Anti-Inflammatory Drugs Flashcards
(25 cards)
acute vs chronic pain (duration)
acute lasts less than 3 months
chronic lasts more than 6 months
allodynia
exaggerated pain response to a normally no-noxious stimulus (sunburn and tshirt)
functional characteristics of NSADS
analgesia, antipyretic, anti-inflamm
Acetaminophen
NOT AN NSAID
has antipyretic and analgesic effects but does not have anti-inflammatory effects
Cox enzymes
cox enzymes convert arachidonic acid to prostaglandins
cox 1 = protective, needed in body at all times
cox 2 = inflammatory, only present when inflammation occurs
NSAIDs block cox enzymes to decrease pain, inflammatoion and fever
NSAIDs
can be selective or non-selective
inhibit prostaglandin synthesis
original (prototype) NSAID
aspirin
Aspirin low and high dose function
low dose = 600 mg/day, analgesic and antipyretic effects
high dose = >4000 mg/day, anti-inflamm effects
aspirin has a high potential for drug interactions
Anti-inflammatory/analgesic effects of aspirin are due to
inhibition of cox 2 and inhibition of PG synthesis
anti-pyretic effects of aspirin are due to
blocks production of PG in CNS to reset temp control at hypothalamus. temp falls due to superficial blood vessel dilation
anti-coagulant effects of aspirin
increases bleeding time
adverse effects of aspirin
GI tract upset due to inhbiting cox 1
GI irritation due to inhibiting PGs
platelet inhbition (increases bleeding time)
Non-selective COX inhibitors
aspirin, ibuprofen, naproxin, indomethacin, oxaprozin, piroxicam, sulindac, ketorolac
cox 2 selective inhbitiors
effects = analgesic, antipyretic, anti-inflammatory w/o GI effects
don’t use if pt has heart issues! (black box warning = celecoxib)
How to choose an NSAID
no 1 best NSAID for each person, rather 1-2 best choices for each individual
balance efficacy, cost-effectiveness, safety, other drugs, etc
Acetaminophen (tylenol)
commonly used in kids and elderly
no anti-inflammatory properties
not an NSAID!
safety of acetaminophen
hepatotoxicity at high doses
narrow therapeutic index!! risk of liver necrosis and liver failure! failure at 350 mg/kg
interacts with ethanol
mechanism of action of capsaicin
binding and activation to TRPV1 leads to release of substance P. Prolonged activation of these neurons due to capsaicin depleates and prevents substance P from reaccumulating in the SC
used to treat RA, OA
DMARDs
disease modifying anti-rheumatic drugs
Methotrexate! = Immunosuppressive
used to treat RA
slows disease development
mechanism of action for NSAIDS vs narcotics
NSAIDs = enzyme inhibition Opioids = opiate receptor agonist
When would you prescribe a cox 2 inhibitor?
if patient has no pre existing heart conditions and maybe if they have GI issues (cox 1 inihbitor may be too hard on stomach)
Non-selective NSAIDs inhibit?
cox 1 and cox 2
aspirin (acetylsalicylic acid), ibuprofen, indomethacin
Selective NSAIDs inhibit?
cox 2
Celecoxib
Ibuprofen (advil)
often prescribed in lower does with analgesic but not anti-inflammatory efficacy (non-selective NSAID)
