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NSAID's

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