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49 Cards in this Set

  • Front
  • Back
Type of pain NSAIDS do not help
Type of pain NSAIDS do help
pain cause by sensitization of pain receptors by PGE and PGI
Effect of NSAIDS on vascular permeability
Indirect decrease. potentiates action of mediators like histamine and bradykinin that lead to edema
NSAIDS effects on chronic inflammation
may worsen. the blocked prostaglandins can decrease lysosomal enzyme, reduce toxic O2 and inhibit lymphocyte activation
Co-administer with NSAIDS to limit GI side effects
Misoprostol (PGE analog)
Effects of NSAIDS on labor
Decrease uterine contractions and delay labor. DANGER: can close Ductus Arteriosus
NSAIDS on renal function
May lower renal function on already compromised individuals. Promotes Na retention and edema.
What electrolites may be effects by NSAIDS?
Sodium can be retained. K is then also retained b/c less Na in distal tubule for exchange
Nephropathy associated with this in older NSAIDS
Shunting of arachdonic acid to leukotriens may cause
Aspirin absorption oddity?
A weak acid, but absorbed better with increasing pH
Aspirin half-life/dose relationship
High dose results in higher half life by overwhelming metabolism
Urine pH and excretion with Aspirin
Increasing pH increases excretion
Contraindications for Aspirin
Increase in Reye's syndrome assoc with viral illness. Not for use in chicken pox or influenza
Also CI for asthmatics or pts with nasal polyps
Salicylic Acid
too irritating orally, used for warts and corns
Uric acid secretion with Salicylates
Low concentraion, high serum urate and vice versa.
Salicylates and CNS function
at High Conc: stimulate resp, excitation confusion nausea and vomiting
pH and Salicylate toxicity
Early, hypervent, low CO2, high pH. Late, resp failure, norm to high CO2, acidemia
high side effects
treat refractory fever in Hodgkins
treat acute gout
prevent labor
close ductus arteriosus
Indomethacin and gout
not a uricosuric, but potent anti inflam, so it is used
Indomethacin and labor
may prevent premature labor, but can close DA. Good for closing DA after birth
metabolized form 500 times more potent. less GI toxicity than Indo, less renal side effects (less active compound regenerated in kidneys)
rh arthritis, osteoarth and ankylosing spondylitis (RA, O, AS).
Plasma bound but doesnt interfere with others
can cause anaphylaxis, even if other NSAIDS don't
better pain relief than most NSAIDS, but high GI toxicity. Used IV after surgery
Mefanamic acid
no advantages
cause diarrhea
only for analgesia
Proprionic Acid Derivates
Ibuprofen and Naproxen
Half life of Ibuprofen vs Naproxen
IB 2 hours

Naproxen 14 hours
Contraindications for Ibuprofen
Pregnant women or breast feeders. Crosses placent and appears in milk

long half life of 50 hrs
cause bone marrow suppresion
displaces other plasma bound drugs
urcosuric for gout
less toxic than pheynylbutazone
Three COX-2 inhibitors and their trade names
Celecoxib = Celebrex
Rofecoxib = Vioxx
Valdecoxib = Bextra
Half lifes of:
11 hours
8 hours
Half life of Acetominophen
2 hours
Acetominophen effects
Lowers fever
Reduces pain
No anti-inflammatory
No blood thinings
No excretion of uric acid
Major pathway for metabolism of acetominophen
Conjugate with glucouronic acid
P450 breaks som tylenol into reactive intermediate that is combines with what to be eliminated?
Overwhelming glutathione causes?
adducts in cellular proteins leading to hepatic necrosis
Used to treat acetominophen poisoning
Last line drugs for rheumatoid arthritis
Gold compounds
List the three gold compounds
Gold Sodium Thiomalate
Which gold compound is taken orally
Contraindication of gold therapy
Renal disease
More potent than Indomethacin with less GI and renal side effects
Good for post op pain relief when given IV (not for oral use)
This drug is more effective than aspirin for dymenorrhea
equivalent to other NSAIDS but has very long half life
Less toxic form of phenylabutazone and its use
Apazone, gout
Used to treat acetominophen poisoning