Pharmacology: NSAIDs and COX Pathways
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Questions and Answers

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?

  • Cardiovascular harm (correct)
  • Renal protection
  • Acetaminophen overdose
  • Increased gastrointestinal bleeding
  • 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?

    <p>It does not cause gastric ulceration.</p> Signup and view all the answers

    What is a significant side effect of NSAIDs, including selective COX-2 inhibitors?

    <p>Hepatotoxicity</p> Signup and view all the answers

    Why is aspirin associated with a risk of gastric ulceration?

    <p>It inhibits COX-1 pathways.</p> Signup and view all the answers

    Which of the following correctly reflects acetaminophen's mechanism of action?

    <p>Primarily decreases prostaglandin synthesis in the CNS.</p> Signup and view all the answers

    What is true regarding the combination of celecoxib and other NSAIDs?

    <p>They share the same metabolic pathway, posing risks when combined.</p> Signup and view all the answers

    What is a therapeutic use of aspirin?

    <p>Antipyretic</p> Signup and view all the answers

    Which of the following is an early sign of salicylate toxicity?

    <p>Tinnitus</p> Signup and view all the answers

    Which condition is considered a contraindication for the use of aspirin?

    <p>Gastric bleeding</p> Signup and view all the answers

    What is the primary side effect of aspirin that can lead to severe complications?

    <p>GI bleeding</p> Signup and view all the answers

    What is the mechanism of action of acetaminophen?

    <p>Centra nervous system prostaglandin synthesis inhibition</p> Signup and view all the answers

    Which type of NSAID is celecoxib classified as?

    <p>Second generation, selective</p> Signup and view all the answers

    What long-term effect can high doses of aspirin have on the liver?

    <p>Hepatic damage</p> Signup and view all the answers

    What can happen as a result of chronic use of NSAIDs?

    <p>Gastrointestinal complications</p> Signup and view all the answers

    Which effect is unique to aspirin compared to other NSAIDs?

    <p>Inhibits thromboxane synthesis</p> Signup and view all the answers

    What does the COX-1 pathway primarily support?

    <p>Housekeeping needs of tissues</p> Signup and view all the answers

    Which of the following statements about acetaminophen is true?

    <p>It is not considered an NSAID due to its mechanism of action</p> Signup and view all the answers

    Which pathway is mainly stimulated by tissue injury?

    <p>COX-2 pathway</p> Signup and view all the answers

    What side effect is associated with the use of NSAIDs like ibuprofen?

    <p>Increased risk of thrombotic events</p> Signup and view all the answers

    What is the role of the COX-1 pathway in the body?

    <p>Protects gastric mucosa</p> Signup and view all the answers

    Which statement about COX-2 is correct?

    <p>It primarily contributes to pain and inflammation</p> Signup and view all the answers

    What should be a concern when taking NSAIDs like naproxen?

    <p>Gastrointestinal bleeding</p> Signup and view all the answers

    How does aspirin differ from other NSAIDs in its mechanism?

    <p>It irreversibly inhibits cyclooxygenase enzymes</p> Signup and view all the answers

    What is a major characteristic of COX-2 inhibitors?

    <p>They reduce pain without affecting gastrointestinal protection</p> Signup and view all the answers

    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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    Description

    This quiz tests your knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and their mechanisms of action, particularly focusing on the COX-1 and COX-2 pathways. Understand the differences between acetaminophen and traditional NSAIDs like aspirin, and their effects on pain and inflammation.

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