NSAIDs and Antigout

4 As of NSAIDs

anti-pyretic, anti-inflammatory, anti-platelet(aspirin), analgesic

Salicylates drug + use

aspirin

mild-mod pain, MI

aspirin doses

81mg- cardiac issue

325mg- pain

4000mg+ is toxic

aspirin adverse effects

bleeding (GI), risk of ulcers, Reye’s syndrome (<18 year old)

aspirin triad (RUN AERD)

rhinitis, asthma, nasal polyps

leads to aspirin exacerbated respiratory disease

salicylate toxicity

tinnitus, difficulty hearing, dizziness, N/V, confusion

Propionic Acid drugs + MOA

ibuprofen, naproxen

mild-mod pain/inflammation, reduce fever, gout attacks, arthritis

ibuprofen adverse effects

BBW: increased risk of CV event

GI bleeding, do not take with alcohol

meloxicam

arthritis

BBW: GI bleeding

Acetic acid derivate drugs

ketorolac, indomethacin

indomethacin

arthritis/gout pain, IV stops labor

BBW: GI bleeding

ketorolac

pain relief similar to opioids (IV NSAID)

can effect bones; DO NOT USE FOR MORE THAN 5 DAYS IN A ROW

celecoxib

only selective NSAID

arthritis and colorectal polyps (less risk of GI bleeding)

BBW: CV risk

general NSAID considerations

high risk of bleeding/GI bleeding and peptic ulcers

gout MOA

uric acid buildup in joints; under excreted in joints or overproduction of uric acid

mitotic agent

colchicine

MOA-stops WBC movement into areas w urate crystals; lowers inflammatory reaction

go-to for acute gout treatment

colchicine AE

GI related N/V, liver toxicity