Anti Inflammatory Medications

Question 1

Aspirin

Function, Indications (4), Side effects (1), Adverse effects (3), Some interactions

Answer 1

COX inhibitor (inhibits prostaglandin synthesis)
antipyretic, analgesic, anti-inflammatory, anti-platelet
GI Upset (nausea, gastritis)
Prolonged bleeding times, GI ulceration, Allergic reactions (bronchoconstriction, angioedema, or even anaphylaxis)
Competes w/ Coumadin; displaces phenytoin (Dilantin); decreases excretion of methotrexate; with alcohol, increases risk of GI bleeding

Question 2

NSAIDS

Function, indications (3), side effects (2), some interactions (4)

Answer 2

Ibuprofen (Advil, Motrin, etc) COX1 and 2 inhibitor (non-selective)
Antipyretic, analgesic, anti-inflammatory
SE: fluid retention and edema; GI irritation (less than aspirin, but still can cause ulcers in elderly)
Int: allergic reactions same as ASA; fluid retention might counteract effects of some diuretics and HTN drugs; may increase bleeding if used w/ warfarin; decreases lithium clearance

Question 3

COX-2 NSAIDS

Types / indications, risks

Answer 3

Celecoxib (Vioxx, Celebrex, Bextra… etc) were indicated for RA and DJD
Risks: potentially fatal cardiac effects…

Question 4

Glucocorticosteroids

Types, function, indications, side effects/adverse effects (10)

Answer 4

Cortisol/hydrocortisone and synthetic corticosteroids (prednisone, dexamethasone)
F: inhibit several parts of the inflammatory process: capillary dilation, edema formation, and migration of leukocytes and macrophages to the affected area
I: treatment of RA and DJD
S/AE: adrenal insufficiency; immunosuppression; depression, anxiety, euphoria, “mood swings”, nervousness; cataracts, increased intraocular pressure; cushingoid state (redistribution of fat, hirsuitism, acne, striae on extremities); fluid retention; hyperglycemia; osteoporosis; myopathy; GI disturbances