NSAIDs (non aspirin) non-opioid analgesics, and gout drugs Flashcards
NSAIDs with analgesic and Marked anti-inflammatory action
Acetic acid derivatives
- Indomethacin - semmelweis says its slightly cox-1 selective. literally nobody else does.
- Diclofenac
- Bromfenac
- Sulindac
Enol acids
- Piroxicam
- Meloxicam - sliiiiiightyl COX2 selective, more antiinflamatory than analgesic.
- Tenoxicam
Pyrazolones
- Sulfinpyrazone
- Phenylbutazone
- Aminophenazone
- Methimazole
What is the main difference between the oxicams and indomethacin or diclofenac
The acetic acid derivates are short acting. half life ~ 4 hours.
Piroxicam, Meloxicam, Tenoxicam are very long lasting half life ~50 hours.
What are the effects of the pyrazolone NSAIDs, when are they used
They are mostly anti-pyretic and anti-inflammatory
Phenylbutazone is a very strong anti-inflammatory with severe NSAID side effects, and only used in very severe inflammation.
What are the NSAIDs with analgesia and mild anti-inflammatory.
Priopionic acid derivatives:
- Ibuprofen - 2 hr half life
- Dexibuprofen
- Naproxen - Long half life, 14 hours
- Ketorolac - The only NSAID with parenteral formulations (sike, parecoxib too).
Fenamates:
- Mefenamic acid
- Fludenamic acid
Others: mild COX-2 Selectivity, mainly anti-inflammatory with weak analgesia.
- Nabumetone
- Nimesulide
What are the NSAIDs with only analgesic effects and very weak or no anti-inflammatory effect
Paracetamol/Acetominophen (not really an NSAID)
- Selective COX inhibition in the brain. Doesn’t affect peripheral COX enzymes, nor does it affect inflammation AT ALL.
- May affect CNS cannabinoid receptors via some of its metabolites.
Phenacetin
- Prodrug version that is converted to Acetominophen.
- Not used in the US. Too toxic.
Coxims (Also not really NSAIDs)
- Celecoxib
- Etoricoxib - sulfonamide
- Parecoxib - Parenteral form.