NSAIDS Flashcards
What could a dose of 300-900mg 4/6 hourly prn Aspirin be given for?
Analgesic
What are the special patient group for Aspirin?
-Children under 16
-Ulcers
-Bleeding disorders
-Severe cardiac failure
-Hypersensitivity to NSAID/Aspirin
-Elderly
-Asthma
What does Aspirin interact with?
-Drugs which increase risk of GI irritation / bleeding
-Steroids/NSAIDS/SSRI’s/DOACS
-Drugs with renal side effects -Bisphosphonates
-Drugs where Aspirin can increase toxicity of other drugs - methotrexate
How long does it take for an NSAID to have it’s full effect for pain relief?
1 Week
How long does it take for an NSAID to have its full anti-inflammatory effect?
3 weeks
What are the key side effects of NSAIDS?
*GI irritation
*Kidneys
*Cardiovascular
If NSAIDS are used, they should be used for the lowest effective dose for the shortest duration, True or False?
True
What COX selective has less GI effects but more CV effects?
COX-2
What are examples of non selective NSAIDS?
Ibuprofen, Indometacin, Mefamic acid, Naproxen
What are examples of COX-2 preference NSAIDS?
Diclofenac, Etorloic, Meloxicam,
What are examples of COX-2 selective NSAIDS?
Celecoxib
Etoricoxib
Why do Gi side effects happen from NSAIDS?
1) Suppression of physiological homeostatic prostanoid (COX-1) inhibition
2) Topical irritation and direct epithelia damage
What NSAIDS carry a high GI risk?
Piroxicam, Ketoprofen, Ketorolac
What NSAIDS carry an intermediate GI risk?
Indomethacin, Diclofenac, Naproxen
What NSAIDS carry a low GI risk?
Ibuprofen - dose up to 1.2g!!
COX-2 selective ‘coxibs’
What NSAIDS carry the lowest risk of GI irritation?
COX 2 selective ‘coxibs’
What should be co-prescribed with NSAIDS?
PPI
What NSAIDS carry the highest CV risk?
COX-2 inhibitors, diclofenac 150mg OD, Ibuprofen 2.4g