NSAIDS Flashcards
(11 cards)
Mechanism of Action
Inhibits COX Enzymes
- reducing inflammation, pain and fever and prevention of blood clots.
COX mechanism
required to convert arachidonic acid into thromboxanes, prostaglandins and prostacyclins.
Thromboxanes - platelet adhesion
Prostaglandin - vasodilation
COX 1
Mediator for ensuring gastric mucosal integrity, regulating platelet aggregation and renal blood flow.
COX 2
Mediate pain, inflammation and fever,
COX 2 selective inhibitors
Celecoxib
Rofecoxib
Valdecoxib
Ibuprofen - MOA, CI and Cautions
Inhibition of both COX 1 and 2
Contraindications:
Active bleeding or thrombocytopenia
History of GI bleeding or ulceration.
Cautions:
IHD if high daily dosages.
Aspirin - MOA, CI and Cautions
Inhibition of both COX 1 and 2
Given long term in patients with established cardiovascular disease as secondary prevention.
First line for IHD
Contraindications:
Active bleeding or thrombocytopenia
Reye’s Syndrome
Cautions:
Primary prevention - not recommended.
Hypertension - increased bleeding risk and can impair the other blood pressure medications
Risk of GI bleeding - give PPI
Diclofenac - MOA, CI and Cautions
Inhibition of both COX 1 and 2
Mainly used for oral or dental pain relief.
Contraindications:
Active bleeding or increased bleeding risk.
Indomethacin - MOA, CI and Cautions
Inhibition of both COX 1 and 2
Pain relief for rheumatic and MSK conditions
Gout
Dysmenorrhoea
Contraindications:
Active Bleeding
GI bleeding or ulceration
Cautions:
Renal impairment
GI disorders
Uncontrolled hypertension
Naproxen - MOA, CI and Cautions
Inhibition of both COX 1 and 2
Rheumatic disease, MSK, Dysmenorrhoea, Gout (same as indomethacin)
Migraine
Contraindications:
Active bleeding or increased bleeding risk
GI bleeds or ulceration
Cautions:
Uncontrolled hypertension
NSAIDS and Asthma
Asthma - trigger bronchospasm due to inhibition of COX enzymes - leading to increase in leukotriene production and airway constriction - mainly avoided if possible.
