12.05 non-salicylates and acetaminophen Flashcards
the four A’s of the non-salicylates, NSAIDs and acetaminophen
similar to aspirin
- anti-inflammatory (inhibit PG synthesis)
- Analgesic
- antipyretic
- antithyombotic
how are non-salicylates, NSAIDs and Acetaminophen different from aspirin?
- produce fewer or more side effects,
- have greater tissue distribution,
- be more potent and
- have a longer duration.
- unlike aspirin, they are reversible inhibitors of cyclooxygenase
when should NSAIDs be used with caution? and why?
in individuals with reduced renal or liver function
- NSAIDs can DECREASE GFR in those with renal failure, congestive heart disease or cirrhosis of the liver (esp elderly)
- NSAIDs can produce idiosyncratic interstitial nephritis in some who are “allergic”
- can complicate anti-hypertensive therapy
which are the most potent of the NSAIDS?
the indoles:
- indomethacin
- sulindac
- diclofenac
blocking uterine contractions for early labor
indoles: indomethacin?
frontal headache (severe)
indomethacin
pro-drug (need healthy liver to take) used for RA osteoarthrosis
sulindac
Diclofenac
- potent, half life 1-2 hrs,
- accumulates in synovial fluid
- major drug for RA osteoarthritis, ankylosing spondylitis
- SE: GI effects
Ibuprofen
common, over the counter
-SE: Gi disruption
Naproxen
‘alieve’
- you should not take it with an antacid, it makes it useless
- RA
Piroxicam
- long half life, 20-40 hrs
- RA osteoarthritis
- less, but some, GI problems
Ketorolac
- can replace or reduce morphine and meperidine
- used a lot right after surgery
- not good for chronic inflammation bc it causes kidney damage after around 5 days
Celecoxib
COX-2 inhibitor
what is the antedote for the overuse of acetaminophen (tylenol)?
N-acetylcystein (mucomyst)
not an anti-inflammatory or anti-thrombotic agent (doesn’t inhibit cyclooxygenase) but it is analgesic and antipyretic
acetaminophen
