Inflammation Flashcards
Acetylsalicylic acid (ASA, Aspirin)
Class: Salicylate
Mechanism: Acetyl-salicylic acid irreversibly acetylates COX-1 and -2; metabolite (salicylic acid) reversibly inhibits COX-1 and -2
Therapeutics: Antiplatelet, analgesic and antipyretic, and anti-inflammatory (in ascending order of amount taken); often taken as a “baby aspirin” to prevent MI, CVA
Side Effects: GI irritation, bleeding and anemia, hepatotoxicity, and salicylate toxicity
Diflunisal (Dolobid)
Class: Salicylate
Mechanism: Difluorophenyl derivitive of salicylic acid, which reversibly inhibits COX-1 and -2
Therapeutics: Osteoarthritis, musculoskeletal strains/sprains, pain after dental extraction, and postepisiotomy pain
Side Effects: Fewer GI side effects and less effect on platelets than aspirin
Acetaminophen (Tylenol)
Class: Para-amino phenol
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Analgesic and antipyretic effect similar to aspirin, but weak anti-inflammatory effects
Side Effects: Renal tubular necrosis if chronically abused with other NSAIDs; hepatic necrosis with overdose
Indomethacin (Indocin)
Class: Indole
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Rhematoid arthritis (10X as potent as aspirin), ankylosing spondylitis, osteoarthritis, acute gout
Side Effects: At times, thrombocytopenia, aplastic anemia, and severe frontal headaches
Sulindac (Clinoril)
Class: Indole
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Rhematoid arthritis, ankylosing spondylitis, osteoarthritis, acute gout
Side Effects: At times, thrombocytopenia, aplastic anemia, and severe frontal headaches
Ibuprofen (Advil, Motrin)
Class: Proprionic acid dervitive
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Rheumatic disorders, osteoarthritis, ankylosing spondylitis, postpartum pain, dysmenorrheal pain, and many types of surgeries
Side Effects: GI irritation; hepatotoxicity (less frequent than aspirin)
Flurbiprofen (Ocufen)
Class: Proprionic acid dervitive
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Rheumatic disorders, osteoarthritis, ankylosing spondylitis, postpartum pain, dysmenorrheal pain, and many types of surgeries
Side Effects: GI irritation; hepatotoxicity (less frequent than aspirin)
Naproxen (Aleve)
Class: Proprionic acid dervitive
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Rheumatic disorders, osteoarthritis, ankylosing spondylitis, postpartum pain, dysmenorrheal pain, and many types of surgeries
Side Effects: GI irritation; hepatotoxicity (less frequent than aspirin)
Oxaprozin (Daypro)
Class: Proprionic acid dervitive
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Rheumatic disorders, osteoarthritis, ankylosing spondylitis, postpartum pain, dysmenorrheal pain, and many types of surgeries
Side Effects: GI irritation; hepatotoxicity (less frequent than aspirin)
Piroxicam (Feldene)
Class: Enolic acid
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Long-term treatment of rheumatoid arthritis or osteoarthritis; also, ankylosing spondylitis, acute musculoskeletal disorders, acute gout
Ketorolac (Toradol)
Class: Heteroaryl acetic acids
Mechanism: Reversibly inhibits COX-1 and -2 (favors COX-1)
Therapeutics: Post-operative pain; inflammatory eye conditions
Celocoxib (Celebrex)
Class: COX-2 inhibitor
Mechanism: Selectively inhibits COX-2 (too bulky to reliably interact in COX-1 site)
Therapeutics: Same anti-inflammatory, antipyretic, and analgesic effects as NSAIDs
Side Effects: Less GI toxicity than traditional NSAIDs
Etoricoxib (Arcoxia)
Class: COX-2 inhibitor
Mechanism: Selectively inhibits COX-2 (too bulky to reliably interact in COX-1 site)
Therapeutics: Same anti-inflammatory, antipyretic, and analgesic effects as NSAIDs
Side Effects: Less GI toxicity than traditional NSAIDs
