NSAIDs 1 - Slides 32-38

Question 1

What is Indomethacin?

Answer 1

Slowly reversible, noncompetitive
Most potent CNS and peripheral!
Best as an anti-inflammatory, used to close Ductus arteriosis

Question 2

Side effects of Indomethacin?

Answer 2

Large incidence of side effects (30-50%)
Ulcers, diarrhea, headaches, dizziness
Hematological toxicity

Question 3

Cautions with Indomethacin?

Answer 3

Decreases effects of diuretics

Short term use only (5 days)

Question 4

What is Tolmetin?

Answer 4

Analgesic, antipyretic, anti-inflammatory actions
More potent than aspirin
Anticoagulant at higher doses

Question 5

Side effects of Tolmetin?

Answer 5

25-40% experience side effects

GI problems, anticoagulant at higher doses

Question 6

What is Piroxicam?

Answer 6

Rapid, reversible, competitive
SLOW onset
Used for arthritis
Equipotent to aspirin, naproxen

Question 7

Side effects of Piroxicam?

Answer 7

Fewer GI side effects

11-46% have mild GI side effects

Question 8

What is Meloxicam?

Answer 8

Approved in 2002 for osteoarthritis, 2004 for rheumatoid arthritis
10 fold selectivity for COX2
Less GI toxicity

Question 9

What is Nabumetone?

Answer 9

Prodrug with an active metabolite with some COX2 selectivity
Used for rheumatoid and osteo arthritiss
Side effects: Stomach cramps, diarrhea

Question 10

What is Diclofenac?

Answer 10

Anti-inflammaroy, some COX2 selectivity

Used for rheumatoid arthritis
20% experience GI problems (bleeding, ulcerations)

Question 11

What is Ketorolac?

Answer 11

Slowly reversible, noncompetitive (like Indomethacin)
Parenteral only used for post-op pain (5 day limit)
Less use as anti-inflammatory

Question 12

Side effects of Ketorolac?

Answer 12

Less GI
More hematological (limited to 5 days use)