Analgesics and NSAIDS

Question 1

What are COX?

Types of COX

Answer 1

Isoenzymes non selectively inhibited by NSAIDS.
Catalyzer of prostaglandins and thromboxane.

-COX 1: Constitutive
inhibition -> decrease the prostaglandine formation. (Side effects)
-COX 2: Facultative (inflamation reaction)
inhibition -> antiinflamatory, pain and fever reduction (Therapeutic effect)

Question 2

Classification of NSAIDS

Answer 2

• Salicylates
• Para-aminophenols
• Pyrazolones
• Propionic acid derivatives
• Acetic acid derivatives
• Anthranilic acid derivatives
• Oxicams
• Others
• Selective COX2 inhibitors

Question 3

Salicylates

Answer 3

Aspirin. Irresversible inhibition.

• Analgesic
• Antiinflamatory
• Antipyretic
• Antiplatelet

Side effects:

• Gastric irritation
• Hypersensitivity
• Bleeding
• Reye’s syndrome in children

Question 4

Para-aminophenols

Answer 4

Paracetamol.

• Analgesic
• Antipyretic

Recomended in:

• Children
• Anticoagulated patiens
• Patiens with gastric irritations/ulcers

No significant side effects.

Question 5

Pyrazolones

Answer 5

Dipyrone.

• Analgesic
• Antipyretic

Phenylbutazone.

• Analgesic
• Antiinflamatory
• Uricosuric

Useful in colic pain.

Side effects:
Agranulocytosis, Aplastic anemia

Question 6

Propionic Acid Derivatives

Answer 6

Ibuprofen.

• Analgesic
• Antiinflamatory
• Antipyretic
• Antiplatelet

Cardiovascular Side effects

Question 7

Acetic Acid Derivatives

Answer 7

• Analgesic
• Antiinflamatory
• Antipyretic

Gastrointestinal side effects

Question 8

Anthranilic Acid Derivatives

Answer 8

Antiinflamatory.

Little relevance.

Question 9

Oxicams

Answer 9

Piroxicam/Feldene.

• Analgesic
• Antiinflamatory
• Antipyretic

Ulcerogenic

Question 10

Selective COX 2 inhibitors

Answer 10

Celecoxib, Parecoxib, Etoricoxib
For:
-Rheumatic arthrisis
-Gouty arthrisis
-Osteoarthrisis

NO in ischemic heart disease