Drugs Used in Inflammatory Diseases - NSAIDS Flashcards
What is paracetamol used for?
For pain & Antipyretic.
When cant you take paracetamol?
Children
Low Body weight (<50kg)
Liver impairment.
What is aspirin used for and its doses?
Antiplatelet - 75-300mg OD - No anti-inflammatory effect.
Analgesic - 300-900mg 4-6 hours PRN (Rarlely used inflammatory conditions.
When is aspirin used in children?
Kawasaki Syndorme, Reyes syndrome
What is aspirin cautioned in?
Asthma
What are the interation of aspirin?
Drugs that increase GI irritation & bleeding - Steroids, NSAIDS, SSRISs, Anticaog.
Drugs that increase side effects - Bisphosphinates
Drugs were aspirin increases toxcicity of other drugs - MTX
How long does it take NSAIDs to achieve its anti-inflammatory effect
Up to 3 weeks.
What are the key side effects of NSAIDs?
GI muscosa, Kidney, Cardiovascular system.
What strength and duration should NSAIDs be used for?
Lowest effective dose and the shortest duration of action.
How are GI side effects caused by NSAIDs?
Supression of homeostatic prostanoid COX-1:
Reduces mucus prod
Reduced bicarbonate prod
reduced mucosal blood flow.
What monitoring is Req for NSAIDs?
Reported symptoms of dyspepsia/GI irritation
Hb
Signs of GI bleeding - Haemoptysis, Dark stools.
NSAIDs should be stopped in the case of a CV event but if NSAIDs are required which should you give?
Lower thrombotic risk - Naproxen 1g daily
No evidence for increased risk with Ibuprofen 1.2G daily.
What can NSAIDs cause in the kidney?
Decrease renal blood flow -> Increase risk of AKI
Sodium & water retention - Oedema & hypertension.
What can NSAIDs interact with in the kidneys.
Antihypertensives - Opposite effect.
Lithium & MTX - Decreased renal elimination causing toxicity
What is the moitoring for renal S/E?
EGFR, Urine Output, Urea
BP
Electrolytes - Sodium & Pottasium
Odema
