NSAIDs and Pain Meds

NSAIDs

Non- Steroidal Anti Inflammatory Drugs

Cox-1 and Cox-2

enzymes that cause pain

-produce prostaglandins

NSAIDs try to inhibit these

3 Uses of NSAIDS

anti-inflammatory

analgesic (relieves pain)

antipyretic (relieves fever)

NSAIDS Are Used For What?

ACUTE use

Taking NSAIDS Prophylactically

no evidence that taking NSAIDs as a “preventative” measure works

FDA Recommendation: Taking NSAIDs >10 days

you should be in with a doctor and/or doing so under doctor supervision to help monitor for new or worsening symptoms as a result of medication

Side Effects for NSAIDs

gastric upset

blood thinner

gas/bloating

heartburn

nausea/vomiting

constipation/diarrhea

inhibits kidneys from absorbing water/salt

dehydration

dizziness RP

PRN

“as needed”

typically OTC medications

Rx NSAIDs

typically low dose

for more chronic use

Rx NSAID Ex:

Celebrex —> strong (prescription only)

Indomethaein

Ketoprofen

OTC NSAIDs

low dose, conservative, minimal dosing

for acute use

OTC NSAIDs Ex:

Aspirin

Ibuprofen — “Advil” or “Motrin”

Naproxen — “Alieve”

Aspirin

“wonder drug”

addresses all 3 uses of NSAIDs

can cause Reye’s Syndrome in adolescents

High Doses of NSAIDs Cause

hypertension

irritation to kidneys

ulcers in gut

beware of side effects and comorbiditiesA

Aspirin Dosing

max: 4000 mg/day (spread out)

Ibuprofen Dosing

max: 3200 mg/day —> pills = 200 mg

1800 mg/day min for anti-inflammatory effects

avg: 1600-2400 mg

Naproxen Dosing

440-880 mg/day

pills = 220 mg

slow release pills

Can I take two NSAIDs at the same time?

NO

Tylenol (Acetaminophen)

not an NSAID

should be 1st line of defense for pain OR fever

can take on an empty stomach

not a blood thinner

Medical Fever

100.4 FlassC

Classifications of Pain Meds

-NSAIDS

-Acetaminophen

-Opioids/Narcotics

-Corticosteroids

-Local anesthetic

-Muscle relaxants

-Anti-anxiety

-Anti-depressants

-Anti-convulsants

Opioids/Narcotics

derived from opium

for moderate to severe pain

highly addictive — mimic endorphins

typically prescribed as a “last resort”

Corticosteroids

typically injections

relieve inflammation which relieves pain

Local Anesthetic

ends in “Caine”

derived from cocaine

Muscle Relaxants

usually relaxes a muscle spasm

Rx Pain Meds (short term)

-Codeine

-Fentanyl

-Prednisone

-Cortisone

-Anti-depressants/anti-convulsants

Codeine

lowest level of narcotics

1/10 the power of morphine

Fentanyl

highest level

10-100 times the effect of morphine

1mg is enough to kill you

naloxone (narcan) can reverse harmful effects/overdose

Prednisone

low dose

strong immunocompromiser

good pain/inflammation reliever

not for long term use