Non-narcotic drugs Flashcards
What are non narcotic anlgesics
CNS depressent with no narcosis
Dec. temp
Most
what is mechanism of non narcotic anlgesics
decrease COX
decrease synthesis of 3
Talk about COX-1
PSYCHIC
STOMACH
KIDNEY
TALK ABOUT COX-2
inflamation : pathological
increase PG–> inflamation
example of toxins of infections
IL-1
TNF
example for NSAID which is non selective COX inhibitors
Asprin ( salisclate)
example for NSAID which is slective COX inhibtors
Celecoxib
rofecoxib
Why dont we use saliscylic acid
very irritant
talk about saliscylic acid dervivtives for systemic & local use
S : A-N-SM-Diflunisal
L : SA-MS
Talk about pharmokinetcs of saliscylate
Absorption : Orall-stomach-intestine
Distribution : All-Tissues-albumin
Hepatic metabolism : mostly-little
Excretion : Mainly-Alklinzation
Talk about pharmokinetcs of paracetamol
Absorption : well
Hepatic metabolism : 95&-5%-large dose
Excretion : mostly metabolite-5% uncharged
Duration: 2-3
NABQ accumlation lead to
nephrotoxicity & hepatotoxicity
duration of paracetamol
2-3
what are the elements that conjugate paracetoml & saliscylate
S : G-G
P : G-S-GT
Talk about dynamics of salicylate of C.N.S
CNS :-
A: Central - peripheral : decrease PG: sensitivity
Anti-pyretic : dec. PG : heat loss-toxic dose :anti-gaba
Talk about dynamics of salicylate of blood
Inflamation : decrease leucosytosis to normal
Hypothermia: large dose for long use
irreversible dec. platlet aggregation : small dose
heamolysis in favism
Talk about dynamics of salicylate of uterus
dec.PG : relax uterus: tocolytic
Talk about dynamics of salicylate of uric acid
large dose : hyperuricema
small dose : urisucoric
Talk about dynamics of salicylate of endocrine
increase hypothalamus
Increase adrenal medula
Increase displace of T3 & T4 : dec. T.S.H
Talk about dynamics of salicylate of imune response
Increase cortisol : decrease Ag/At
Talk about dynamics of salicylate of metabolism
Carb.:-
moderate dose: insulin like
large dose: hyperglycemia
Fat: lipolysis ketosis
Protein : catabolic : negative protein balance
B.M.R :increase
Talk about dynamics of salicylate of liver
hydrocholric
increase adrenaline
hepatotoxic
Talk about dynamics of salicylate of kidney
decrease P.G & RENAL V.D : VC–> decrease R.M.F
large dose : neuropathy
Talk about dynamics of salicylate of G.I.T
Local : irritation
systmeic: Hyperacidity
Talk about dynamics of salicylate of respiratory & acid-base balance
Small : no
large dose : increase R.C & respiratory alkalosis
toxic dose : metabolic acidosis
bronchial asthma : dec. COX & change LOX
Talk about dynamics of salicylate of C.V.S
therupatic : no
toxic : V.D
Patients with acute rheumatic
Talk about dynamics of salicylate of Anti-Iflammatory & Anti-Rheumatic
inhibit PG synthesis : dec. COX induced-Large dose
Dec. action kinins
what are mediators that affect by salicylate at C.N.S
Histamine
Bradychinin
5-HT
what are mediators that affect by salicylate at anti-inflammatory
histamine
kinins
IL
INF
Talk about paracetamol dynamics
dec. COX-3 at CNS : anti-pyretic & analgesic
no periphery action or anti-inflammatory action
what is the other name of paracetamol
Acetaminophen
Talk about therupatic uses of saliscylate
anti-pyretic analgesic : 3 rheumatic fever rheumatoid arthritis anti-platlet: prophylaxis agansit thrmobo prophylaxis aganist cancer , alzaheimr
Talk about therupatic uses of paracetamol
anti-pyretic analgesic to patients who cant tolerant: 6
how should i take paracetamol
250-500mg 3-4 times/day
talk about preparation of salicylate
Asprin : 2T-B-E-M
Na : Enteric coated tablet
Diflunsal: more 3 , no anti-pyretic-uricosuric-less 2
What are adverse affects of salicylate
acute toxicity Salicylsim GIT irritation Allergy Tetanogecity Idiosyncrasy neuropathy Reyes syndrome
Talk about contradictions of salicylate
Bronchal asthma pregenecy bleeding tendency allergy peptic ulcers idiosynercasy children Gout
examole of drug treat NSAID induced asthma
LOX inhibtors : zeiltunel
Cystenil LT-1 recpetorblockers : kast
example of drug treat NSAID induced ulcer
misoprostol
example for drugs that salicylate discplace and lead to what
oral anticogulants
oral hypoglecima
lead to toxcitity
what does salicylate antagonize
other urosceroic agents
other anti inflammatory drugs
anti hypertensive effect
which drug lead to increase metabolism of saliscyhlae
Phenobarbitone
which drugs lead to increase ulcergenic effect of salicylate
NSAID
Alchol
corticosteroids
which drug lead to increase & decrease excretion of salicylate
alkalinzers of urine as NaHCO3 : increase excretion
acidificers of urine : ammonium cholride : decrease
talk about side effects of paracetamol
allergy
toxic dose : dec. gluthionic SH: hepato-nephrotoxicity
what is managment of toxicity of paracetamol
oral methionen+ N-acetlsysteine
what are the rest of nsaid charcterized with
decrease COX1-2 at CNS & periphery gastic irritaion action displace other drugs anti-pyretic & analgesic anti-inflammotry action Contridcate with bronchal asthma & ulcer
what are uses of other NSAID
antipyretic analgesic
anti-inflammatory: arthrits-mytosis-acute gout
Colic: dysmenorrhea
what is small dose of salicylate
1g ( 3 tabletes)
what is large dose of salicylate
more than 5g ( more than 15 tabletes)
what is salicylate theruaptic index
high
what is toxic dose of salicylate
more than 200 mg
what are manifestations of acute toxicity of salicylate
hypotenstion hypoprothrembonia hyperacidity: heamdolysis hyperglycemia hyper reflexia hyperprepxia hyperventilation hyperthiridia convulsions , excitation till coma acid-base imbalance dehydration
what are managment of acute toxicity of salicylate
correct acid/base imbalance correct dehydration vit k + fresh blood anti-convulsions stomach wash by NaHCO3 heamdolysis increase urinary excretion ice bags
