NSAIDs (non aspirin) non-opioid analgesics, and gout drugs Flashcards

1
Q

NSAIDs with analgesic and Marked anti-inflammatory action

A

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
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2
Q

What is the main difference between the oxicams and indomethacin or diclofenac

A

The acetic acid derivates are short acting. half life ~ 4 hours.

Piroxicam, Meloxicam, Tenoxicam are very long lasting half life ~50 hours.

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3
Q

What are the effects of the pyrazolone NSAIDs, when are they used

A

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.

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4
Q

What are the NSAIDs with analgesia and mild anti-inflammatory.

A

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
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5
Q

What are the NSAIDs with only analgesic effects and very weak or no anti-inflammatory effect

A

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.
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