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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 - 2024...

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  • August 23, 2024
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  • Nura 221 COX Inhibitors and Opioids
  • Nura 221 COX Inhibitors and Opioids
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Nura 221 COX Inhibitors and Opioids Exam 1 - 2024



COX - 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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