Contraindications of NSAIDs
Contraindications of NSAIDs ( 5 Questions)
A nurse is administering aspirin (ASA), a nonselective COX inhibitor, to a client who has rheumatoid arthritis. What are some of the specific indications of aspirin in this condition?
This is because aspirin (ASA), a nonselective COX inhibitor, inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, which are responsible for prostaglandin synthesis in various tissues¹. Prostaglandins are involved in inflammation, pain, fever, and platelet aggregation. Therefore, aspirin has anti-inflammatory, analgesic, antipyretic, and antiplatelet effects¹².
- Aspirin is used to relieve the symptoms of rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), osteoarthritis (arthritis caused by breakdown of the lining of the joints), systemic lupus erythematosus (condition in which the immune system attacks the joints and organs and causes pain and swelling) and certain other rheumatologic conditions (conditions in which the immune system attacks parts of the body)¹.
- Aspirin is also used to prevent cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis¹². However, this effect requires low doses of aspirin (typically 75 to 81 mg/day) that are insufficient to inhibit COX-2 and have anti-inflammatory effects².
- Aspirin does not treat gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid. This is the mechanism of action of allopurinol, a drug used for gout³. In fact, aspirin can worsen gout by increasing uric acid levels in the blood and decreasing its excretion in the urine⁴.
- Aspirin does not induce labor by stimulating uterine contractions and cervical ripening by blocking the production of prostaglandins. This is the mechanism of action of misoprostol, a synthetic prostaglandin E1 analog used for labor induction. In fact, aspirin is contraindicated in pregnancy because it can cause bleeding complications, premature closure of the ductus arteriosus, and delayed onset of labor¹ .
It is not a specific indication of aspirin in rheumatoid arthritis, but a general indication of aspirin in cardiovascular prevention. Aspirin can prevent cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis, but this effect requires low doses of aspirin that are not effective for rheumatoid arthritis .
Option C is wrong because it is not the mechanism of action of aspirin, but of allopurinol, a drug used for gout. Aspirin does not inhibit the enzyme xanthine oxidase and reduce the production of uric acid, but rather it inhibits both COX-1 and COX-2 enzymes and blocks the production of prostaglandins. Aspirin is not used to treat gouty arthritis, but rather it can worsen it by increasing uric acid levels in the blood and decreasing its excretion in the urine.
Option D is wrong because it is not the mechanism of action of aspirin, but of misoprostol, a drug used for labor induction. Aspirin does not stimulate uterine contractions and cervical ripening by blocking the production of prostaglandins, but rather it inhibits both COX-1 and COX-2 enzymes and blocks the production of prostaglandins. Aspirin is not used to induce labor, but rather it is contraindicated in pregnancy because it can cause bleeding complications, premature closure of the ductus arteriosus, and delayed onset of labor.
A. It reduces inflammation, pain, fever, and platelet aggregation by blocking the production of prostaglandins.
This is because aspirin (ASA), a nonselective COX inhibitor, inhibits both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes, which are responsible for prostaglandin synthesis in various tissues¹. Prostaglandins are involved in inflammation, pain, fever, and platelet aggregation. Therefore, aspirin has anti-inflammatory, analgesic, antipyretic, and antiplatelet effects¹².
- Aspirin is used to relieve the symptoms of rheumatoid arthritis (arthritis caused by swelling of the lining of the joints), osteoarthritis (arthritis caused by breakdown of the lining of the joints), systemic lupus erythematosus (condition in which the immune system attacks the joints and organs and causes pain and swelling) and certain other rheumatologic conditions (conditions in which the immune system attacks parts of the body)¹.
- Aspirin is also used to prevent cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis¹². However, this effect requires low doses of aspirin (typically 75 to 81 mg/day) that are insufficient to inhibit COX-2 and have anti-inflammatory effects².
- Aspirin does not treat gouty arthritis by inhibiting the enzyme xanthine oxidase and reducing the production of uric acid. This is the mechanism of action of allopurinol, a drug used for gout³. In fact, aspirin can worsen gout by increasing uric acid levels in the blood and decreasing its excretion in the urine⁴.
- Aspirin does not induce labor by stimulating uterine contractions and cervical ripening by blocking the production of prostaglandins. This is the mechanism of action of misoprostol, a synthetic prostaglandin E1 analog used for labor induction. In fact, aspirin is contraindicated in pregnancy because it can cause bleeding complications, premature closure of the ductus arteriosus, and delayed onset of labor¹ .
The other options are wrong because they are either false or irrelevant to the specific indications of aspirin (ASA), a nonselective COX inhibitor, in rheumatoid arthritis.
- Option B is wrong because it is not a specific indication of aspirin in rheumatoid arthritis, but a general indication of aspirin in cardiovascular prevention. Aspirin can prevent cardiovascular events such as myocardial infarction and stroke by inhibiting platelet aggregation and thromboxane synthesis, but this effect requires low doses of aspirin that are not effective for rheumatoid arthritis .
- Option C is wrong because it is not the mechanism of action of aspirin, but of allopurinol, a drug used for gout. Aspirin does not inhibit the enzyme xanthine oxidase and reduce the production of uric acid, but rather it inhibits both COX-1 and COX-2 enzymes and blocks the production of prostaglandins. Aspirin is not used to treat gouty arthritis, but rather it can worsen it by increasing uric acid levels in the blood and decreasing its excretion in the urine.
- Option D is wrong because it is not the mechanism of action of aspirin, but of misoprostol, a drug used for labor induction. Aspirin does not stimulate uterine contractions and cervical ripening by blocking the production of prostaglandins, but rather it inhibits both COX-1 and COX-2 enzymes and blocks the production of prostaglandins. Aspirin is not used to induce labor, but rather it is contraindicated in pregnancy because it can cause bleeding complications, premature closure of the ductus arteriosus, and delayed onset of labor.