PAIN + INFLAMMATION

Question 1

what is used for pain related to inflammation

rheumatoid arthritis, back pain, soft tissue disorder

Answer 1

NSAID = analgesic + anti-inflammatory

Question 2

NSAIDs CI

Answer 2

• asthmatics
• MHRA = risk to foetal growth with prescribing NSAIDs from 20th week of pregnancy

Question 3

COX-2 selective inhibitors

Answer 3

• celecoxib
• etroicoxib

Question 4

NSAIDs cautions

Answer 4

• low dose aspirin = inc GI bleed risk (only use if needed)
• alcohol = inc GI bleed risk

Question 5

what is given with NSAIDs

Answer 5

PPI as stomach protection

Question 6

s.e of NSAID

Answer 6

• hypersenstivity reactions
• cross sensitivity with aspirin

Question 7

when to avoid NSAIDs

Answer 7

• renal impairment (risk of fluid retention and further impairment)
• avoid in pregnancy (caution in breastfeeding)

Question 8

NSAIDs high risk level

GI and cardiovascular s/e

Answer 8

GI S/E
- piroxicam
- ketorolac
- ketoprofen
Cardiovascular S/E
- COX2 selective inhibitors

Question 9

NSAIDs medium risk level

GI s/e

Answer 9

GI S/E
- indometacin
- diclofenac
- naproxen

Question 10

NSAIDs low risk level

GI and cardiovascular s/e

Answer 10

GI S/E
- ibuprofen
Cardiovascular S/E
- naproxen
- ibuprofen 2.4g

Question 11

NSAIDs lowest risk level

GI s/e

Answer 11

GI S/E
- cox-2 selective inhibitors

Question 12

NSAIDs interactions

Answer 12

• MTX/lithium - reduces clearance
• ciprofloxacin - inc risk of seizures
• blood thinners - high risk of bleeding
• drugs cause hyperkalaemia
• drugs cause renal failure = AKI