NonSteroidal Anti-inflammatory Flashcards
Nonsteroids Antiinflammatory
Antiinflammatory
Antipyretic
Analgesia
Platelet Aggregation
Is tylenol NSAIDS
no
5 cardinal signs of inflammation
Tissue damage Inflammation More tissue damage More prostaglandin release More inflammation
Steroid in joint
Rest promote healing
Tissue inury
Increased Blood flow
Increase permeability
Phospholipase A2
Block arachidonic
Block leukotrienes pathway
Blocking COX
Leukotrienes
NSAIDs MOA
inhibition of cyclooxygenase ac/vity and the resultant decrease in the peripheral synthesis of prostaglandins
NSAIDS and opioids
decrease pot op opioids by 20-50%
Most common reaction is
Dyspepsia
Renal adverse effect
High bound to plasma proteins
NSAIDS
Acetaminophen a metabolite of
phenacetin is associated with the development of ESRD.
***Factors that favor NSAID induced nephrotoxicity include,
hypovolemia, preexisting renal disease, CHF,
sepsis, and combination with other nephrotoxic
drugs or radio contrast dyes, DM, and cirrhosis.
At risk for bleeding hold NSAIDs for
5 half lives
Hold aspirin for
7-10 days
Perioperative uses
By inhibi/ng cyclooxygenase and decreasing /ssue
prostaglandin synthesis, NSAIDs lead to decrease in
postopera/ve pain, and requirements for opioids.
NSAIDS Summary
know benefits
No sedation, no respiratory depression , LESS NARCOTICS, less post op and vomiting
Avoid NSAIDs in
renal failure
Prevent MI patient from subsequent MI
ASPIRIN
ASpirin more appropriate
post MI
is the earliest sign of salicylate overdose.
Tinnitus
Aspirin induced inhibition of platelets is
irreversible
and last the en/re life of the platelet.
Life time of platelet
7-10 days
Tylenol has
no antiinflammatory effects
is a highly reactive metabolite which detoxified by conjugation with glutathione.
N-acetyl-p-benzoquinone (NABQI)
• treat with ASA overdose
acetylcysteine (antioxidant substitute for glutathione)
• treat with ASA overdose
acetylcysteine (antioxidant substitute for glutathione)
Allopurinol use for
Hyperuricemia
Allopurinol only
Prevent uric acid deposition , NOT USEFUL in acute attack
Allopurinol can be used to
Prevent urice acid deposits
