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NSAIDS - Coggle Diagram
NSAIDS
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Uses of NSAIDS
NSAIDs are used for the treatment of mild to moderate pain, especially the pain of inflammation.
• NSAIDs are useful in the treatment of musculoskeletal disorders, such as rheumatoid arthritis and osteoarthritis.
• Many NSAIDs are approved for the treatment of rheumatoid arthritis, osteoarthritis, gout, ankylosing spondylitis, and dysmenorrhea.
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AE of NSAIDS
• GI EFFECTS
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• Misoprostol, proton pump inhibitors, and H2 blockers reduce the risk of gastric ulcer and are used in the treatment of gastric damage induced by NSAIDs.
Lowest Risk
• Celecoxib
Low Risk
• Ibuprofen
Aspirin
• Diclofenac
Medium Risk
• Naproxen• I
High Risk
• Piroxicamndomethacin
RENAL EFFECTS
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• Analgesic Nephropathy; Chronic interstitial nephritis caused by prolonged and excessive consumption of analgesics.
• The use of the NSAID phenacetin, which is no longer available, was particularly associated with analgesic nephropathy.
COX 2 inhibitors: COX-2 is constitutively active in the kidney.
• COX-2 inhibitors cause renal toxicities similar to those caused by the non-selective NSAIDs.
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• CARDIOVASCULAR EFFECTS
• NSAIDs can increase the risk of CV events (heart attack, stroke, death).
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• This may lead to vasoconstriction, platelet aggregation, and thrombosis.
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• Coxibs have fewer GI side effects. COX 2 inhibitors
• But their usefulness has been reduced by their association with thrombotic events.
• Currently, celecoxib is the only selective COX-2 inhibitor available in the USA.
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black box warning
• NSAIDs can increase risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease.
• Patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use.
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• Patients treated with NSAIDs following a first heart attack are more likely to die in the first year after the heart attack.
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contraindications
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• They are contraindicated in children and young adults < 20 yo with fever associated with viral illness.
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• Pregnancy, especially close to term, is a relative contraindication to the use of all NSAIDs.
actions of NSAIDS
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• Inhibition of PG synthesis mediates the anti- inflammatory, analgesic and antipyretic actions of NSAIDs
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