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16 Cards in this Set

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Non-acetylated salicylates
Used primarily for their anti-inflammatory effects in osteoarthritis and rheumatoid arthritis

Sodium salicylate

Choline magnesium trisalicylate

Salsalate
Adverse reactions of salicylic acid derivatives
Bleeding complications, gastric intolerance, hypersensitivity reactions, renal toxicity, hepatotoxicity, Reye's syndrome
Aspirin overdose
Hyperventilation, metabolic acidosis, hyperpyrexia, coma, and renal, vasomotor, and respiratory failure
Contraindications of aspirin use
Pregnancy, hemophilia (existing clotting disorder), children with fever by viral illness (Reye's syndrome), and prior to surgery
Adverse reactions for NSAIDs (not including acetaminophen)
GI irritation, cardiovascular thrombotic events, sodium and fluid retention, actual renal failure, hepatotoxicity, and bronchospasm
Propionic acid derivatives
Ibuprofen and naproxen

Pharmacologic actions - analgesic, antipyretic, and anti-inflammatory

Adverse reactions - GI

Therapeutic uses - mild to moderate pain, rheumatoid and osteoarthritis

Note: naproxen is 20 times more potent than aspirin as a cyclooxygenase inhibitor
Acetic acid derivatives
Sunlindac, Indomethacin, Nabumetone, and Ketorolac
Ketorolac
Acetic acid derivative NSAID

Available in tablets for oral use and for parenteral injection. The salt is a water-soluble weak acid with a pKa of 3.5

Pharmacologic actions: analgesic, antipyretic, and anti-inflammatory

Potency - 30 mg of ketorolac is equivalent to the analgesia produced by 6 to 12 mg of morphine, both give IM

Therapeutic uses - short term pain (less for anti-pyretic effects)
Indomethacin
Acetic acid derivative NSAID

Available for oral use and for parenteral injection

Adverse reactions - GI, CNS effects, renal toxicity, ocular toxicity

Therapeutic uses - arthritis, acute gout, and patent ductus arteriosus
Sulindac
Acetic acid derivative NSAID

Prodrug that is an inactive sulfoxide

Metabolized by the liver and kidney to an active (liver) and inactive (kidney) metabolite

NOT "renal sparing"

Adverse reactions - GI

Therapeutic uses - rheumatoid and osteoarthritis, suppresses familial intestinal polyposis
Nabumetone
Acetic acid derivatives NSAID

This is a non-acidic (it's a ketone) and non-ionized

Once a day dosing is possible (bonus)

Adverse reactions - GI

Therapeutic uses - Rheumatoid arthritis and osteoarthritis; very little antiplatelet effects
Organic sulfur compounds - 2nd generation selective COX-2 inhibitors
Celecoxib, Rofecoxib, Valdecoxib
Celecoxib
Organic sulfur compound COX-2 inhibitor

Pharmacological actions - analgesic, antipyretic, and anti-iinflammatory

Adverse reactions - nephrotoxicity, edema and hypertension, headache, dyspepsia and abdominal pain, dermatologic (Stevens Johnson syndrome), and thrombosis

ADVERSE CV DATA

Therapeutic uses - rheumatoid arthritis and osteoarthritis, ankylosing spondylitis, familial adenomatous polyposis, primary dysmenorrhea, and acute pain

Contraindications - patients hypersensitive to NSAIDs or sulfonamides, and patients with renal dysfunction, perioperative CABG
Rofecoxib
Phenyl methylsulfone derivative that was voluntarily withdrawn from the market September 30, 2004

CV risk
Valdecoxib
Diaryl-substituted isoxazole derivative that was voluntarily withdrawn from the market in early 2005

CV risk
Acetaminophen
Pharmacologic actions - analgesic and antipyretic, NOT ANTI-INFLAMMATORY

Inhibits COX-1 and COX-2 in the CNS

Drug interactions - very few; warfarin and caffeine

Adverse reactions - hepatic and kidney necrosis

Overdose - gastroenteritis within hours, hepatotoxicity within 1-3 days, then it resolves or multiple organ failure + death

*leading cause of drug-induced liver injury