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
- Dose dependent hepatitis
- Reye’s syndrome
Metabolic
- Uncoupling of Oxid. Phosphorylation
- Hyperglycemia and depletion of muscle and hepatic glycogen
Endocrine: corticosteroids, thyroid
Read more in the Attached Lecture
