Proto: aspirin, ibuprofen, ketorolac, celecoxib
Expected action: Cyclooxygenase inhibition - COX 2 decreases inflammation, COX 1 which leads to decreased platelet aggregation
• Inflammation suppression / analgesia / decreased fever
• dysmenorrhea / suppression of platelet aggregation
• GI discomfort, aspirin induced ulceration and bleeding (use misoprostol as prophylaxis, and/or PPI and/or H2-receptor agonist decreased risk of ulceration)
• Renal dysfunction
• Reye syndrome (in kids with viral illnesses) • Salicylism (tinnitus, resp. alkalosis, dizziness)
• Peptic ulcers / bleeding disorders / hypersensitivity / pregnancy / kids ĉ viral inf.
Interactions: • Glucocorticoids (increased gastric bleeding) - use antiulcer prophylactic like misoprostol (Cytotec) to prevent
• Warfarin (increased bleeding)
• EtOH ( increased bleeding) • Ibuprofen (decreased antiplatelet effects of low-dose aspirin)
• Give with food or milk to reduce GI discomfort.
• If can't tolerate 1st generation, give 2nd generation (celecoxib)