Analgesics: NSAIDs/APAP; muscle relaxants
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21 terms
Terms | Definitions |
|---|---|
 acetaminophen | not an NSAID, commonly combined w/other products MOA: analgesia: not clear, antipyretic: inhibit action of pyrogens INDICATIONs: pain, fever DOSING: max 1 dose adult is 1000mg (4g/day) (concentrated infant drops being phased out) ADRs: well tolerated; avoid ETOH and other hepatotoxic drugs; OD txed with n-acetylcysteine PREGGERS: (C) good place to start (lowest dose possible) |
| aspirin | carboxylic acid NSAID |
| salsalate diflunisal choline magnesium trisalicylate | carboxylic acids no plt effect may not work at all |
| ibuprofen | proprionic acid NSAID >400mg offer no more analgesia, just improved anti-inflammatory properties |
| naproxen | proprionic acid NSAID |
| fenoprofen, ketoprofen, flurbiprofen, oxaprozin | proprionic acid NSAIDs less commonly used |
| indomethacin | acetic acid derivative NSAID IV used for PDA closure only. NOT in pregnant |
| diclofenac | acetic acid derivative NSAID |
| ketorolac | acetic acid derivative NSAID CAUTION: limit IM/IV <5d d/t toxicity |
| sulindac, etodolac, tolmetin | acetic acid derivative NSAID less commonly used |
| piroxicam | enolic acid NSAID |
| melxicam | enolic acid NSAID |
| fenamates napthylkanones | enolic acids not freq used |
| NonSelective NSAIDs | USE: analgesia, antipyretic, dysmenorrhea, anti-inflammatory INTERACTIONS: warfarin w/caution; inc gi bleed risk w/ETOH, corticosteroids, anti-plt agents interfere w/anti-plt effect of ASA, dec diuretics, inc [Li] CAUTION: asthma, HTN, CKD, CHF CONTRAS: recent CABG, Pregnant ADRs: 1.)Gi effects dyspepsia/gastritis/ulcers/etc (naproxen>ibuprofen) 2.) Cardiovascular effects (can interfere w/ASA), take ASA 1 hr before NSAID 3.) may precipitate asthma attack (not true allergy) 4.) reversible plt dysfct 5.) Nephroxicity |
| Risk FActors for GI Toxicity | High risk: hx of complicated PUD OR >2 of rf below moderate risk: >65 high dose NSAID hx Hx of uncomplicated PUD concurrent asa, anticoagulant or corticosteroid usage (+) H. pylori |
| celecoxib | COX-2 selective NSAID doesn't bind plt *no more effective than nonselective NSAIDs same cautions, adrs as non-selective less GI toxicity may be prothrombotic? |
| cyclobenzaprine | oral muscle relaxant MOA: similar too amitryptyline (TCA), reduces tonic somatic motor activey by acting on central serotoneric pathways has most efficacy USE: muscle spasm ass. w/MS disorders INTERACTIONs: careful w/depression meds, tramadol, other CNS depressants CONTRAs: arrhymias, recent AMI, or CHF ADRs: sedation, dizziness, xerostomia, QTc prolongation |
| carisoprodol | oral muscle relaxant DONT USE removed form europe, schedule IV |
| metaxalone, methocarbamol, chlorzoazone, tizanidine, orphenadrine | oral muscle relaxants don't really that well, all interchangeable |
| baclofen | oral muscle relaxant USE: spasticity in MS or SC injury pts works well, w/drawl syndrome possible |
| dantrolene | oral muscle relaxant USE: spasticity in MS or SC injury, malignant hyperthermia ADR: dose dependent hepatotoxicity |
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