3 - Analgesics Flashcards
what is the classic mechanism by which all NSAIDs work?
act by inhibiting the synthesis of prostaglandins
what are the 3 NSAID drugs?
acetaminophen (tylenol - not an NSAID), ibuprofen (advil) and celecoxib (celebrex)
what are the indications for acetaminophen?
pain (mild) and fever
what is the pharmacology for acetaminophen?
analgesic and antipyretic
what is the mechanism of action for acetaminophen?
acts by inhibiting COX and enhancing 5-HT release
also acts centrally at hypothalamus - PG synthetase inhibition
in what ways is acetaminophen different from aspirin?
no inflammatory control, no platelet inhibition, central pain relief only, no GI effects and is SAFE in pregnancy
what are the common side effects of acetaminophen?
nausea, rash, headache
what are the hepatic side effects for acetaminophen?
acute hepatoxicity usually with high doses (>4000mg)
*drug of choice for suicide
what are the renal side effects for acetaminophen?
acute renal tubular necrosis and chronic analgesic nephropathy
what happens if you take acetaminophen with a combo acetaminophen/antihistamine drug?
there is an additive effect - hepatoxicity
what happens if you take acetaminophen with ASA?
there is an additive effect - nephrotoxicity
what happens if you take acetaminophen with topical lidocaine?
there is an additive effect - methemoglobinemia
what are the indications for ibuprofen?
mild to moderate pain, primary dysmenorrhea and fever
what is the mechanism for ibuprofen?
inhibits COX and reduces PG and TXA2 synthesis
what are the common side effects for ibuprofen?
headache, fluid retention, ecchymosis, and photosensitivity
what are the neuro side effects for ibuprofen?
tinnitus
what are the renal side effects for ibuprofen?
acute renal tubular necrosis and chronic analgesic nephropathy
what happens if you take ibuprofen with ASA or acetaminophen?
there is an additive effect - hemorrhagic risk
what happens if you take ibuprofen with acetaminophen or cyclosporine?
there is an additive effect - nephrotoxicity
what are the indications for celecoxib?
arthritis, ankylosing spondylitis, dysmenorrhea and acute pain
what is the mechanism of action for celecoxib?
selectively inhibits COX2 only and reduces PG synthesis