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51 Cards in this Set
- Front
- Back
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MOA of NSAIDS |
inhibit prostaglandin synthesis by inhibiting cyclo-oxygenase (cox) |
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Difference between aspirin and other NSAIDS
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Aspirin irreversibly inhibits cyclooxygenase |
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Four main actions of NSAIDS
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Anti-inflammatory, analgesia, antipyretic and antiplatelet activity |
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Agent used for closure of patent ductus arteriosus
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1. Indomethacin 2. Ibuprofen |
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Aspirin is contraindicated in children with viral infection
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Potential for development of Reye's syndrome |
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SE of salicylates
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Tinnitus, GI bleeding
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NSAID also available as an ophthalmic preparation -> T(x) solar keratoses |
Diclofenac |
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NSAID available orally, IM and ophthalmically |
Ketoralac |
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NSAID that is used for acute condition, such as pre-op anesthesia and has limited duration (<5 days) of use due to nephrotoxicity
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Ketoralac |
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Newer NSAID that selectively inhibits COX-2
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Celecoxib |
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COX 2 inhibitors may have reduced risk of
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Gastric ulcers and GI Bleeding
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COX 2 inhibitors should be used cautiously in pts with
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Pre-existing cardiac or renal disease
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Acetaminophen only has
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Antipyretic and analgesic activity
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SE of acetaminophen
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Hepatotoxicity |
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Antidote for acetaminophen toxicity
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N-acetylcysteine
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DMARDs are slow acting drugs for
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Rheumatic disease
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MOA of gold salts
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Alter activity of macrophages and suppress phagocytic activity of PMNs
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SE of gold salts
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Dermatitis of the mouth aplastic anemia and agranulocytosis
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Causes bone marrow suppression
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Methotrexate
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SE of penicillamine
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Aplastic anemia and renal
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Interferes with activity of T-lymphocytes
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Hydroxychloroquine
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Anti-malarial drug used in rheumatoid arthritis (RA)
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Hydroxychloroquine
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SE of hydroxychloroquine
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Retinal destruction and dermatitis
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MOA of Leflunomide (newer agent)
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Inhibiting Dihydroorotate Dehydrogenase which leads to decreased pyrimidine synthesis
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Proteins that prevent action of tumor necrosis factor alpha (TNF-alpha)
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Infliximab and etanercept
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Anti-rheumatic agent also used for ulcerative colitis
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Sulfasalazine
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Anti-rheumatic agent also used for Chron's disease
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Infliximab
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NSAID used in gout
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Indomethacin
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NSAID contraindicated in gout
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Aspirin
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MOA of Colchicine (used in acute gout)
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Selective inhibitor of microtubule assembly |
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SE of colchicine
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Kidney and liver toxicity, diarrhea |
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Agent used to treat chronic gout by increasing uric acid secretion
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Probenecid and sulfinpyrazone
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Allopurinol treats chronic gout by inhibiting
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Xanthine oxidase
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What P450 processes NSAID? |
CYP3A, CYP2C |
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What mechanism do NSAID use to inhibit chemotaxis? |
decreased IL-1 decreased free radicals and superoxide interference with calcium-mediated intracellular |
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What can be used to treat preeclampsia eclampsia |
aspirin |
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What drug does not inhibit platelet aggregation and may be preferable in asthmatics? |
NonAcetylated Salicylates |
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What drug is known to inhibit synthesis of thromboxane A2? |
Meloxicam |
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At what dose does ibuprofen have an anti-inflammatory effect? |
2400 mg |
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What should pts taken both aspirin and ibuprofen be warned? |
ibuprofen limits the cardioprotective effects of aspirin |
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What are rare side effects associated with ibuprofen? |
agranulocytosis and aplastic anemia |
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What SE have been noted with indomethacin? |
pancreatitis, headache, dizziness, confusion, depression, psychosis with hallucination |
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Drug used to replace morphine for post surgical pain? |
Ketorolac |
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What drug is the only nonacid NSAID currently in use with a half-life of more than 24 hours? |
Nabumetone |
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Drug is in a slow release formation, has a higher free fraction in women, and has lower incidence of GI bleeding? |
Naproxen |
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What effect does release of TXA2 have? |
released from platelets during injury tigers the recruitment of new platelets for aggregation and local vasoconstriction |
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What effect does PGI2 have when released from endothelial cells |
inhibiting platelet aggregation and producing vasodilation |
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Why does aspirin form stomach ulcers? |
PGE2 & PGFalpha2 are not formed resulting in increased acid secretion and decreased mucus secretion |
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Which salicylate does not cross blood brain barrier? |
Diflunisal |
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Reye's syndrome |
often fatal, fulminating hepatitis with cerebral edema |
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What propionic acid derivative has such a long half life that it is only administered once a day? |
Oxaprozin |
