Module 2-2 Antiinflammatory drugs

Question 1

NSAIDs

Answer 1

Large and chemically diverse group of drugs
with the following properties:
 Analgesic
 Antiinflammatory
 Antipyretic
 Antirheumatic

Question 2

NSAIDs: Mechanism of Action

Answer 2

Activation of the arachidonic acid
pathway causes:
 Pain
 Headache
 Fever
 Inflammation

Question 3

NSAIDs: Mechanism of

Action (cont’d)

Answer 3

Analgesia—treatment of headaches, mild to
moderate pain and inflammation
 Block the chemical activity of either or both COX
enzymes (prostaglandin [PG] pathway)
 Result: limits the undesirable inflammatory effect of PGs

Question 4

NSAIDs: Mechanism of

Action (cont’d

Answer 4

Antipyretic: reduce fever
 Inhibit prostaglandin E2 within the area of the brain
that controls temperature

Question 5

ChemicaNSAIDs: Salicylatesl Categories of NSAIDs

Answer 5

Salicylates
 Acetic acid derivatives
 Cyclooxygenase 2 (COX 2) inhibitors
Cyclooxygenase-COX- Enolic acid derivatives
 Propionic acid derivatives

Question 6

NSAIDs: Salicylates

Answer 6

Salicylates also have antiplatelet activity
 Inhibit platelet aggregation
 Examples: aspirin, diflunisal (Dolobid)

Question 7

NSAIDs: Acetic Acids

Answer 7

indomethacin (Indocin)
 ketorolac (Toradol)
 diclofenac sodium (Voltaren)
 sulindac (Clinoril)
 tolmetin (Tolectin)
 etodolac (Lodine)

Question 8

NSAIDs: COX-2 Inhibitor

Answer 8

celecoxib (Celebrex)
 First and only remaining COX-2 inhibitor
 Indicated for osteoarthritis rheumatoid arthritis
osteoarthritis, arthritis,
acute pain symptoms, ankylosing spondylitis, and primary dysmenorrhea

Question 9

NSAIDs: Enolic Acid Derivatives

Answer 9

piroxicam (Feldene)
 meloxicam ( Mobic)
 nabumetone (Relafen)

Question 10

NSAIDs: Propionic Acids

Answer 10

fenoprofen (Nalfon)
 flurbiprofen (Ansaid)
 ibuprofen (Motrin, Advil)
 ketoprofen (Orudis KT)
 naproxen (Naprosyn, Aleve)
 oxaprozin (Daypro)

Question 11

NSAIDs: Indications

Answer 11

Analgesia (mild to moderate)
 Antigout effects
 Antiinflammatory effects
 Antipyretic effects
 Relief of vascular headache
 Platelet inhibition (ASA)

Question 12

NSAIDs: Indications (cont’d)

Answer 12

Relief of mild to moderate pain
 Acute gout
 Various bone, joint, and muscle pain
 Osteoarthritis
 Rheumatoid arthritis

Question 13

NSAIDs: Indications (cont’d)

Answer 13

 Juvenile rheumatoid arthritis
 Dysmenorrhea
 Fever

Question 14

NSAIDs: Salicylates

Answer 14

salicylates (aspirin)
 More potent effect on platelet aggregation
 Analgesic
 Antipyretic
 Antiinflammatory
 Antithrombotic effect: used in the treatment of MI and other thromboembolic disorders

Question 15

NSAIDs: Adverse Effects

Answer 15

Gastrointestinal Dyspepsia, heartburn, epigastric distress, nausea GI bleeding*
Mucosal lesions* (erosions or ulcerations)Renal
 Reductions in creatinine clearance
Acute tubular necrosis with renal failure


Question 16

NSAIDs: Salicylate Toxicity

Answer 16

Adults: tinnitus and hearing loss
 Children: hyperventilation and CNS effects
 Metabolic acidosis and respiratory alkalosis
may be present

Question 17

NSAIDs: Interactions

Answer 17

Serious interactions can occur when given with:
 Anticoagulants
 Aspirin
 Corticosteroids and other ulcerogenic drugs
 Protein bound drugs

Question 18

Antigout Drugs

Answer 18

Gout: condition that results from inappropriate
uric acid metabolism
 decreased excretion of uric acid
 excessive production of uric acid
 Uric acid crystals are deposited in tissues and
joints, resulting in pain

Question 19

Antigout Drugs: Indications

cont’d

Answer 19

allopurinol (Zyloprim)
 Used to reduce production of uric acid
colchicine
 Reduces inflammatory response to the deposits of urate
crystals in joint tissue
probenecid (Benemid), sulfinpyrazone (Anturane)
 Increases excretion of uric acid in the urine