NSAIDs Flashcards
What are the two types of NSAIDs?
- Non-selective
- Selective
What are the non-selective NSAIDs?
- Ibuprofen
- Diclofenac
- Naproxen
What is an example of a selective NSAID?
Parecoxib
What is the main advantage of selective NSAIDs?
Target inflammatory cells and less likely to cause GI irritation
How do NSAIDs work?
Block production of prostaglandins from arachidonic acid by inhibiting COX-1 and COX-2
Prostaglandins are mediators of inflammation and pain
What are the routes of administration of NSAIDs?
- PO
- IV
What are the indications for NSAIDs?
- Mild to moderate pain, e.g. dental pain, dysmenorrhoea
- Inflammatory pain, particularly MSK pain
- Dental pain
- Dysmenorrhoea
- Back pain and soft tissue disorders
What are the cautions and contraindications for NSAIDs?
- Asthma
- Active gastric ulceration or bleeding
- NSAID hypersensitivity
- Renal impairment
- Severe heart failure and liver failure
- Pregnancy and breastfeeding - avoid in 3rd trimester
What mnemonic can be used to remember some contraindications for use of NSAIDs?
NSAID
What does the mnemonic NSAID stand for?
- Nursing a baby (pregnant/breastfeeding)
- Severe bleeding
- Asthma
- Issues with renal function
- Drug allergy
What drugs can NSAIDs interact with to cause increased risk of GI ulceration?
- Corticosteroids
- Aspirin
What drugs can NSAIDs interact with to cause increased risk of GI bleeding?
- Anti-coagulants
- Other NSAIDs
- SSRIs
- Venlafaxine
What drugs can NSAIDs interact with to cause increased risk of renal impairment?
Nephrotoxic drugs e.g. aminoglycosides, ACEi, ARBs
What drugs can NSAIDs interact with to cause increased risk of lithium toxicity?
Lithium
What monitoring should patients have prior to starting NSAIDs?
U+Es
