficial as COX2

Back 23

nonselective NSAID + PPI or misoprostol

Front 24

AHA now recommends d/c all NSAIDs except ASA in?

Back 24

MI pts hospitalized for MI or UA

Front 25

pts with AF on either ASA or warfarin for stroke prevention should ______NSAIDs

Back 25

avoid

Front 26

_________is preferred choice because safer for the CV symptoms in CV disease or a high CV risk

Back 26

Naproxen