NSAIDs and Radiographic Progression in Ankylosing Spondylitis
NSAIDs IN DENTISTRY
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Transcript of NSAIDs IN DENTISTRY
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NON-STEROIDAL ANTI-INFLAMMATORY
DRUGS (NSAIDs)
PREPARED BY : VISHAL GOHIL (21) FINAL YR BDS
GUIDED BY : DR. VEENA PATEL DR. JIGAR JOSHI DR. NIMESH PATEL
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VISHAL GOHIL
CONTENTS
•INTRODUCTION
•MECHANISM OF ACTION
•CLASSIFICATION
• THERAPEUTIC USES
• DOSES OF FEW DRUGS
• ADVERSE EFFECTS
•DENTAL CONSIDERATIONS
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VISHAL GOHIL
NSAIDs• Non-steroidal anti-inflammatory
drugs• Large & chemically diverse group of
drugs with the following properties :
- Analgesic- Anti-inflammatory- Antipyretic
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VISHAL GOHIL
• It inhibits cyclooxygenase ( COX ) enzymes, which is responsible for the formation of prostaglandins that promote pain & inflammation.
NSAIDs : Mechanism of Action
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VISHAL GOHIL
NSAIDs : Mechanism of Action• Analgesic effect : Blocks the undesirable
effects of prostaglandin which causes pain.
• Anti-inflammatory effect : Inhibit the leukotriene pathway or the prostaglandin pathway or both.
• Antipyretic effect : Inhibit prostaglandin E2 ( dinoprostone ) within the area of the brain
that controls temperature
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VISHAL GOHIL
CLASSIFICATION• A. Nonselective COX inhibitors ( traditional NSAIDs ) : 1. Salicylates : Aspirin 2. Propionic acid derivatives : Ibuprofen, Ketoprofen,
Naproxen 3. Anthranilic acid derivative : Mephenamic acid 4. Aryl-acetic acid derivatives : Diclofenac, Aceclofenac 5. Oxicam derivatives : Piroxicam, Tenoxicam 6. Pyrrolo-pyrrole derivative : Ketorolac 7. Indole derivative : Indomethacin 8. Pyrazolone derivatives : Phenylbutazone,
Oxyphenbutazone
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VISHAL GOHIL
B. Preferential COX-2 inhibitors : Nimesulide, Meloxicam
C. Selective COX-2 inhibitors :Celecoxib, Etoricoxib
D. Analgesic - antipyretics with poor antiinflammatory action :
1. Paraaminophenol derivative : Paracetamol2. Pyrazolone derivatives : Metamizol3. Benzoxazocine derivative : Nefopam
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VISHAL GOHIL
THERAPEUTIC USES• Relief of mild to moderate pain• Acute gout• Various bone, joint & muscle pain• Osteoarthritis• Rheumatoid arthritis• Juvenile rheumatoid arthritis• Dysmenorrhea
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VISHAL GOHIL
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VISHAL GOHIL
ADVERSE EFFECTS
Gastric irritation, erosions, peptic
ulceration, gastric bleeding/perforation,
esophagitis
NA+ & water retention, chronic
renal failure, interstitial nephritis,
papillary necrosis ( rare )
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VISHAL GOHIL
Raised transaminases,
hepatic failure ( rare )
Headache, mental confusion,
behavioural disturbances,
seizure precipitation
Bleeding, thrombocytopenia, hemolytic anemia,
agranulocytosis
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VISHAL GOHIL
OTHERS• Asthma exacerbation• Nasal polyposis : Soft, painless,
noncancerous growths on the lining of nasal passages or sinuses.
• Skin rashes• Pruritus : Severe itching of the skin• Angioedema : Rapid swelling of the
dermis, subcutaneous tissue, mucosa & submucosal tissues.
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VISHAL GOHIL
DENTAL CONSIDERATIONS• If patient is allergic to any NSAID, you will have to avoid them.• Paracetamol is the safest NSAID.• Ibuprofen is contraindicated in asthma patients as it
causes bronchoconstriction. - It is not recommended for pregnant or nursing women.• If the patient is taking aspirin, then no surgery or even
simple extraction should be done. - As it can lead to profuse bleeding because of its
antiplatlet-action. Aspirin should be stopped before 7-10 days of any surgical procedure till 2-3 days after procedure.
- Young children are highly susceptible to aspirin poisoning (therapeutic overdose).
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VISHAL GOHIL
REFERENCE• ESSENTIALS OF PHARMACOLOGY FOR
DENTISREY BY K D TRIPATHI 2ND EDITION
• BURKET’S ORAL MEDICINE 12TH EDITION
• TEXTBOOK OF ORAL & MAXILLOFACIAL SURGERY BY S M BALAJI 2ND EDITION
• WIKIPEDIA
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VISHAL GOHIL
THANK YOU