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level: Level 4 - NSAIDs & COX 2 inhibitors

Questions and Answers List

NSAIDs & COX 2 inhibitors

Question	Answer
Anti-platelet •MOA: irreversibly inhibits platelet COX so that it's effect lasts 8-10 days (THE LIFE OF THE PLATELET) decreases the incidence of TRANSIENT ISCHEMIC ATTACKS, UNSTABLE ANGINA, CORONARY ARTERY THROMBOSIS WITH MYOCARDIAL INFARCTION and THROMBOSIS after coronary artery bypass grafting long-term use is associated with LOWER INCIDENCE OF COLON CANCER	•Acetylsalicylic acid (ASA)
Aspirin Doses 1 At low doses (>2g/day): 2 At high doses:	. 1uric acid excretion is DECREASED 2 uric acid secretion may be UNCHANGED OR INCREASED
NONACETYLATED SALICYLATES	• Magnesium choline salicylate • Sodium salicylate • Salicyl salicylate - less effective than aspirin & do not inhibit platelet aggregation SMS
less effective than aspirin & do not inhibit platelet aggregation	Salicyl salicylate
•"COXIBS"' •have ANALGESIC, ANTIPYRETIC and ANTI INFLAMMATORY effects	COX-2 SELECTIVE INHIBITORS BAD COX
COX-2 SELECTIVE INHIBITOR •withdrawn from the market due to HIGH INCIDENCE OF CARDIOVASCULAR THROMBOTIC events	Rofecoxib & Valdecoxib
• associated with FEWER ENDOSCOPIC ULCERS than most other NSAIDs • a sulfonamide, thus MAY CAUSE RASHES • does NOT AFFECT PLATELET AGGREGATION COX-2 SELECTIVE INHIBITOR	CELECOXIB • Celebrex® Etoricoxib (Arcoria)
• an ENOLCARBOXAMIDE RELATED TO PIROXICAM • approved for TREATMENT OF OSTEOARTHRITIS (Wear and Tear no inflammation no pain) COX-2 SELECTIVE INHIBITOR	MELOXICAM •Mobic®