NSAIDs & SAIDs Flashcards
Why does inflammation occur?
- Increases blood flow into damaged, injured, traumatized or infected areas of tissues
- This increases migration of leukocytes into the tissue
What are the 4 signs of inflammation?
- Heat
- Redness (erythermia)
- Pain
- Swelling
What is the inflammatory response?
- Tissue damage and infection
- Release of inflammatory mediators and cytokines
- Vasodilation and diapedesis
- Removal of invading microbes
- Repair of the tissue
What are 3 examples of acute inflammation?
- Colitis
- Allergy
- Sepsis
What are 2 examples of chronic inflammation?
- Osteoarthritis
- Chronic asthma
What is the arachidonic acid pathway?
- Cycloocygenase pathway: releases prostacyclin and thromboxane which causes platelet aggression
- Lipooxygenase pathway: releases leukotrienes, which causes bronchoconstriction, asthma attacks and smooth muscle contraction
- These pathways can’t be carried out as arachidonic acid is not released, due to DNA alteration.
What are steroidal anti-inflammatory drugs (SAIDs)?
- Group of hormones produced by the cortex of the adrenal gland, which alters transcript of DNA, which changes cellular metabolism reducing inflammatory response, as arachidonic acid is not released
- 2 groups: Glucocorticoids and mineralcorticoids
What are the pharmacodynamics of glucocorticoids?
- Direct effect: inhibit phospholipase and COX to a lesser degree
- Indirect effect: inhibit product of other mediators and reduce vascular permeability and hence reduces swelling
- Short, immediate and long-acting
Give an example of short-acting glucocorticoids
- Hydrocortisone
Give an example of an immediate-acting glucocorticoid
- Prednisolone as prednicare, prednidale or PLT
Give 2 examples of long-acting glucocorticoids
- Dexamethasone
- Betamethasone
What are the pharmacokinetics of glucocorticoids?
- Metabolised by the liver
- Eliminated via the kidneys
What are the adverse reactions of glucocorticoids?
- Skin thinning
- Muscle wasting
- Decreased wound healing
- Hyperglycaemia
What are the contraindications of glucocorticoids?
- Glaucoma
- Cataracts
- Hypertension
- Tachycardia
- Gastric ulcers
- Atrophy
What are the pharmacodynamics of non-steroidal anti-inflammatory drugs (NSAIDs)?
- Work by inhibiting COX-1 or COX-2 selectively as an enzyme inhibitor
What are the pharmacodynamics of aspirin?
- Irreversible inhibition of COX-1 , which prevents the production of prostaglandins and thromboxanes
What are the adverse reactions of aspirin?
- GI ulcerations/irritation
- Renal necrosis
What are the contraindications of Aspirin?
- Dehydration
- Hypovolaemia
- Hypotension
- GIT disease
- Pregnancy and neonates
What are the pharmacodynamics of carprofen?
- Inhibit COX-2 , which reduces prostaglandins involed in inflammation
What are the adverse reactions of carprofen?
- GI ulceration/irritation
What are the contraindications of carprofen?
- Dehydration
- Hypovolaemia
- Hypotension
- Blood clotting abnormalities
- Renal disease
What are the pharmacodynamics of meloxicam?
- Inhibition of COX-2, which reduces prostaglandins
What are the adverse reactions of meloxicam?
- GI ulceration/irritation
What are the contraindications of meloxicam?
- Dehydration
- Hypovolaemia
- Hypotension
- Blood clotting abnormalities
- Pregnancy and neonates
What are the pharmacodynamics of robenacoxib?
- Inhibition of COX-2, which reduces prostaglandins
What are the adverse reactions of robenacoxib?
- GI ulceration/irritation
What are the contraindications of robenacoxib?
- Dehydration
- Hypovolaemia
- Hypotension
- Blood clotting abnormalities
- Pregnancy
What are the pharmacodynamics of firocoxib?
- Inhibition of COX-2, which reduces prostaglandins
What are the adverse reactions of firocoxib?
- GI ulceration/irritation
What are the contraindications of firocoxib?
- Dehydration
- Hypovolaemia
- Hypotension
- Blood clotting abnormalities
- Pregnancy and lactating
What are the pharmacokinetics of NSAIDs?
- All metabolised by the liver
- Excreted through the kidneys
