NCM 106: Pharmacology Lecture 5

Study Notes

The immune system identifies and eliminates foreign materials like bacteria, viruses, fungi, and drugs.
Two types of immunity: natural (inborn & permanent) and acquired (adaptive).
Involves both cellular and chemical body components to respond to injury and infections.

Injury leads to tissue damage, causing a physiological reaction.
Tumor (swelling) occurs as fluid accumulation aims to protect and heal tissues.
Rubor (redness) results from widened blood vessels, allowing increased blood flow.
Calor (heat) is due to the warm blood supplied to the affected area.
Dolor (pain) arises from irritation of surrounding nerves by injury and swelling.

Mast Cells: Release chemicals that enhance inflammation and increase blood vessel permeability.
Polymorphonuclear Leukocytes (PMN): Scavenger white blood cells with antibacterial enzymes.
Macrophages: Large cells that clear away damaged cells and pathogens.
Lysosomes: Enzymes from macrophages that break down bacteria.
Interferon & Interleukins: Proteins that modulate the immune response duration and intensity.

Defined as a beneficial reaction of living tissues to injury.
Treatments are categorized into steroidal and nonsteroidal anti-inflammatory drugs (NSAIDs).

Chemically related to salicylic acid.
Aspirin (ASA): Inhibits prostaglandins, can cause gastric issues, and is effective for heart attack prevention due to anti-platelet properties.

Target various types of arthritis and inhibit cyclooxygenase (COX-1 and COX-2) prostaglandins.
May cause gastric irritation and bleeding, particularly with long-term use.

Celecoxib (Celebrex): Not recommended in third trimester of pregnancy.
Diclofenac (Voltaren, Cataflam): Avoid crushing enteric-coated tablets; interact cautiously with milk and antacids.
Etodolac (Lodine): Effective for managing acute pain and osteoarthritis symptoms.
Ibuprofen (Advil): Monitor for possible visual changes.
Indomethacin (Indocin): Caution against use with aspirin; monitor for gastrointestinal bleeding.
Ketoprofen (Oruvail): Available as a sustained-release capsule.
Ketorolac (Toradol): Used short-term (less than one week); protects from light exposure.
Naproxen (Naprosyn): Can prolong bleeding time; advisable for cautious use.
Piroxicam (Feldene): Administered once daily, effects may take two weeks to manifest.

Educate patients on the role of NSAIDs in reducing pain and inflammation.
Inform about common side effects of NSAIDs.
Advise taking NSAIDs with food, milk, or antacids to minimize gastrointestinal upset.
Encourage monitoring stools for signs of gastrointestinal bleeding.
Discuss potential drug interactions with other medications.