NSAIDS & Paracetemol (COX Inhibitors) + Opioids

Question 0

What are Aspirins MOA & Kinetics?

Answer 0

1) Irreversibly acetylates COX I & COX II
2) Oral admin w/ rapid stomach & SI absorption
3) Metabolized in liver (glycine conjugation)

Question 1

NSAIDs include?

Answer 1

1) Diclophenac
2) Indomethacin
3) Piroxicam
4) Ibuprofen
5) Naproxen
6) Mefenamic acid

(Reversible COX I + II inhibition; inhibits thromboxane production)

(Analgesic; Anti-inflammatory; Anti-pyretic; Dose related effects [prevent MI, strokes & clot formation])

Question 2

What are Paracetamol’s MOA & Therapeutic effects?

Answer 2

1) Reversible, non-competitive inhibition of COX I & COX II (in brain)
2) Analgesic; Anti-pyretic; No GIT effects/bleeding & safe to use at therapeutic doses

Question 3

Opioids include?

Answer 3

1) Codeine (mild)
2) Morphine (strong)

(Opioid receptor agonist. Mimic effects of natural endorphins; analgesic, antitussive & anti-diarrhoea; Resp. depression, euphoria, sedation, nausea & vomiting, constipation)

Question 4

What is the MOA etc. of Celecoxib & Etoricoxib?

Answer 4

MOA: COX II selective inhibitor. Oral admin.

Therapeutic use: Osteoarthritis, rheumatoid arthritis, acute pain, menstrual pain

Side effects: MI, stroke, renal vasoconstriction, change in BP, dec. GFR

C/I: sulfonamide sensitivity