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13 Cards in this Set

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Mechanism of NSAIDS
- inhibition of COX (cyclo-oxygenase)
- this enzyme ultimatley used in the formation of prostaglandins
COX-1
- found in a variety of tissues
- involved in many housekeeping functions of prostaglandins
COX-2
- involvedi n the inflammatory responses, fever, and algesia
- also expressed in vessels, kidney, heart, brain
Actions of prostoglandins
- vasodilation
- vasoconstriction
- contracts other smooth muscle**
- INHIBIT MAST CELL SECRETION
- PYROGENIC
- Sensitize nerve endings to other algesic mediators
Actions of Leukotrienes
- aids in the migration of leukocytes
- long lasting BRONCHIOLAR CONSTRICTION
- increased capillary permeability
NSAIDS and INFLAMMATION
- reduce vasodiations, edema, and pain associated with inflammation
- MAINLY ACUTE PHASE
- require high dose of NSAID
- ion trapping
-
NSAIDS and Analgesia
- inhibition of COX-2
- classified as mild analgesics
-
NSAIDS and ANTI-PYRESIS
- centrally mediated effect via resetting of temp control center of the hypothalamus
- INHIBIT THE COX-2 and block production of prostaglandins in the brain
NSAIDS AND PLATELET AGGREGATION
- inhibit COX-1
- this is involved with TxA2 (thromboxane)
- SO... increase bleed time
- inhibition of platelet aggregation
ASPRIN
- covalently madifies and IRREVERSIBLY INHIBITS PLATELET CYCLO-OXYGENASE
- achieved at low dose
NSAIDS and Cardiovascular effects
- COX-2 protects from reperfusion injury
NSAIDS renal effects
- Prostaglandins not involved in maintaining normal renal blood flow, but become inmportant in the compromised kidney
- Pts that are volume depleted are at risk of renal ischemia when on NSAIDS
NSAIDS AND GI effects
- gastric distress
- gastric bleeding
- sudden acute hemorrhage
can see too much acit secretion