NSAIDS Flashcards
What are NSAIDs?
Non Steroidal Anti Inflammatory Drugs
What do NSAIDs do?
Analgesic (anti-pain), antipyretic (anti-fever), anti-inflammatory (except acetaminophen)
With a ceiling effect
How do NSAIDs work?
Stop the formation of prostaglandins by blocking the COX 1,2,3 enzymes
What does cyclo-oxygenase-1 do?
Found in many cell types. Many critical functions like maintaining stomach lining
Not involved in fever
What does cyclo-oxygenase 2 do?
This form is induced in immune cells
Responsible for pain, inflammation and fever
What are the 3 phases of inflammation?
Acute transient phases (local vasodilation, increased capillary permeability)
Delayed subacute phase (infiltration of leukocytes and phagocytes)
Chronic proliferative phase (tissue degeneration and fibrosis)
What do prostaglandins do?
Released following cell damage, cause local inflammation, increased blood flow, severe pain, increase hypothalamic set point, stimulate local pain fibres
What are NSAIDs most useful for?
Uterine cramping, joint swelling
Would be more superior than opioids but take too long to work
What are the other effects of prostaglandins?
Platelet aggregation formation, modulate stomach acidity and mucous lining, uterine contraction
What are the 2 mechanisms of action of ASA?
Irreversibly acetylates COX enzymes (unlike the other NSAIDs) with the effect lasting as long as it takes to replace the enzymes
Not dependent on clearance
How can caffeine be used to help NSAIDs?
Will increase the effect of all non-opioid analgesics to give a co-analgesic effect.
60-120 mg (cup of coffee)
What happens in caffeine withdrawal?
Sudden onset of a headache
What can cause salicylate overdose?
Pepto bismol (bismuth salicylate) and methylsalicylate (oil of wintergreen-4 ml)
What are some symptoms of salicylate overdose?
Tinntus
Increase in metabolic rate due to interference with oxidative metabolism (hyperventilation, metabolic acidosis, severe hypoglycemia)
What are the immediate dangers of a salicylate overdose?
Hyperthermia, dehydration and hypoglycemia