Pharmacology

Non Steroidal Anti Inflammatory Drugs (NSAIDs) PDF

Non Steroidal Anti Inflammatory Drugs (NSAIDs)

Non Steroidal Anti Inflammatory Drugs (NSAIDs) 

Content of Following Presentation Are:

  • Common therapeutic indications
  • Common adverse effects
  • Different pharmacokinetics and potency
  • Different chemical families
  • Common mechanism of action (cyclooxygenase inhibition)
  • Different selectivities to COX I and II
  • Similarities more striking than Differences

Common Pharmacological Effects

  • Analgesic (CNS and peripheral effect) may involve non-PG related effects
  • Antipyretic (CNS effect)
  • Anti-inflammatory (except acetaminophen) due mainly to PG inhibition.
  • Some shown to inhibit activation, aggregation, adhesion of neutrophils & release of lysosomal enzymes
  • Some are Uricosuric

Common Adverse Effects

  • Platelet Dysfunction
  • Gastritis and peptic ulceration with bleeding (inhibition of PG + other effects)
  • Acute Renal Failure in susceptible
  • Sodium+ water retention and edema
  • Analgesic nephropathy
  • Prolongation of gestation and inhibition of labor.
  • Hypersenstivity (not immunologic but due to PG inhibition)

The Salicylates – Aspirin

Effect on Respiration: triphasic

  • Low doses: uncoupling phosphorylation → ↑ CO2 → stimulates respiration.
  • Direct stimulation of respiratory center → Hyperventilation → resp. alkalosis → renal compensation
  • Depression of respiratory center and cardiovascular center → ↓ BP, respiratory acidosis, no compensation + metabolic acidosis also

GI system

  1. Dose dependent hepatitis
  2. Reye’s syndrome

Metabolic

  1. Uncoupling of Oxid. Phosphorylation
  2. Hyperglycemia and depletion of muscle and hepatic glycogen

Endocrine: corticosteroids, thyroid

Read more in the Attached Lecture