Iid - Nsaids

Front 1

Non-acetylated salicylates

Back 1

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

Sodium salicylate

Choline magnesium trisalicylate

Salsalate

Front 2

Adverse reactions of salicylic acid derivatives

Back 2

Bleeding complications, gastric intolerance, hypersensitivity reactions, renal toxicity, hepatotoxicity, Reye's syndrome

Front 3

Aspirin overdose

Back 3

Hyperventilation, metabolic acidosis, hyperpyrexia, coma, and renal, vasomotor, and respiratory failure

Front 4

Contraindications of aspirin use

Back 4

Pregnancy, hemophilia (existing clotting disorder), children with fever by viral illness (Reye's syndrome), and prior to surgery

Front 5

Adverse reactions for NSAIDs (not including acetaminophen)

Back 5

GI irritation, cardiovascular thrombotic events, sodium and fluid retention, actual renal failure, hepatotoxicity, and bronchospasm

Front 6

Propionic acid derivatives

Back 6

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

Front 7

Acetic acid derivatives

Back 7

Sunlindac, Indomethacin, Nabumetone, and Ketorolac

Front 8

Ketorolac

Back 8

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)

Front 9

Indomethacin

Back 9

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

Front 10

Sulindac

Back 10

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

Front 11

Nabumetone

Back 11

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

Front 12

Organic sulfur compounds - 2nd generation selective COX-2 inhibitors

Back 12

Celecoxib, Rofecoxib, Valdecoxib

Front 13

Celecoxib

Back 13

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

Front 14

Rofecoxib

Back 14

Phenyl methylsulfone derivative that was voluntarily withdrawn from the market September 30, 2004

CV risk

Front 15

Valdecoxib

Back 15

Diaryl-substituted isoxazole derivative that was voluntarily withdrawn from the market in early 2005

CV risk

Front 16

Acetaminophen

Back 16

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