Effects of NSAIDs Quiz

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Questions and Answers

Which of the following is NOT a consequence of NSAIDs blocking PGE2 and PGI2 synthesis?

Increased platelet activity

Bronchospasm

Venodilatation (correct)

Renal problems

Why are NSAIDs contraindicated for children/adolescents with fever?

To prevent bronchospasm

To reduce pulmonary arterial pressure

To lower the hypothalamic temperature set point

To avoid Reye's syndrome (correct)

What is the main function of PGI2 (Prostacyclin) in the body?

Mediating venodilatation

Increasing platelet activity

Lowering pulmonary arterial pressure (correct)

Inhibiting platelets

How do NSAIDs affect arachidonic acid metabolism in the airways?

Increase leukotriene synthesis Signup and view all the answers

Which NSAID has anti-platelet/cardio-protective activity at very low doses?

Aspirin Signup and view all the answers

Why are all NSAIDs considered analgesic and antipyretic?

They block PGE2 synthesis Signup and view all the answers

What is the main mechanism of action of NSAIDs?

Inhibition of cyclooxygenase (COX) Signup and view all the answers

Which COX isoform is considered the 'bad' isoform and is inducible by toxins and infectious agents?

COX2 Signup and view all the answers

What distinguishes prostacyclin (PGI2) from other prostaglandins?

It is the only PG with a bicyclic system consisting of carbon atoms only Signup and view all the answers

What is the effect of NSAIDs on leukotrienes and other eicosanoids?

Block synthesis of all eicosanoids except leukotrienes Signup and view all the answers

What is the chemical class to which Aspirin (acetylsalicylic acid) belongs?

Nonsteroidal anti-inflammatory drugs (NSAIDs) Signup and view all the answers

Which component is NOT included in the synthesis inhibition by NSAIDs according to the passage?

Leukotrienes Signup and view all the answers

What is the main prostaglandin responsible for gastric protection and nourishment?

PGE2 Signup and view all the answers

Which synthetic prostaglandin is used for gastric protection and is co-prescribed with NSAIDs to prevent peptic ulcers?

Misoprostol Signup and view all the answers

Which drug is administered for uterine bleeding post-labor and is a synthetic form of PGE2?

Dinoprostone Signup and view all the answers

Which medication, injected directly into the penis, is used for erectile dysfunction by inducing penile vasodilation?

Alprostadil Signup and view all the answers

Which prostaglandin is mainly responsible for keeping the ductus arteriosus open in newborns?

PGE2 & PGE1 Signup and view all the answers

Which COX inhibitor is still available on the market in the US among the coxibs or selective COX2 inhibitors?

Celecoxib Signup and view all the answers

How do NSAIDs primarily provide pain relief?

By reducing the levels of specific mediators like prostaglandins Signup and view all the answers

Which enzyme do non-selective NSAIDs block to affect blood clotting and gastrointestinal functions?

Cox enzyme Signup and view all the answers

What is the specific target of selective NSAIDs to reduce side effects?

Cox-2 enzyme Signup and view all the answers

Which of the following is NOT a mediator released by immune cells during the inflammatory response?

Histidine Signup and view all the answers

What role do prostaglandins E2 and F2 play in pain perception and inflammation?

They have a crucial role in pain perception and inflammation Signup and view all the answers

Study Notes

NSAIDs Mechanism of Action and Effects

NSAIDs mediate venodilatation by furosemide, inhibit platelets, and lower pulmonary arterial pressure.
They cause renal problems by blocking the synthesis of beneficial prostaglandins (PGE2 and PGI2) in the kidney.

Effects on Airways and Asthma

NSAIDs divert arachidonic acid metabolism to leukotriene synthesis, increasing the risk of bronchospasm and asthma-related inflammation.

Analgesic, Antipyretic, and Anti-Inflammatory Effects

All NSAIDs are analgesic and antipyretic, except for acetaminophen, which is only analgesic and antipyretic at all doses.
At higher doses, NSAIDs are also anti-inflammatory, except for acetaminophen.

Aspirin and Cardio-Protective Activity

Aspirin is contraindicated for fever in children/adolescents due to Reye's syndrome.
At very low doses, aspirin has anti-platelet/cardio-protective activity via thromboxane TXA2 synthesis inhibition in platelets.

Patent Ductus Arteriosus and GI Protection

All NSAIDs help close patent ductus arteriosus in preterm infants, with ibuprofen and indomethacin being the NSAIDs of choice.
COX1 synthesizes PGE1 and PGE2, which protect and nourish gastric mucosa and epithelia.
Misoprostol, a PGE1 synthetic analog, is co-prescribed with an NSAID for gastric protection.

Additional Uses of Prostaglandins

Synthetic PGE2 (dinoprostone) is used for uterine bleeding post-labor.
Synthetic PGE1 (alprostadil) is used for erectile dysfunction, inducing penile vasodilation.

COX Inhibition and Eicosanoids

The MOA of NSAIDs is cyclooxygenase (COX) inhibition, blocking the synthesis of prostaglandins (PGs) and thromboxanes (TXs).
Two functional COX isoforms in humans: COX1 (constitutive and "good") and COX2 (inducible and "bad").
All eicosanoids come from arachidonic acid, and NSAIDs block synthesis of all PGs and TXs but not of leukotrienes or other eicosanoids.

Chemistry and Nomenclature

All PGs and TXs have 20 carbon atoms (eicosanoids) and are carboxylic acids (arachidonic acid derivatives) with one or more double bonds and at least one ring.

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Description

Test your knowledge on the effects of NSAIDs on venodilatation, platelet inhibition, pulmonary arterial pressure, and renal problems. Learn about how NSAIDs impact arachidonic acid metabolism and leukotriene synthesis.