Anti Inflammatory Agent

8/14/2019 Anti Inflammatory Agent

1/18

The inflammatory response is designed to

protect the body from injury and pathogens. It employs a variety of potent chemicalmediators to produce the reaction that helpsto destroy pathogens and promote healing. Anti-inflammatory agents generally block oralter the chemical reactions associated withthe inflammatory responses to stop one ormore of the signs and symptoms of

inflammation.


2/18


3/18

Drug name: Fenoprofen (Nalfon) Dosage: 200 600 mg PO t.i.d. or q.i.d.Indication: is used to treat pain and manage arthritis.

2. Drug name: Flurbiprofen (Ansaid) Dosage : 200 300 mg PO in divided doses; ophthalmic solution: 1 gtt q30 min beginning 2 h after surgery Indication: is used for the long-term management of arthritis and as atopical preparation for managing pain after eye surgery.

3. Drug name: Ibuprofen (Motrin, Advil, and others)

Dosage : Adult: 400 800 mg PO t.i.d. to q.i,.d.Pediatric: 30 40 mg/kg/d PO in three to four divideddoses for arthritis; 5 10 mg/kg./d PO q6-8h for

fever Indication: is used as an OTC pain medication and for long-termmanagement of artyhritis pain and dysmenorrhea; it is the mostwidely used of the NSAIDs.


4/18


5/18

1. Drug name: Diclofenac (Voltaren, Cutaflam) Dosage : 100 200 mg/d PO

25 50 mg PO b.i.d. to q.i.d. POIndication: is used to treat acute and long-term painassociated with inflammatory conditions .

2. Drug name: Etodolac (Lodine) Dosage : 800 1200 mg/d PO in divided doses

200 400 mg q6-8h PO for pain managementIndication: is widely used for arthritis pain.

3. Drug name: Indomethacin (Indocin) Dosage : Adult: 75 150 mg/d PO in three to four divided doses

Pediatric: >2 y; in special circumstances, 2 mg/kg/d PO individed doses

Indication: is available in oral, topical, and rectal preparations for therelief of moderate to severe pain associated with inflammatoryconditions and in intravenous form to promote closure of the patientductus arterious in premature infants.


6/18

4. Drug name: Ketorolac (Toradol)Dosage : 10 mg PO q4-6h, 30-60 mg IM, switching

to oral form as soon as possible, or 30 mg IV as a singledose.

Indication: is used for short-term management of pain &topically to relieve ocular itching.

5. Drug name: Nabumetone (Refalen)Dosage : 1000 mg/d PO as a single dose

Indication: is used to treat acute and chronic arthritis pain.

6. Drug name: Sulindac (Clinoril)Dosage : 150 200 mg PO b.i.d.Indication: is used for long and short- term treatment of the signs and

symptoms of various inflammatory conditions.

7. Drug name: Tolmetin (Tolectin)Dosage : Adult: 400 mg PO t.i.d.; 600-800 mg/d in 3-4 doses for

maintenance. Indication: is used to treat acute attacks of rheumatoid arthritis and

juvenile arthritis.


7/18

Drug name: Meclofenamate (generic)Dosage : 200-400 mg/d PO in divide doses; 50-100 mg PO q4-6h

for mild pain. Indication: is used to treat dysmenorrhea, mild pain, and arthritis.

2. Drug name: Mefenamic acid (Ponstel)Dosage: 500 mg PO, then 250 mg PO q6h as needed

Indication: is used only for short-term treatment of pain.

3. Drug name: Piroxicam ( Feldene)Dosage : 20 mg/d PO as a single dose

Indication: is used to treat for moderate pain and for the treatmentof arthritis.

4. Drug name: Diflunisal (Dolobid)Dosage : 500 1000 mg/d PO in two divided

doses Indication: is used for moderate pain and for the

treatment of arthritis


8/18

Drug name: Celecoxib (Celebrex)

Dosage: Initially : 100-200 mg PO b.i.d.400 mg, then 200 m,g PO b.i.d. for acute pain

400 mg PO b.i.d for FAPIndication: is used for the acute and long-term treatment of arthritis, particularly in pt. who cannot tolerate the GIeffect of the NSAIDs.

2. Drug name: Valdecoxib (Bextra) Dosage : Adult: 10 mg/d PO; 20 mg PO b.i.d.Indication: is used as a once-a-day treatment for osteoarthritis, & treatment of adult rheumatoid arthritis &primary dysmenorrhoea.

3. Drug name: Rofecoxib (Vioxx)Dosage PO Osteoarthritis Initial: 12.5 mg once daily.Rheumatoid arthritis 25 mg/day. Acute symptomatic painInitial: 50 mg once daily, then 25-50 mg/day.


9/18

Absorption The NSAIDs are rapidly absorbed from the GI tract,reaching peak levels.

Distribution The NSAIDs cross the placenta and cross into breast milk.

Metabolism Metabolized in the liver and excreted in the urine.

Excretion 1 to 3 hours.

Route Onset Peak DurationOral 30 mins. 1-2 hrs. 4-6 hrs.


10/18

-Pt. receiving NSAIDsoften experience :

Nausea

Dyspepsia

GI pain

Constipation

Diarrhea or Flatulence

- The potential caused bydirect GI bleeding oftenis a cause of discontinuation of thedrug.

2. Headache

3. Dizziness

4. Somnolence

5. Fatigue


11/18

1. Screen for know allergies to any salicylates, NSAIDsor tartazine; pregnancy or lactation; hepatic or renaldisease; cardiovascular dysfunction; hypertension;and GI bleeding or peptic ulcer.

2. Screening for baseline status before beginningtherapy & for potential adverse effects.

1. The NSAIDs are contraindicated in the presence of allergy to any

NSAIDs or salicylate, and celecoxib is also contraindicated in thepresence of allergy to sulfomides.

2. Cardiovascular dysfunction or hypertension, peptic ulcer, andpregnancy.


12/18

Are popular anti-inflammatory agents, not only becauseof their ability to block the inflammatory response, but alsobecause of their antipyretic (fever blocking) and analgesic

(pain-blocking) properties. They are generally availablewithout prescription and are relatively non-toxic whenused as directed.

Salicylates are some of the oldest anti-inflammatorydrugs used. They were extracted from willow bark, poplar trees, and other plants by ancient peoples to treat fever,pain and what we now call inflammation.


13/18

1. Drug name : aspirin (Bayer, Empirin others)Dosage: Adult: 325 650 mg PO or PR q4hMyocardial infraction (MI): 300 325 mg POPediatric: 65 100 mg/kg per day PO or PR in four to six divided

doses: if 12 y: 870 mg PO q3-4h

Indication: Relief of mild pain, fevers; treatment of arthritis


14/18


15/18

Absorption Salicylates are readily absorbed directly from thestomach, reaching peak levels.

Distribution Salicylates cross the placenta and enter breast milk.

Metabolism They are metabolized in the liver and excreted in theurine, with a half life of 15 minutes to 12 hours, depending on thesalicylates involved.

Excretion 5 to 30 minutes

Route Onset Peak Duration

Oral 5-30 mins. 0.25-2 hrs. 3-6 hrs.

Rectal 1-2 hrs. 4-5 hrs. 6-8 hrs.


16/18

- Result of direct drug effectson the stomach

Nausea

Dyspepsia

Heartburn

Epigastric discomfort

- On clotting systems

Blood loss

Bleeding abnormalities

-Salicylisn can occur withhigh levels of aspirin

Dizziness

Ringing in the ears

Difficulty of hearing

Nausea

Vomitting

Diarrhrea

Mental confusion

Lassitude


17/18


18/18

1. Screen for any known allergies to any salicylates,NSAIDs, or tartrazine; renal disease; bleedingdisorders; chicken pox; influenza; and pregnancy or lactation.

2. Include screening for baseline status beforebeginning therapy and for any potential adverseeffects.

Anti Inflammatory Agent

Documents

Transcript of Anti Inflammatory Agent