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14 Cards in this Set

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Acute overdosage of APAP:
dose-dependent fatal necrosis of the liver.
APAP adverse effect:
1. Renal tubular necrosis.
2. Hypoglycemic coma.
3. Formation N-hydroxylation - N- acetyl para benzoquinonime.
What levels are depleted with APAP?
- glutathione levels
- GSH Level: oxidative injury to the liver and binds covalently to cell marcomolecules.
What are the clinical presentation (2-4 days) of hepatotoxicity?
1. elevated aminotransferase
2. elevated bilirubin
3. liver damage
10-20% death
Treatment of APAP toxicity:
sulhydryl compunds and N-acetylcystein (Mucomyst)
What is the major adverse effect of indomethacin?
hematopoietic effects:
- thrombocytopenia
- aplastic anemia
- neutropenia
Specific CONTRAINDICATION FOR indomethacin:
psychiatric illness and CNS disorder.
Drug interactions with indomethacin
1 .Increase in levels when administered with: probenecid
2. antagonizes furosemide, thiazides, beta-blockers, or ace inhibitors.
Diclofenac
hepatic aminotransferase
sulindac
sulfide metabolite
Meclofenamate
decrease in Hb or Hematocrit in 1 out of 6 patients.
COX 2 : CELECOXIB
1. rheumatoid arthritis
2. osteoarthritis
3. acute pain
4. dysmenorrhea
5. decreasing intestinal polyps
Adverse Effect of NSAID
1. Increased risk CV thrombotic events, MI, Stroke, GI adverse effect.
2. Fluid retention and edema.
3. renal toxicity
4. hypertension
5. dermatological toxicity
6. liver toxicity
7. anaphylactic reation
8. premature closure of patent ductus arteriosus.
Contraindication with NSAID
Tx of peri-operative pain in the setting of CABG