Analgesic Drugs-NSAIDS Flashcards
What is “wind up”?
With ongoing pain, hyperalgesia (heightened sense of pain) and allodynia (pain produced by a non-noxious stimulus such as light touch) can occur known as “wind up”.
What are Non-steroidal anti-inflammatory drugs (NSAIDS)
- Excellent pain relief
- Little direct effect on pain receptors
- Modulates inflammation
What are the 4 types of NSAIDS?
- Carboxylic acids - aspirin, salicylate
- Propionic acids - ibuprofen, ketoprofen, carprofen, naproxen
- Enolic acids - oxyphenbutazone, phenylbutazone, piroxicam
- Acetic acids - etodolac, sunlindac, indomethacin
Where are NSAIDS absorbed?
In the stomach and proximal small intestine and are highly protein bound. Most are metabolised into inactive forms.
How do NSAIDS work?
Inhibits cyclooxygenase (COX) system *COX enzymes (prostaglandins) are responsible for inflammation: release of inflammatory cytokines at tissue injury sites results in pain.
What are the toxin effects of NSAIDS?
Gastrointestinal is the most common side effect.
-direct irritant
-decreases in:
Epithelial mucous production
Bicarbonate secretion
Mucosal blood flow
Overall mucosal resistance to injury
-Pain, vomiting, diarrhoea, gastrointestinal ulceration, hemorrhage, perforation
-Always give NSAIDS with food.
Why should NSAIDS be avoided in patients with renal disease? What other contraindications are there?
- Further renal injury could occur.
- Contraindicated in hypovolemic and dehydrated patients.
- Chronic overuse of NSAIDS can cause liver damage.
- Should not be used with another NSAID or steroidal agents - worsen GI problems.
- Avoid other highly protein-bound drugs
What drugs can NSAIDS increase toxicity of?
- Anticoagulants
- midazolam
- furosemide
- spironolactone
What drugs does NSAIDs decrease the therapeutic effects of?
- Furosemide
- Thiazides
- ACE inhibitors
- Beta-blockers
What drugs can increase the toxicity of NSAIDS?
- Amnioglycosides
* Phenobarbital
