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34 Cards in this Set
- Front
- Back
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-triptan |
serotonin-receptor agonist for migranes (e.g. sumatriptan) |
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Labs to monitor with NSAIDS |
Blood urea nitrogen (BUN), creatinine (Cr), Glomerular filtration rate (GFR) |
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What are three results of the COX-1 enzyme? |
Gastric protection, maintenance of renal function, and platelet aggregation |
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What are six results of the the COX-2 enzyme? |
Inflammation, pain, fever, promotion of colon cancer, maintenance of renal function, vasodilation |
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Give one benefit of inhibiting COX-1 |
Prevention of platelet aggregation |
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List four benefits of inhibiting COX-2 |
Suppress inflammation, relieve pain, reduce fever, reduce risk of colorectal cancer |
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Inhibiting cyclooxygenase (COX) interferes with the production of what? |
Prostaglandins |
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Name two COX inhibitors that do not suppress inflammation. |
Acetaminophen (Tylenol), ketorolac (Toradol) |
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Give three adverse effects of inhibiting COX-1 |
Gastric ulceration, renal impairment, bleeding (except Tylenol) |
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Name three adverse effects of selective COX-2 inhibitors other than gastric ulceration with bleeding. |
Renal impairment, vasoconstriction, increased risk of MI & stroke |
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Which COX inhibitor has an irreversible action? |
Acetylsalicylic acid (Aspirin) |
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What syndrome can occur withthe administration of aspirin to children who have chickenpox or influenza? |
Reye's syndrome |
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How long does aspirin suppress platelet aggregation? |
8 days |
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Should aspirin be recommended to pregnant women? |
NO- detrimental to mother and fetus |
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Give four signs of early salicylism. |
Tinnitus, dizziness, sweating, headache |
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List three conditions which increase the risk of hypersensitivity with salicylates. |
Asthma, allergic rhinitis, nasal polyps |
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Acute poisoning with salicylates begins with what breathing pattern? |
Hyperventilation |
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How does ibuprofen (Motrin, Advid) alter the action of aspirin? |
Blocks ASA access to COX-1 receptors on platelets, preventing ASA from inhibiting platelet aggregation. Give ibuprofen 2 hours after aspirin. |
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Which NSAID decreases the risk of MI and stroke? Which NSAID does not increase the risk of MI and stroke? Which NSAID increase the risk of MI and stroke? Which has the highest risk of MI and stroke |
Decreases risk = Aspirin. Not increase = Acetaminophen (Tylenol). Increase risk of MI and stroke= First-generation NSAIDs (not including aspirin) and the second generation NSAID. Highest risk = celecoxib (Celebrex) the 2nd generation NSAID |
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An allergy to what class of drug is a contraindication for celecoxib (Celebrex)? |
Sulfonamides |
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Where does inhibition of prostaglandins occur with acetaminophen (Tylenol)? |
CNS, no anti-inflammatory effects. |
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What pathway can create toxic metabolites when metabolizing large amounts of Tylenol? |
Minor pathway |
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What is the maximum recommended dosage of Tylenol per day for nondrinkers? |
4 g per day |
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What is the maximum recommended dosage of Tylenol per day for patients who drink or have liver disease? |
2 g per day |
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What is the maximum recommended dosage of Tylenol per day for patients with malnutrition? |
3 g per day |
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What drug is given for Tylenol toxicity? |
Acetylcysteine |
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WHy does alcohol increase the liklihood of Tylenol toxicity? |
It induces the minor pathway & alcoholics have depleted glutathione stores. |
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How long before surgery should NSAIDs be stopped? |
1 week or 5 half-lives |
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Which drugs increase the risk of stroke and myocardial infarction? |
First-generation COX inhibitors, not including aspirin or acetaminophen. Second generation COX inhibitors |
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Name two drug categories that should be avoided with triptans and why. |
SSRIs, SNRIs, or other triptans. Increased risk for serotonin syndrome. |
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How does 5-HT activation reduce the symptoms of migraines? |
Causes vasoconstriction of cranial blood vessels and suppresses release of pro-inflammatory neuropeptides. |
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What are major contraindications or cautions for the use of sumatriptan (Imitrex)? |
Cardiovascular and cerebrovascular disorders. (may cause vasospasm). |
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When should sumatriptan (Imitrex) be taken? |
At first sign of a headache. |
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Celebrex drug interactions |
◦Increaseswarfarin (Coumadin) levels◦Decreasesdiuresis from ACE inhibitors or furosemide (Lasix) due to renal impairment
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