Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
15 Cards in this Set
- Front
- Back
|
How much and how long of NSAIDs should a patient take? |
Lowest effective dose for the shortest duration to control symptoms
|
|
|
What role does prostaglandin E2 play in inflammation? |
Activates inflammatory cells |
|
|
What does the ability of NSAIDs to relieve pain and provide anti inflammatory effects locally rely upon? |
Their ability to control COX enzyme activity |
|
|
How do NSAIDs produce damage to gastric mucosa? |
Direct chemical irritation and inhibition of PGE2, interrupting cytoprotective mechanisms in the stomach involving mucus secretion, bicarb release, and initiation of essential repair processes. |
|
|
Do H2 receptor antagonists or proton pump inhibitors have superior efficacy to reduce GI tocixity? Why? Caveats? |
PPIs because they have more complete acid suppression but this may reduce bioavailability or efficacy of a concurrent drug.
|
|
|
Production of what is significantly inhibited when a patient takes a COX2 selective drug leading to a more prothrombotic state? What is not inhibited? |
Prostacyclin. Thromboxane A2 is not inhibited. |
|
|
Are high doses of ibuprofen or diclofenac associated with increase in vascular events? |
Yes |
|
|
Is high dose of naproxen associated with increase in vascular events? |
No
|
|
|
How is there an increase CV risk with taking daily low dose aspirin? |
Traditional NSAIDs reversibly bind to platelets and competitively inhibit aspirin from irreversibly binding |
|
|
Which NSAID has a significantly increased risk of hepatotoxicity? |
Sulindac |
|
|
What can inhibition of PGI2 and PGE2 by chronic NSAID use give rise to? Why? |
PGs maintain renal blood flow and GFR in renal insufficiency so blocking them with NSAIDs might cause renal ischemia and other kidney issues |
|
|
Routine patient monitoring in NSAID use? |
LFTs, serum creatinine/BUN, stool guaiac, and CBCs |
|
|
For intentional drug overdose of aspirin, what serum level of what should be monitored? Why? |
Salicylate because it can pass the blood brain barrier to stimulate respiratory alkalosis |
|
|
What criteria is used in the evaluation of NSAID use in elderly? |
Beers criteria |
|
|
What is the big issue with tylenol? |
Widespread availability in many OTC products and potential for overdose |
