NSAIDS/OPIOIDS/GLUCOCORTICOIDS

is ibuprofen selective or non selective/NSAID?

NON selective NSAID

is etoricoxib (selective/non selective) / (NSAID?)

selective, nsaid

is paracetamol an nsaid

NOT NSAID.

diclofenac potassium (selective/non selective) / (NSAID?)

NSAID, NON selective

celecoxib (selective/non selective) / (NSAID?)

NSAID, selective

mefenamic acid (selective/non selective) / (NSAID?)

NSAID, non selective

ketoprofen (selective/non selective) / (NSAID?)

nsaid, non selective

naproxen sodium (selective/non selective) / (NSAID?)

nsaid, non selective

aspirin (selective/non selective) / (NSAID?)

nsaid, non selective, irreversible

clopidogel (selective/non selective) / (NSAID?)

NOT NSAID.

diclofenac sodium (selective/non selective) / (NSAID?)

nsaid, non

prednisone (selective/non selective) / (NSAID?)

NOT NSAID

non opioid analgesic name them

paracetamol, aspirin, glutocorticoids, nsaid

glutocorticoids are usually given as

antiinflammatory drugs

is acetaminophen an nsaid

no

enzyme responsible for production of leukotrienes

lipoxygenase

function of leukotrienes

for inflammatory response. bronchoconstriction, increase vascular permeability (edema, swelling), chemotaxis

eicosanoids are associated with

prostaglandins, thormboxanes, leukotrienes

properties of paracetamol

antipyretic, analgesic ONLY

enzymes responsible for prostaglandins and thromboxanes

COX1, COX2

specific leukotrienes for bronchoconstriction and vascular permeability

LTC4, LTD4

specific prostaglandins for vasodilation

PGE2, PGI2

specific thromboxane for vasoconstrictors

TXA2

properties of NSAIDS

anti inflammatory, analgesic, antipyretic, antiplatelet

non selective nsaid definition

both COX1 and COX2 inhibited

selective nsaid definition

inhibits COX2 only

common prefix of selective NSAID medicines

'coxib'

properties of acetaminophen

anti pyretic, analgesic

opioids function

moderate to severe pain

for which medicines is gastrointestinal bleeding an adverse effect?

aspirin, clopidogrel, nsaid, glucocorticocoids

endogenous ligand of mu receptor

endorphins

function of mu receptor

supraspinal/spinal analgesia, sedation, respiratory depression, slowed GI transit, euphoria

function of delta receptor

supraspinal/spinal analgesia

endogenous ligand of delta receptor

enkephalins

function of kappa receptor

supraspinal/spinal analgesia, psychotomimetic effects (dysphoria, hallucinations), slowed GI transit

endogenous ligand of kappa receptor

dynorphins

physiologic effects of glutocorticoids

1. increases blood glucose and liver glycogen

2. breaks down muscle to AA

3. breaks down lipids to free fatty acids

4. increases glycogenolysis (breakdown of glycogen to glucose)

function of glutocorticoid

1. mimics cortisol

2. reduce inflammation and suppress overactive immune systems

3. allergic reaction, collagen problems, eczema, lupus

common NON NSAID meds

1. acetaminophen

2. paracetamol

common NSAID meds

1. aspirin

2. ibuprofen

inflammation

1. injury to tissue

2. phospholipidase secretes phospholipids

3. phospholipids secrete arachidonic acid

4. cycloxygenase (COX) and lipoxygenase metabolize (breaks down) arachidonic acid

5. eicosanoids produced

mechanism of nsaids

1. inhibits COX

2. arachidonic acid cant be converted to PG

3. because PGE2 sensitizes nerve endsings to pain mediators (bradykinin, histamine)

mechanism of glucocorticoids

1. binds to glucocorticoid receptor

2. alters gene transcription

3. inhibits phospholipase A2 -> ⬇ arachidonic acic release-> ⬇ prostaglandins & leukotrienes

4. stabilize lysosomal enzymes

5. decrease vascular permeability leading to edema

6. suppress cytokine production

opioid receptors

mu, kappa, delta

mechanism of action opioids

1. binds to presynaptic and postsynaptic opioid receptors (G protein coupled)

2. presynaptic decreases Ca2+, induces hyperpolarization

3. decreased neuronal excitability

4. decreased pain transmission WITHOUT LOSS OF CONSCIOUSNESS, TOUCH, PROPRPIOCEPTION