Non steroidal anti-inflammatory drugs

Apr 8th, 2015
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Study guide on NSAIDS

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Nonsteroidal Antiinflammatory Drugs (NSAIDs)Common therapeutic indicationsCommon adverse effectsDifferent pharmacokinetics and potencyDifferent chemical familiesCommon mechanism of action (cyclooxygenaseinhibition) Different selectivities to COX I and IISimilarities more striking than DifferencesCommon PharmacologicalEffects Analgesic (CNS and peripheral effect) mayinvolve non-PG related effects Antipyretic (CNS effect) Anti-inflammatory (except acetaminophen) duemainly to PG inhibition.Some shown to inhibit activation, aggregation, adhesionof neutrophils & release of lysosomal enzymes Some are UricosuricCommon Adverse Effects Platelet Dysfunction Gastritis and peptic ulceration with bleeding(inhibition of PG + other effects) Acute Renal Failure in susceptible Sodium+ water retention and edema Analgesic nephropathy Prolongation of gestation and inhibition oflabor. Hypersenstivity (not immunologic but due toPG inhibition)NSAIDLoss of PGI2 induced inhibition of LTB4 mediatedendothelial adhesion and activation of neutrophils Leukocyte-EndothelialInteractionsCapillaryObstructionProteases +Oxygen RadicalsIschemicCell InjuryEndo/EpithelialCell InjuryMucosal UlcerationThe Salicylates - Aspirin Effect on Respiration: triphasic1. Low doses: uncoupling phosphorylation CO2 stimulates respiration.2. Direct stimulation of respiratory center Hyperve

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