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30 Cards in this Set

  • Front
  • Back
Salicylates
Aspirin
Sulfasalazine
Propionic Acid Derivatives
Flurbiprofen
Ibuprofen
Naproxen
Oxaprozin
Acetic Acid Derivatives
Diclofenac
Ketorolac
Sulindac
Indole Derivatives
Indomethacin
Oxicams
Meloxicam
Piroxicam
Coxib
Celecoxib
Non-NSAID Analgesic-Antipyretic
Acetaminophen
Clinical Uses of Salicylates
Local derm use as keratolytics, antifungal agents, counterirritants;
Antipyresis;
Analgesia - nonspecific relief of pain caused by headache, toothache, arthralgia, myalgia, dysmenorrhea, tendinitis, bursitis, low back pain, bone metastases, postop pain, etc;
Inflammatory diseases - acute rheumatic fever, RA, ankylosing spondylitis;
Thromboembolic disease prophylaxis
Aspirin
Irreversible inhibition of COX1 & COX2; increase formation of LTs from LOX pathway;
CIed in pregnant women; Hypersensitivity to aspirin is a CI to therapy with any other NSAID!!!
Sulfasalazine
ONLY NSAID used for ulcerative colitis and Crohn's disease; safe for pregnant women
Reye's Syndrome
Do NOT use aspirin to treat children with fevers from viral infections; develops in 2 phases: respiratory infection, then after 4 days, nausea and vomiting, sudden change in mental status, lab signs of liver damage; may be mild or may progress to toxic encephalopathy which is rapidly fatal (20% lethality)
CIs and Precautions of Salicylates
Gastritis, peptic ulcer, and other ulcerative GI diseases (except for Sulfasalazine); alcohol consumption; coagulation disorders; G6PD deficiency; renal disease; gout; advanced heart failure; sever hypertension; asthma; NSAID hypersensitivity; viral febrile illnesses in children (Reye's Syndrome);
Concomitant use of the following drugs: Methotrexate, Anticoagulants, Bilirubin, Corticosteroids, Phenytoin, Probenecid
Flurbiprofen
RoA: oral, ophthalmic, IV;
particularly effective for inhibition of intraoperative miosis (ophthalmic); peroperative analgesia in minor ear, neck, and nose surgery (IV); sore throat (oral)
Ibuprofen
RoA: oral, topical, IV;
much higher doses are required for anti-inflammatory effects;
particularly effective for closing PDA (oral & IV); primary knee osteoarthritis (topical); postsurgical dental pain;
Safe to use in children!!
AEs of Ibuprofen
Aseptic meningitis (especially SLE patients), fluid retention, agranulocytosis, aplastic anemia
Naproxen
RoA: oral, topical, and ophthalmic;
Half dose will achieve same effects because it is a single enantiomer;
Safe to use in children!!!
Oxaprozin
RoA: oral;
particularly effective for gout because it is mildly uricosuric therefore increasing the excretion of uric acid
Diclofenac
Inhibits COX nonselectively and also inhibits LOX (low level), also decreases ROS production;
RoA: oral, ophthalmic, topical, and rectal;
particularly effective for postop ophthalmic inflammation; solar ketoses (topical); preemptive analgesia and postop nausea (rectal)
Ketorolac
RoA: Oral, IV, IM, and ophthalmic;
Primarily used for analgesic action, not anti-inflammatory - used in conjunction with opioids to reduce opioid requirement by 25-50%
Sulindac
RoA: oral; administered as a PROdrug to prolong duration of action to 12-16 hours;
particularly effective for familial intestinal polyposis; may inhibit colon, breast, and prostate cancer development
AE of Sulindac
Stevens-Johnson syndrome, thrombocytopenia, agranulocytosis, nephrotic syndrome, cholestatic liver damage
Indomethacin
RoA: oral, rectal, ophthalmic, epidural, topical (oral rinse);
MoA: potent nonselective COX inhibitor, inhibits phospholipase A & C, decreases neutrophil migration and B&T cell proliferation
Uses of Indomethacin
Gout, ankylosing spondylitis, closure of PDA, conjunctivitis (ophthalmic), gingivitis (oral rinse), analgesia in postlaminectomy syndrome (epidrual)
Meloxicam
RoA: oral;
MoA: highly selective inhibitor of COX2, also inhibits TXA2 synthesis;
particularly effective for osteoarthritis
Piroxicam
RoA: oral;
MoA: nonselective COX inhibitor, inhibits PM leukocyte migration and lymphocyte function, decreases ROS production;
displays an increased incidence (9.5x higher) of peptic ulcer and bleeding
Celecoxib
RoA: oral;
MoA: Highly selective COX2 inhibitor, does not affect platelet aggregation at usual doses;
BLACK BOX Warning: Cardiovascular Risk;
CIed in use with warfarin and pregnant women
Acetaminophen
MoA: potent inhibitor of COX1 and COX2 in the CNS!! Weak COX inhibitor in the periphery;
PREFERRED to aspirin in children with viral infections!!!
Short to Medium Acting Glucocorticoids
Cortisone
Hydrocortisone
Methylprednisolone
Prednisolone
Prednisone (PROdrug)
Intermediate Acting Glucocorticoids
Triamcinolone
Long Acting Glucocorticoids
Betamethasone
Dexamethasone