Clinical Use of Analgesics I - Paracetamol Flashcards

1
Q

What are the paracetamol associated ADRs?

A

Rash, blood disorders, acute pancreatitis

Liver and renal damage following overdose

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2
Q

What does paracetamol interact with?

A

Not many

Warfarin (increases the INR)

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3
Q

What are the GI tract ADRs that can be caused by NSAIDs

A

Ulceration and erosion

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4
Q

What are the renal ADRs that can be caused by NSAIDs

A

Poor renal perfusion
Retention of sodium and potassium
Water retention

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5
Q

What are the haematological ADRs that can be caused by NSAIDs

A

reduce platelet aggregation as reduced thromboxane (COX-1)
aspirin irreversible
NSAIDs reversible

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6
Q

What are the respiratory ADRs that can be caused by NSAIDs?

A

Bronchospasm PGs involved

Leukotrienes increase sensitivty of bronchioles

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7
Q

What options are there for gastroprotection?

A

H2 receptor antagonists completely inhibit histamine at H2 receptors on gastric parietal cells to modulate pH

Misoprostol - synthetic PG E1 analogue

Proton pump inhibitors inhibit acid secretion by binding irreversibly to proton pump

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8
Q

What is the role of coxibs?

A

Target PGs released as a result of pain and inflammation
As effective as NSAIDs
Reduce but do not eliminate GI adverse effects

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9
Q

What are the precautions with COX-2 inhibitors (coxibs)

A

Patients with significant risk factors for cardiovascular disease (e.g. hypertension, hyperlipidaemia, DM, smoking) or peripheral vascular disease
Diclofenac also similar cardiovascular risk

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