and Answers 2025|2026 Verified
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What is the level of importance of the different characteristics of a
drug?
1. Effectiveness
2. Safety
3. Selectivity
What are the two types of nonsteroidal anti-inflammatory drugs
(NSAIDs)?
First-generation NSAIDs (COX-1 and COX-2 inhibitors)
- Aspirin
- Ibuprofen
- Naproxen
- Ketorolac
Second-generation NSAIDs (selective COX-2 inhibitors)
- Celecoxib
What is the expected pharacological action of NSAIDs?
Inhibition of Cyclooxygenase (COX):
,- inhibition of COX-1 can result in decreased platelet aggregation and
kidney damage
- inhibition of COX-2 results in decreased inflammation, fever, and pain
and does not decrease platelet aggregation
What are some therapeutic uses for NSAIDs?
- inflammation suppression
- analgesia for mild to moderate pain (osteoarthritis and rheumatoid
arthritis)
- fever reduction
- dysmenorrhea
- inhibition of platelet aggregation (protects against ischemic stroke and
myocardial infarction -> aspirin)
- celecoxib suppresses inflammation, relieves pain, decreases fever, and
can protect against colorectal cancer
What are some complications that can occur with NSAIDs?
Gastrointestinal discomfort
- dyspepsia
- abdominal pain
- heartburn
- nausea
Impaired kidney function
- decreased urine output
- weight gain from fluid retention
- increased BUN and creatinine
, Increased risk of heart attack and stroke
- with non-aspirin NSAIDs
Salicylism (can occur w aspirin)
- manifestations -> tinnitus, sweating, headache, dizziness, and
respiratory alkalosis
Reye Syndrome (rare but serious)
- occurs when aspirin is used for fever reduction in children and
adolescents with a virus
Aspirin toxicity
- progresses from mild in salicylism to sweating, high fever, acidosis,
dehydration, electrolyte imbalance, coma, and respiratory depression
What are some contraindications/precautions of NSAIDs?
First-generation NSAIDs
- pregnancy
- peptic ulcer disease
- bleeding disorders
- hypersensitivity to aspirin and other NSAIDs
- aspirin in children/adolescents w a virus
- do not take ketorolac for more than 5 days
Second-generation NSAIDs
- celecoxib is a last resort medication for chronic pain because of the
risk of myocardial infarction and stroke
- celecoxib contraindicated in pt with allergy to sulfonamides