NUR 331: Analgesics (Non-Steroidal
Anti-Inflammatory Drugs (NSAIDS) and
Acetaminophen)
What is cyclooxygenase and prostaglandin? What are the affects of non-selective
COX inhibitors (NSAIDs) and Cox-2 inhibitors in the mediating of pain and
inflammation?
1. Cyclooxygenase
- An enzyme responsible for formation of prostanoids (including prostaglandins)
a. COX-1
- Stomach: Reduces gastric acid secretion, ↑ HCO3 and cytoprotective mucus
secretion and maintains submucosal blood flow
- Neonate: Keeps ductus arteriosis open
- Kidney: Maintains renal blood flow
- Blood: Promotes Platelet aggregation
b. COX-2
- Tissue Injury: Promotes inflammation and pain sensation
- Brain: Mediates fever and contributes to perception of pain
- Kidney: Maintains renal blood flow and promotes tumor growth and metastasis
2. Prostanglandins
- A group of lipids formed at sites of tissue damage or infection that are involved in
dealing with injury and illness
a. Prostacyclin: Inhibits platelet activation and is an effective vasodilater
b. Thromoboxane: Vasoconstrictor and Potent Hypertensive Agent, that facilitates
platelet activation and aggregation
, What are the therapeutic actions of NSAIDS and name several drugs who fall in the
NSAID category?
Therapeutic Actions of NSAIDS
1. Analgesia
- Occur both centrally and peripherally
- Treats Mild to Moderate Pain
- Occurs d/t PG synthesis being inhibited in inflamed tissues
2. Antipyretic Action
– Fever, Heat Stroke, ↑ temp are hypothalamic problems that release interleukins
3. Anti-inflammatory Action
- PGs in inflammation cause Vasodilation and ↑ Vascular Permeability
- NSAIDs inhibit PGs from causing inflammation
- Inhibits the leukotriene pathway
4. Antiplatelet Action
- Inhibits platelet aggregation
Drugs in NSAID Category
- Ibuprofen = Treatment of Muscle Pain
- Indomethacin = Treatment of Acute GOUT Attacks
- Ketorolac = Powerful Analgesic
- Meloxicam = Pain of Osteoporosis and Musculoskeletal Use
- Naproxen = Musculoskeletal Pain
What are the adverse effects and significant drug interactions of NSAIDS?
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