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Nura 221 COX Inhibitors and Opioids Exam 1 - 2024
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Nura 221 COX Inhibitors and Opioids Exam 1 - 2024COX - ANSWER cyclo-oxygenase
an important enzyme in the synthesis of prostaglandin
Cox is found in all tissues and helps regulate many processes
COX inhibitors - ANSWER NSAIDs (Non-Steroidal Anti-Inflammatory
Medications)
and selective COX2 inhibitors
COX-1 (5 things) - ANSWER *This is the protective cox and is located in all
tissues
1. Protects the gastric area by reducing the secretion of gastric acid
2. Increasing secretion of bicarbonate and cytoprotective mucus
3. Maintenance of sub-mucosal blood flow
4. Catalyzes the synthesis of PGE2 and PGI2 which promote vasodilation and
therefore increase renal blood flow
5. Promotes synthesis of TXA2 (which stimulates platelet aggregation, which can
be a negative event) in a positive way it can clot (stop bleeding) a cut
COX-2 - ANSWER *reactive cox
This is present only at the site of tissue injury and the brain
When activated it:
Causes inflammation
Causes pain
Causes fever (increased heat at the site of injury)
Two types of COX - ANSWER COX-1
,COX-2
Examples of NSAIDs - ANSWER - Ibuprofen (Advil/Motrin)
- Naproxen & Naproxen Sodium (Naprosyn & Aleve)
- Aspirin
- Indomethacin (Indocin)
- Ketorolac (Toradol)
3 primary functions of NSAIDs - ANSWER •Suppression of inflammation
•Relief of pain (analgesic)
•Reduction of fever (anti-pyretic)
Two types of Cox inhibitors - ANSWER specific and non-specific
What are non-specific cox inhibitors? - ANSWER NSAID that blocks the action of
cox1 and cox2
also called First-generation
What are specific Cox inhibitors? - ANSWER NSAIDs that mostly block cox2
also called Second Generation
What will non-specific (first-gen) COX inhibitors do? - ANSWER Blockage of
Cox2
•Suppression of inflammation
•Suppression of fever
•Suppression of pain
Blockage of Cox1 (which can lead to-)
•Gastric erosion and ulceration
•Bleeding tendencies
•Acute renal failure
, Positive effects of blocking COX 1 - ANSWER •AMI/CVA protection
•Inhibiting unwarranted platelet aggregation by blocking/stopping the synthesis of
TXA2
Most widely used NSAID (first gen) and also the DOC (drug of choice) for RA? -
ANSWER ASA
What is ASA? - ANSWER Acetylsalicylic Acid (Aspirin)
from the salicylate family
non-selective cox inhibitor
Reasons to use ASA - ANSWER •Highly recommended for prophylaxis to platelet
aggregation with AMI/CVA high-risk patients.
Pain relief
Inflammation relief (requires higher dosage to achieve this relief)
Reduces fever
Dysmenorrhea- (to inhibit prostaglandins in uterine smooth muscle)
Suppression of platelet aggregation
What is dysmenorrhea? How does ASA help? - ANSWER painful menstruation
(ASA can help bc it inhibits Prostaglandins which cause uterine contractions)
SE/AR of ASA - ANSWER GI problems (bleeding, cramps, ulceration in gastric
lining)
Bleeding
Renal impairment - don't use ASA if kidney issues
Salicylism
Reye's syndrome
What is salicylism? What to do when it happens? - ANSWER A toxic condition
produced by the excessive intake of salicylic acid or salicylates (aspirin) and
marked by tinnitus, N/V, sweating, headache, and dizziness and hyperventilation
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