Pharmacology - Analgesics, Antipyretics, Anti-inflammatory

Nociceptive pain

Injury to tissue

Somatic pain

A type of nociceptive pain due to injury to somatic tissues

Visceral pain

A type of nociceptive pain due to injury to visceral tissues

Neuropathic pain

Injury to the peripheral nerves; responds poorly to opioids

Analgesics

NSAIDs and acetaminophen

Can relieve pain without causing loss of consciousness

Increasing the dose does not provide greater analgesia, avoiding addiction

Acetaminophen

Tylenol

Inhibits prostaglandins to the CNS

Antipyretic and Analgesic

Max dose is 4g/24 hour

Can lead to hepatotoxicity (do not use on those with severe liver disease)

Antidote: acetylcysteine (mucomyst) which is most affective when given within 10 hours

Alcohol with acetaminophen can lead to liver damage (goes through minor pathway, and alcohol destroys glutathione)

NSAIDs

Ibuprofen, naproxen, aspirin

COX inhibition, leading to decrease in prostaglandins

Antipyretic, analgesic, and anti-inflammatory

Can cause GI bleeding

Works faster than acetaminophen

All first gen NSAIDs can have an increased risk of GI bleeding

Colchicine

Used to treat gout

Inhibits WBC migration to body tissues that have urate crystals, decreasing inflammation

Eliminated in stool

Give with food

Do not drink grapefruit juice

Report severe abdominal pain or diarrhea

Allopurinol

Reduces serum uric acid levels for gout flare ups

Inhibits enzymes that convert purines to uric acid

Dose is based on creatinine clearance

Corticosteroids Glucocorticoids

All end in -one

Prednisone

Anti-inflammatory, immunosuppressive, antiallergic

Decreases inflammation in four hours

Suppresses immune system, making one prone to disease

Suppresses inflammation and immune response by inhibiting prostaglandin and leukotriene synthesis

Can lead to hyperglycemia, hypokalemia, hypertension

Be cautious in diabetes and hypertension

Corticosteroids Mineralocorticoids

Fludrocortisone

All end in -one

Mimics natural hormones from the adrenal cortex to reduce inflammation, suppress immune response, and affect metabolism and fluid balance

Promotes sodium and water retention, and K+ excretion (mimicking aldosterone)

Can lead to hyperglycemia, hypokalemia, hypertension

Be cautious in diabetes and hypertension