Non-steriodial anti inflammatory drugs

Question 1

Discuss non-steroidal anti-inflammatory drugs (NSAIDS):

Answer 1

a group of analgesics that have anti-inflammatory properties and pain relieving properties. Can be selective and non-selective.

Question 2

What is the MOA of NSAIDS?

Answer 2

block the synthesis of prostaglandins in th ebody by the inhibitory enzymes called cycloxygenases. They can be selective and only inhibit COX-2 or non-selective and inhibit both COX-1 and COX-2

Question 3

common side effects of NSAIDS?

Answer 3

GI ulcers, worsening ashtma, impaired renal function.

Question 4

Discuss aspirin:

Answer 4

indication: for the secondary prevention of cardiovascular disease, ischaemic attack/ stroke/ apin. Contraindication: active/peptic ulceration, bleeding disorders (antiplatelet dose), children under 16 (risk of reyes syndrome), haemophilia, hypersensitivity to aspirin/ other NSAIDs. Inhibits both COX-1 and COX-2. Side effects= nausea and vomiting, diarrhoea, constipation, rash, diziness, headache, drowsiness.

Question 5

Discuss diclofenac/ mefenamic acid/ naproxen/ piroxlcam.

Answer 5

indication: pain and inflammation. Contraindication: hsitory of GI bleeding, GI ulceration, history of GI haemorrhage, ischaemic heart disease, mild/severe heart failure. Side effects: nausea and vomiting, diarrhoea, constipation. rash, diziness, headache, drowsiness. Monitoring requirements: in renal impairment- monitor function, sodium and water retention may occur and renal function may deteriorate. Patient/ carer advice: children info booklet.

Question 6

Discuss ibuprofen/ ketoprofen.

Answer 6

indication: pain and inflammation. Contraindication: 1) IV use, active bleeding (GI tract or intracranial), neonates (coagulation defects), life threatening infection, pulmonary hypertension and thrombocytopenia. 2) systemic use: acute GI bleeding/ ulceration, heart failure, ischaemic heart disease. Side effects: IV: in neonates, fluid retention, intraventricular haemorrhage, neutropenia. Systemic use: n&v, diarrhoea, constipation, rash, diziness, headache and drowsiness. Patient/ carer advice: in topical use in adults- wash hands immediatly after and avoid excessive exposure to sunlight - photosensitisation.

Question 7

Discuss celecoxib/ meloxicam

Answer 7

indication: pain and inflammation in osteoarthritis and rheumatoid arthritis. Contraindication: history of GI bleeding/ ulceration/ haemorrhage, ischaemic heart disease, mild/ severe heart failure. Mechanism of action: selectively inhibits cycloxygenase 2 (COX-2) enzyme which is found in inflammatory response cell.s The inhibition of this helps to prevent an inflammatory response as cox enzymes are essential for the synthesis of prostaglandins. Side effects: dysponea, influenza like symptoms. Monitoring requirements: monitor BP before and during treatment and in renal impairment, monitor renal function (sodium and water retention may occur).

Question 8

what are the names of all the non-selective NSAIDs?

Answer 8

aspirin, ibuprofen, ketoprofen, diclofenac, mefenamic acid, naproxen, piroxlcam.

Question 9

what are the names of all the selective NSAIDs?

Answer 9

celecoxib and meloxicam.