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Questions and Answers
Which of the following is a therapeutic use of acetaminophen?
Which of the following is a therapeutic use of acetaminophen?
- Sedative
- Antibiotic
- Antihistamine
- Analgesic (correct)
What is the primary concern associated with selective COX-2 inhibitors?
What is the primary concern associated with selective COX-2 inhibitors?
- Cardiovascular harm (correct)
- Renal protection
- Acetaminophen overdose
- Increased gastrointestinal bleeding
What is a risk associated with concurrent use of NSAIDs and acetaminophen?
What is a risk associated with concurrent use of NSAIDs and acetaminophen?
- Enhanced renal impairment
- Increased liver toxicity
- Severe allergic reactions
- Potential overdose if not monitored (correct)
Which of the following statements about acetaminophen is true?
Which of the following statements about acetaminophen is true?
What is a significant side effect of NSAIDs, including selective COX-2 inhibitors?
What is a significant side effect of NSAIDs, including selective COX-2 inhibitors?
Why is aspirin associated with a risk of gastric ulceration?
Why is aspirin associated with a risk of gastric ulceration?
Which of the following correctly reflects acetaminophen's mechanism of action?
Which of the following correctly reflects acetaminophen's mechanism of action?
What is true regarding the combination of celecoxib and other NSAIDs?
What is true regarding the combination of celecoxib and other NSAIDs?
What is a therapeutic use of aspirin?
What is a therapeutic use of aspirin?
Which of the following is an early sign of salicylate toxicity?
Which of the following is an early sign of salicylate toxicity?
Which condition is considered a contraindication for the use of aspirin?
Which condition is considered a contraindication for the use of aspirin?
What is the primary side effect of aspirin that can lead to severe complications?
What is the primary side effect of aspirin that can lead to severe complications?
What is the mechanism of action of acetaminophen?
What is the mechanism of action of acetaminophen?
Which type of NSAID is celecoxib classified as?
Which type of NSAID is celecoxib classified as?
What long-term effect can high doses of aspirin have on the liver?
What long-term effect can high doses of aspirin have on the liver?
What can happen as a result of chronic use of NSAIDs?
What can happen as a result of chronic use of NSAIDs?
Which effect is unique to aspirin compared to other NSAIDs?
Which effect is unique to aspirin compared to other NSAIDs?
What does the COX-1 pathway primarily support?
What does the COX-1 pathway primarily support?
Which of the following statements about acetaminophen is true?
Which of the following statements about acetaminophen is true?
Which pathway is mainly stimulated by tissue injury?
Which pathway is mainly stimulated by tissue injury?
What side effect is associated with the use of NSAIDs like ibuprofen?
What side effect is associated with the use of NSAIDs like ibuprofen?
What is the role of the COX-1 pathway in the body?
What is the role of the COX-1 pathway in the body?
Which statement about COX-2 is correct?
Which statement about COX-2 is correct?
What should be a concern when taking NSAIDs like naproxen?
What should be a concern when taking NSAIDs like naproxen?
How does aspirin differ from other NSAIDs in its mechanism?
How does aspirin differ from other NSAIDs in its mechanism?
What is a major characteristic of COX-2 inhibitors?
What is a major characteristic of COX-2 inhibitors?
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Study Notes
Acetaminophen and NSAIDs
- Acetaminophen is not classified as an NSAID due to its different mechanism of action.
- Aspirin has analgesic, antipyretic, and anti-inflammatory properties and promotes platelet aggregation.
COX Pathways
-
COX-1 Pathway
- Present in almost all tissues for "housekeeping" functions.
- Protects gastric mucosa, supports renal function, and promotes platelet aggregation.
-
COX-2 Pathway
- Activated in response to tissue injury.
- Responsible for pain, fever, and inflammation. Beneficial during injury.
- NSAIDs block prostaglandins and thromboxane, impacting the inflammatory response.
NSAIDs Specifics
- Non-selective NSAIDs inhibit both COX-1 and COX-2, affecting various physiological pathways.
- Some NSAIDs, like naproxen and ibuprofen, have less impact on platelet aggregation, yet may increase thrombotic risk.
- Selective COX-2 inhibitors are associated with a higher cardiovascular risk.
Acetaminophen
- Mechanism of action: Decreases prostaglandin synthesis primarily in the CNS.
- It has been used since the late 1800s; however, its exact pathway remains partially understood.
- Does not cause bleeding or gastric ulceration and doesn't impair renal function.
Aspirin
- Also known as acetylsalicylic acid (ASA), utilized for analgesic, antipyretic, anti-inflammatory effects, and as a platelet inhibitor.
- Originated from willow bark dating back over 2000 years.
- Most common side effect: GI bleeding, especially at doses above 325 mg (noted on the Beers List), leading to baby aspirin formulations (81 mg).
Adverse Effects of Aspirin
- Nausea and vomiting.
- Tinnitus can indicate ASA toxicity, potentially leading to hyperventilation and convulsions.
- Long-term usage risks hepatic damage, renal impairment, and signs of jaundice.
- Used to prevent transient ischemic attacks (TIAs).
Drug Interactions and Dosing
- Avoid using aspirin with Celecoxib due to shared pathways.
- Acetaminophen can be administered with NSAIDs, but total daily dosage should not exceed 4000 mg for acetaminophen.
- Alternating doses of acetaminophen and NSAIDs can be effective for pain management.
General NSAID Information
- Provide anti-inflammatory effects similar to corticosteroids without steroid-related side effects.
- Conventional NSAIDs, excluding celecoxib, are non-selective in their COX inhibition.
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