Anti-inflammatory (Systemic and local) Flashcards
Contra-indications for NSAIDS?
Active GI Bleeding or Ulceration or history of either Cerebrovascular disease History of NSAID related GI bleeding Ischaemic Heart Disease Mild or Severe Heart Failure Peripheral Arterial Disease
Common Side effects of NSAIDS
GI Ulcers
Worsening Asthma
Impaired Renal Function
Indications for NSAIDs
Inflammatory pain
Indications for Prednisolone?
Oral - Exacerbation of COPD
REctal - Ulcerative Colitis
Prednisolone Contra-Indications?
Avoid injections containing benzyl alcohol in neonates
Live vaccines (immune suppressive doses)
Systemic Infection
Avoid along in the presence of untreated ear infection (combine with suitable ant-infective)
Bowel Perforation (Rectal)
Extensive Fistulas
Recent intestinal anastamoses
Common Side effects of prednisolone?
Osteoporosis Diabetes Avascular necrosis of the femoral head (high doses) Muscle wasting Psychiatric reactions
Is it safe to abruptly stop treatment of prednisolone?
Not for certain patient groups as can lead to renal insufficiency
If disease is unlikely to relapse and t/ment received for less than 3 weeks and not part of specific patient groups mentioned in BNF then abrupt withdrawal is ok
What are ICS used to treat?
Asthma - improve control/reduce frequency of exacerbations
Severe/very severe COPD - reduce frequency of exacerbations
Are there any contra-indications to ICS?
No
Common side effects of ICS?
Oropharyngeal candiadis
headache
hoarseness (Dysphonia)
sore throat
Can ICS be stopped abruptly?
Usually need to reduce dose gradually
What organ do NSAIDs sometimes negatively affect and why?
Kidneys
Some prostaglandins in COX-1 pathway effects pressure of blood flow through Kidneys