Name the NSAIDS.
What is a synthetic prostaglandin? What's the side affect?
Antidote for NSAID induced gastritis.
Misoprotol: causes diarrhea
Which compounds are used to treat pain?
Which compounds are used as an analgesic?
Aspirin, Indomethacin, Naproxen, Piroxialam
Which drug is the same as naproxen but more costly?
Analgesic which is better than aspirin?
Only NSAID given intraveneously?
NSAID used to treat gout?
What causes inflammation? edema and pain?
Cytokines and Prostaglandins released by PMNs
What is the precursor for ALL prostaglandins?
What causes the release of arachodonic acid?
What is the result of PGE2 release?
What is the enzyme of importance in the protaglandin biosynthesis pathway that controls the production of cyclic endoperoxides?
Cyclic endoperoxides are converted into what three products?
Thromboxanes, Prostaglandins, and Prostacyclins
What is the purpose of thromboxanes?
aggregation of blood cells-clotting
What is the purpose of prostacyclin (PGI2)?
inhibits aggregation (vasodilator)
What is the affect of prostaglandins released in the stomach?
increased muscous secretion
reduced acid secretion
Inflammation in the immune system
What is the mode of action of an anti-inflammatory drug?
Block the cyclo-oxygenase
What is the affect of blocking the production of cyclic endoperoxides by inhibition of cyclo-oxygenase (COX)?
mucous secretion in the stomach decreases
acid secretion increases
results in gastritis
Cyclo-oxygenase is 2 enzymes? what are adverse affect are they responsible for?
COX I enyzme inhibitor: gastritis
COX II enzyme inhibitor: stops inflammation
Number one weak acid? where is it absorbed?
Three major affects of aspirin in the body?
inflammation, analgesia, anit-pyretic
What's the mode of action for aspirin?
it blocks the migration of PMNs into the tissue
blocks production arachidonic acid
How do steriod work? MOA?
block phospholipase A2 and stop arachidonic acid
How does aspirin work to reduce pain?
reduce PGE2 in the central nervous system
How does aspirin work as an antipyretic?
lowering PGE2 in the hypothalamus
What are the 2 reasons patients stop using aspirin?
gastritis and acidosis
What are the 2 molecules resulting from aspirin metabolism? What is the significance?
acetate (prevent plalet aggregation) and salicylate
Major use of aspirin?
DJD (degenerative joint disease) in the knee
What is a major difference between acetomenophen and aspirin?
acetomenophen is NOT an anti-inflammatory agent
What is a therapetic strategies for aspirin to avoid bleeding?
Given patient's aspirin products to relieve pain and disease; DVD; strategy is to keep a low dose by given it every OTHER day therapy (12 pills/day)
Antidote for NSAID over-dose?
How to avoid irritation of NSAID therapy?
add steroid with ketorolac
What is the reason that geriatic patients have adverse effects with acetomenophen?
They take it forever; benzoqueinone destroys the liver; glutathione (prodced in body) afterwards: acetylcysteine is the antidote since it has lots of SH groups