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Flashcards in NSAIDs Deck (19)
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1
Q

Give 4 examples of NSAIDs

A

Aspirin, ibruprofen, diclofenac, indometacin

2
Q

Name 3 actions of NSAIDs

A

Analgesia, anti-inflammatory, anti-pyuretic

3
Q

How do they work?

A

By inhibiting prostaglandin synthesis by the cyclo-oxygenase pathway

4
Q

Name 4 prostaglandins

A

PGD2, PGE2, PGF2a, PGI2

5
Q

How are prostaglandins formed during inflammation?

A

Membrane phospholipids are converted to arachidonic acid via phospholipidase A2
COX-1 and COX-2 then convert it to PGG2->PGH2
-> prostaglandins via PG synthase

6
Q

Apart from prostaglandins, what can arachidonic acid be converted into?

A

Leukotrienes and thromboxane (TXA2)

7
Q

Aspirin is a -?

A

Salicylic acid

8
Q

Ibruprofen and naproxen are -?

A

Propionic acids

9
Q

An example of an acetic acid NSAID is-?

A

Indometacin

10
Q

Name 2 selective COX-2 inhibitors

A

Celecoxib, etoricoxib

11
Q

Roles of prostaglandins

A

Pain, inflammation (vasodilation), fever (PGE1 in hypothalamus), platelet aggregation inhibition, maintenance of renal blood flow, reduce gastric acid secretion, induces labour

12
Q

How do prostaglandins have a role in pain

A

By sensitising nerves to bradykinin and histamine (produced from the tissue trauma)

13
Q

What drug is given for MIs?

A

Low dose aspirin due to anti-platelet effect of TXA2 inhibition
(Thromboxane is also produced via COX)

14
Q

Why is selective COX-2 inhibition beneficial?

A

Allows COX-1 to maintain physiological role of GI protection, renal blood flow maintenance and platelet aggregation

15
Q

How do you reduce the side effect of gastric ulceration/bleeding?

A

Use COX-2 selective inhibitor
Enteric coated tablets
Combine with proton pump inhibitor
Combine with synthetic prostaglandin

16
Q

What are the renal side effects of NSAIDs?

A

Reduced renal blood flow (↓GFR, afferent arterial constriction) increased salt and water retention, especially in renal failure and elderly

17
Q

What are the effects of an aspirin overdose?

A

Tinnitus, vertigo, vomiting, resp and metabolic acidosis

18
Q

Name some other adverse effects of NSAIDs

A

Aspirin- Reye’s syndrome in children, gout
Increased MI?
Premature closure of ductus arteriosus in fetus

19
Q

Name 4 uses of NSAIDs

A

Rheumatoid and osteoarthritis, headache, fever, pre-term labour, gout