Anti-inflammatory Drugs Flashcards
Eicosanoids
Prostaglandin
Leukotriene
Thromboxane
Pain
Increase prostaglandin
Allergy
Increase leukotriene
Injury
Release of thromboxane
Clinical indication for Non narcotic analgesics
Non narcotic drugs interrupt mild to moderate pain associated with inflammatory condition without altering consciousness.
Two elements of pain
Localized stimulation of peripheral nerves through damage
Recognition of pain within the CNS
Mechanism of Action for Non narcotic analgesics
Non narcotic analgesics inhibits prostaglandin synthesis centrally and peripherally.
Enhance local inflammation
Produce local edema
Constrict blood vessels
Types of non narcotic analgesics
Acetaminophen- paracetamol
Salicylates- aspirin, diflunisal
Synthetic NSAID- naprosyn, fenoprofen, ibuprofen, indomethacin
Salicylates and aspirin are known to
Reduce fever and pain
Vasodilation
Prophylactically inhibit clotting
Pharmacological effects of salicylates
Gastrointestinal- decrease of prostaglandin, nausea due to erosion of stomach lining
Cardiovascular- inhibits platelet aggregation, reduce the risk of death
Salicylates adverse effect
Hepatoxicity
Rash
Prolonged bleeding time
Nausea
Vomiting
Dyspepsia
Heartburn
Gastrointestinal bleeding
in NSAID, inflammation is characterized by
Swelling
Pain
Redness
Warmth
Mechanism of Action for NSAID
Inhibit inflammation and reduce pain by blocking the synthesis of prostaglandin.
Stabilize cell membranes to prevent edema
NSAIDs adverse effect
Nausea
Gastrointestinal bleeding
Vomiting
Headache
Vertigo
CNS stimulation
Hypersensitivity reaction
Mental confusion
Hepatic damage
is a constellation of symptoms that occur in some patients with the chronic use of large doses of aspirin and other salicylates
Salicylism
Chronic salicylate toxicity
• Nausea
• Vomiting
• Headache
• Tinnitus (ringing in the ears)
• Hyperglycemia
• Delirium
Acute Salicylate Poisoning
» Depression of respiratory centers
» Respiratory acidosis
» CNS depression
» Sweating
» Dehydration, electrolyte imbalance
» Hypotension & vasodilation
» Coma
» Death
Acetaminophen
• Weak prostaglandin synthetase inhibitor
• Useful for reducing fever and headache (nonmigraine)
• Should not substitute for antiinflammatory drugs
• Does not affect platelet aggregation/clotting
• May be used as an aspirin substitute in aspirin-sensitive patients
Adverse effect for acetaminophen
Acute toxicity
• Nausea
• Vomiting
• Hepatoxicity (elevated serum enzymes)
• Acidosis
• Respiratory depression
Antigout Drugs Clinical Indication
Treatment of gout, a special inflammatory condition in which uric acid deposits in the joint fluid of the toes, knees, or kidneys because uric acid is
– overproduced or
– not efficiently excreted
Antigout Drugs
Drugs in this class include
Acute treatment
• Colchicine
• Aspirin, naproxen
Prophylaxis
• Allopurinol blocks uric acid production
• Probenecid for uric acid excretion
• Sulfinpyrazone for uric acid excretion
