More presentations from Naina Mohamed Pakkir Maideen
Ø Non-Steroidal Anti Inflammatory Drugs (NSAIDs) relieve pain and inflammation by inhibiting the synthesis of Prostaglandins (PGs) through the blockade of Cycloxygenase (COX) enzyme.
Ø NSAIDs are classified as…
· Salicylic acid derivatives (Aspirin, Diflunisal)
· Propionic acid derivatives (Ibuprofen, Ketoprofen, Naproxen)
· Acetic acid derivatives (Diclofenac, Aceclofenac, Ketorolac, Indomethacin)
· Enolic acid derivatives (Meloxicam, Piroxicam, Tenoxicam)
· Fenamates (Mefenamic acid, Meclofenamic acid)
· Butylpyrazolidines (Phenylbutazone)
· Cox 2 inhibitors (Celecoxib, Etoricoxib)
· Anilides (Paracetamol (Acetaminophen))
Ø NSAIDs are indicated in Inflammation, Pain, Fever, Cardioprotection, Patent Ductus arteriosus (PDA), Bartter Syndrome and Systemic mastocytosis.
Ø NSAIDs except Cox 2 inhibitors block both COX 1 and COX 2 enzymes. Inhbition of COX 1 by NSAIDs is responsible for the GI side effects.
Ø The Adverse Drug reactions (ADRs) of NSAIDs include
· Gastro intestinal ulceration (Anorexia, nausea, dyspepsia, abdominal pain, and diarrhea)
· Hypersensitivity reactions (Pseudoallergic and allergic reactions)
· Risk of Hemorrhage
· Risk of Thrombosis
· Early closure of Ductus Arteriosus
· Renal Ischemia
· Risk of Edema
Ø NSAIDs are contraindicated in the following conditions
· Active gastric or duodenal ulcer
· Bronchial Asthma
· Third trimester of pregnancy
· Hypersensitivity to NSAIDs
Ø The risk of bleeding is increased by the concomitant use of NSAIDs and Anticoagulants, Antiplatelets or Fibrinolytics.
Ø Co-administration of NSAIDs and Leflunomide, Teriflunomide or Lomitapide increase the risk of liver damage.
Ø The risk of kidney damage is elevated by the concomitant use of NSAIDs and Adefovir, Cidofovir, Tenofovir, Tacrolimus, Sirolimus, Sodium Biphosphate or IV Immunoglobulins.
Ø GI complications may be increased with the use of NSAIDs and Corticosteroids or SSRIs.
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