Question | Answer |
enzyme required to produce cascade of events that occur during inflammation | cyclo-oxygenase (COX) |
synthesized continuously and is present at all times in all tissues and cells | COX 1 |
synthesized mainly in response to pain and inflammation | COX 2 |
mainly COX 1 selective NSAIDs | asa, ketoprofen, ansaid, Indocin, feldene, sulindac |
slightly COX 1 selective NSAIDs | ibuprofen, naproxen, diclofenac |
slightly COX 2 selective NSAIDs | etodolac (Lodine), Relafen, Mobic (meloxicam) |
COX 2 selective NSAIDs | Celebrex, vioxx, bextra (both removed from the market d/t increased risk for cardiovascular events |
more readily absorbed than naproxen and is used when rapid analgesia is desire | naproxen sodium |
should not be used in pts with chronic alcoholism | tylenol |
diclofenac produced in combination with cytoprotective agent misoprostol | arthrotec |
NSAIDs are pregnancy category B | ketoprofen, ibuprofen, diclofenac, indomethacin, medlomen, feldene, sulindac but should be avoided in last trimester |
NSAIDs that are pregnancy category C | lodine, ansaid, toradol, Relafen, daypro |
if used in pregnancy, agents that inhibit prostaglandin synthesis may cause | closure of the ductus arteriosus |
a single dose of Tylenol; 150 mg/kg in children or 7.5-10 grams | may be toxic dose of tylenol |
dose of Tylenol that is usually fatal | 25 grams |
obtain a serum Tylenol assay 4 hours after ingestion, if level is > ?, 90% will have hepatic damage | 300mg/m: |
antidote for Tylenol toxicity | n-acetylcysteine (Mucomyst) |
if Tylenol is taken in large doses or regularly the store of ? become depleted and may create hepatic necrosis | glutathione, a hepatic conjugate; glucuronidation, the metabolic pathway |
NSAID that shows no difference in overall safety and efficacy between older and younger patients | Relafen (nambumetone) |
if pt with RA would benefit from NSAID but are at increased risk for GI effects recommendations for tx are: | low dose prednisone instead of NSAID, nonacetylated salicylate, Celebrex, use NSAID in combo with gastroprotective agent, use low dose aspirin if antiplatelet therapy is indicated |
acetaminophen max dose | 4 grams |
Tylenol provides little benefit when ? is the cause of pain | peripheral inflammation |
nsaids indicated for gout | Indocin, sulindac, ketoprofen |
max dose of ibuprofen | for mild-moderate pain: 2400mg/day;
for oa or ra: 3200mg/day |
max dose of naprosyn | mild-mod pain: 1250mg/day
oa ra: 1500mg/day |
propionic acid group short acting | ibuprofen, ketoprofen |
acetic acid group short acting | diclofenac (volatren), indomethacin |
fenamic acid group short acting | meclofenamate |
pyrrolizine carboxylic acid group short acting | toradol |
pyranocarboxylic acid group short acting | etodolac (lodine) |
propionic acid group intermediate | naproxen, naproxen sodium |
acetic acid group intermediate | sulindac |
propionic acid group long-acting | ketoprogen er, oxaprozin (daypro) |
oxicams long-acting | meloxicam (Mobic), piroxicam (feldene) |
naphthylalkanone long acting | nabumetone (Relafen) |