ATI PHARMACOLOGY MOST TESTED
QUESTIONS AND 100% CORRECT
ANSWERS
Nonopioid analgesics: drug classes (3) and names (8)
1. NONSALICYLATES
- acetaminophen (Tylenol)
2. SALICYLATES
- aspirin
- choline: magnesium trisalicylate (Trilisate)
3. NSAIDs
- ibuprofen (Motrin, Nuprin, Advil)
- naproxen (Naprosyn, Aleve)
- ketorolac (Toradol)
- diclofenac K (Cataflam)
- celecoxib (Celebrex)
Nonopioid analgesics: characteristics (4)
1. ANALGESIC CEILING
- increasing dose beyond upper limit provides no greater analgesia
2. Do not produce tolerance or physical dependence
3. Many available without prescription (OTC)
4. Used for mild to moderate pain, often in conjunction with other opioids
- OPIOID-SPARING EFFECT: allow for effective pain relief using lower opioid doses,
thereby causing fewer opioid side effects
NSAIDs (COX-1 and COX-2 inhibitors): drug names (5)
1. Aspirin
2. Ibuprofen (Advil, Motrin)
3. Naproxen (Naprosyn, Aleve)
4. Indomethacin (Indocin)
5. Ketorolac (Toradol)
NSAIDs (COX-1 and COX-2 inhibitors): pharmacologic action
Inhibit cyclooxygenase
COX-1 enzyme: stimulates release of protective prostaglandins
- protects gastric mucosa (increased mucus production, decreased stomach acid
production)
, - enhances platelet aggregation
- promotes kidney function/perfusion
COX-2 enzyme: stimulates release of prostaglandins secondary to injury
- inflammation
- pain
- fever
NSAIDs prescribed as antiinflammatory, analgesic, and antipyretic, but side effects
occur because inhibiting COX-1 as well (GI, bleeding, and adverse kidney effects)
NSAIDs (COX-1 and COX-2 inhibitors): side/adverse effects (6)
NSAIDs prescribed as antiinflammatory, analgesic, and antipyretic, but side effects
occur because inhibiting protective effects of COX-1 as well
1. Decreased GI protective effects
- gastric upset
- heart burn
- nausea
- gastric ulceration
2. Bleeding (less with non-aspirin NSAIDs)
3. Kidney dysfunction
4. Salicysm: aspirin toxicity
- tinnitus and decreased hearing
- headache and dizziness
- nausea, vomiting, diarrhea, diaphoresis
- convulsions, coma
5. Reye's syndrome: rare; found in children who receive NSAIDs secondary to viral
infection (esp flu or chicken pox)
- signs/symptoms: vomiting, confusion, seizures, loss of consciousness
- complications: liver damage, brain damage, death
- take acetaminophen instead
6. Thromboembolic events (non-aspirin NSAIDs)
NSAIDs (COX-1 and COX-2 inhibitors): patient instructions (4)
1. Take with food, milk, or 8 oz water
2. Avoid taking with alcohol
3. Report:
- gastric irritation
- unusual/prolonged bleeding
- changes in urine output
QUESTIONS AND 100% CORRECT
ANSWERS
Nonopioid analgesics: drug classes (3) and names (8)
1. NONSALICYLATES
- acetaminophen (Tylenol)
2. SALICYLATES
- aspirin
- choline: magnesium trisalicylate (Trilisate)
3. NSAIDs
- ibuprofen (Motrin, Nuprin, Advil)
- naproxen (Naprosyn, Aleve)
- ketorolac (Toradol)
- diclofenac K (Cataflam)
- celecoxib (Celebrex)
Nonopioid analgesics: characteristics (4)
1. ANALGESIC CEILING
- increasing dose beyond upper limit provides no greater analgesia
2. Do not produce tolerance or physical dependence
3. Many available without prescription (OTC)
4. Used for mild to moderate pain, often in conjunction with other opioids
- OPIOID-SPARING EFFECT: allow for effective pain relief using lower opioid doses,
thereby causing fewer opioid side effects
NSAIDs (COX-1 and COX-2 inhibitors): drug names (5)
1. Aspirin
2. Ibuprofen (Advil, Motrin)
3. Naproxen (Naprosyn, Aleve)
4. Indomethacin (Indocin)
5. Ketorolac (Toradol)
NSAIDs (COX-1 and COX-2 inhibitors): pharmacologic action
Inhibit cyclooxygenase
COX-1 enzyme: stimulates release of protective prostaglandins
- protects gastric mucosa (increased mucus production, decreased stomach acid
production)
, - enhances platelet aggregation
- promotes kidney function/perfusion
COX-2 enzyme: stimulates release of prostaglandins secondary to injury
- inflammation
- pain
- fever
NSAIDs prescribed as antiinflammatory, analgesic, and antipyretic, but side effects
occur because inhibiting COX-1 as well (GI, bleeding, and adverse kidney effects)
NSAIDs (COX-1 and COX-2 inhibitors): side/adverse effects (6)
NSAIDs prescribed as antiinflammatory, analgesic, and antipyretic, but side effects
occur because inhibiting protective effects of COX-1 as well
1. Decreased GI protective effects
- gastric upset
- heart burn
- nausea
- gastric ulceration
2. Bleeding (less with non-aspirin NSAIDs)
3. Kidney dysfunction
4. Salicysm: aspirin toxicity
- tinnitus and decreased hearing
- headache and dizziness
- nausea, vomiting, diarrhea, diaphoresis
- convulsions, coma
5. Reye's syndrome: rare; found in children who receive NSAIDs secondary to viral
infection (esp flu or chicken pox)
- signs/symptoms: vomiting, confusion, seizures, loss of consciousness
- complications: liver damage, brain damage, death
- take acetaminophen instead
6. Thromboembolic events (non-aspirin NSAIDs)
NSAIDs (COX-1 and COX-2 inhibitors): patient instructions (4)
1. Take with food, milk, or 8 oz water
2. Avoid taking with alcohol
3. Report:
- gastric irritation
- unusual/prolonged bleeding
- changes in urine output
