Podcast
Questions and Answers
What is the brand name for Methyl Salicylate?
What is the brand name for Methyl Salicylate?
Which medication is classified as a Phenylbutazone derivative?
Which medication is classified as a Phenylbutazone derivative?
What is the generic name for Pepto Bismol?
What is the generic name for Pepto Bismol?
Which drug is a Selective COX-2 Inhibitor?
Which drug is a Selective COX-2 Inhibitor?
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What is the brand name for Paracetamol?
What is the brand name for Paracetamol?
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Which medication was withdrawn due to safety concerns?
Which medication was withdrawn due to safety concerns?
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What is the primary reason why NSAIDs are contraindicated for people with hypertension?
What is the primary reason why NSAIDs are contraindicated for people with hypertension?
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What is a common risk factor that contributes to NSAID-induced gastrointestinal ulceration?
What is a common risk factor that contributes to NSAID-induced gastrointestinal ulceration?
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Which NSAID has a long-half life of 50 hours and a higher risk for peptic ulcer disease?
Which NSAID has a long-half life of 50 hours and a higher risk for peptic ulcer disease?
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Why are aspirin and tolmetin contraindicated in individuals with gout?
Why are aspirin and tolmetin contraindicated in individuals with gout?
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What is the mechanism of action of opioids?
What is the mechanism of action of opioids?
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Which NSAID category includes Bismuth subsalicylate, which is used for peptic ulcer disease?
Which NSAID category includes Bismuth subsalicylate, which is used for peptic ulcer disease?
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Which NSAID was withdrawn from the market due to bone marrow suppression and Steven-Johnson syndrome?
Which NSAID was withdrawn from the market due to bone marrow suppression and Steven-Johnson syndrome?
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What is the primary effect of NSAIDs on vasodilation during inflammatory processes?
What is the primary effect of NSAIDs on vasodilation during inflammatory processes?
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Which category of NSAID includes Paracetamol (Tylenol) as a weak anti-inflammatory agent?
Which category of NSAID includes Paracetamol (Tylenol) as a weak anti-inflammatory agent?
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What is the primary mechanism through which NSAIDs induce gastrointestinal ulceration?
What is the primary mechanism through which NSAIDs induce gastrointestinal ulceration?
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Which NSAID has the advantage of lesser risk for NSAID-induced peptic ulcer disease but a disadvantage of acute thrombotic events like stroke and myocardial infarction?
Which NSAID has the advantage of lesser risk for NSAID-induced peptic ulcer disease but a disadvantage of acute thrombotic events like stroke and myocardial infarction?
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What is the major pathway of metabolism for Paracetamol (Tylenol)?
What is the major pathway of metabolism for Paracetamol (Tylenol)?
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Study Notes
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- A sharp decline in fever within 24 hours directs the workup away from infection and suggests a neoplastic disorder
- Tolmetin (Tolectin ®) is contraindicated in patients with gout
- Pyrazolone derivatives include phenylbutazone (Butazolidine ®) and oxiphenbutazone
Categories of NSAIDs
- Non-Selective COX Inhibitors:
- Salicylates: methyl salicylate (Salonpas ®), bismuth subsalicylate (Pepto-bismol ®)
- Indole derivatives: indomethacin (Indocin ®)
- Oxicam derivatives: piroxicam (Feldene ®)
- Phenylacetic acid derivatives: diclofenac (Voltaren ®)
- Pyrolealkanoic acid derivatives: tolmetin (Tolectin ®)
- Selective COX-2 Inhibitors:
- Oxicam derivatives: meloxicam (Mobic ®)
- Phenylacetic acid derivatives: etodolac (Lodine ®)
- Coxibs: celecoxib (Celebrex ®), etoricoxib (Arcoxia ®)
Mechanism of Action of NSAIDs
- Inhibit COX, leading to decreased PGE production
- Non-selective COX inhibitors inhibit both COX-1 and COX-2
- Selective COX-2 inhibitors inhibit only COX-2
Side Effects and Adverse Effects of NSAIDs
- Gastrointestinal ulceration (inhibition of COX-1, PGE production)
- Sodium and water retention (inhibition of PG-induced inhibition of renal chloride reabsorption)
- Reversible inhibition of GFR
- Nephrotoxic effects
- Hypersensitivity reactions (asthma-induced allergy)
Paracetamol (Acetaminophen)
- Has analgesic and antipyretic activity, but weak anti-inflammatory activity
- Mechanism of action: weak peripheral inhibitor of COX at peripheral circulation
- Metabolism: major pathway is sulfation and glucuronidation; minor pathway is GSH conjugation
- Toxic metabolite: N-acetyl para-benzoquinone imine
- Non-toxic metabolite: mercapturic acid
- Maximum dose: 4000mg or 8 tablets
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Description
Test your knowledge on NSAIDs with questions about their indications, contraindications, and adverse effects. Learn about specific NSAIDs such as Tolmetin, Phenybutazone, and Piroxicam.
