ANTI-INFLAMMATORY

AGENTS

ANTI-INFLAMMATORY AGENTS:
SALICYLATES
ACTION:
-inhibits prostaglandin synthesis that:
(a) sensitize pain receptors to stimulation
causing pain;
(b) produces s/sy of inflammation;
(c) pyrogens by WBC/ release in the brain
that causes increase in body temperature
- ASPIRIN -> inhibits platelet aggregation
<- inhibits synthesis of thromboxane A2
(vasoconstrictor and platelet aggregation
inducer)

ANTI-INFLAMMATORY AGENTS:
SALICYLATES
USES:
mild to moderate pain, fever, inflammatory
conditions (arthritis, headache, myalgia);
TIA, stroke, reduce risk of death with MI;
>>not recommended for children (Reyes
syndrome)

PHARMACOKINETICS:
A stomach; M liver; E urine

ANTI-INFLAMMATORY AGENTS:
SALICYLATES
ADVERSE EFFECTS:
Gastric irritation (administer with food, water
or antacid), GI bleeding (test stool/emesis),
toxicity (tinnitus, impaired hearing, dimming
vision, sweating, fever, lethargy, dizziness,
confusion, vomiting reduce dose/no
antidote)
DRUG INTERACTIONS:
NSAIDS (reduce platelet inhibiting effects)
administer with gap; Probenecid(Salicylates
inhibits excretion of uric acid) , Warfarin, OHA,
Methotrexate

ANTI-INFLAMMATORY AGENTS:
SALICYLATES
CONTRAINDICATIONS:
Allergy, bleeding abnormalities, impaired renal
function, chicken pox or influenza (Reyes),
surgery/invasive procedures, pregnancy and
lactation

NURSING CONSIDERATIONS:
Assess for contraindications
Administer with food; administer drug as
indicated
Well-hydrate patient
Report untoward signs and symptoms/increase
knowledge

ANTI-INFLAMMATORY AGENTS: NSAIDS

COMMON DRUGS AND USES:
a. Propionic Acids
> ibuprofen OTC pain med; long-term management of arthritis, dysmenorrhea; mostly
used NSAIDS
> ketoprofen short-term management of pain
> naproxen OTC; arthritis, dysmenorrhea

b. Acetic Acids
> diclofenac acute, long term pain (inflammatory)
> indomethacin oral, topical, rectal; moderate to severe pain; IV PDA
> ketorolac short-term management of pain; ocular itching

c. Fenamates
> Mefenamic Acid short-term
> Piroxicam - acute and chronic arthritis
> Diflunisal moderate pain, arthritis

d. Oxicam Derivative
> Meloxicam juvenile arthritis, rheumatoid arthritis, osteoarthritis

e. Cyclooxygenase-2 Inhibitor
> Celecoxib acute, long-term treatment of arthritis -> who cannot tolerate GI effects of
other NSAIDs

ANTI-INFLAMMATORY AGENTS: NSAIDS

ACTIONS:
inhibition of prostaglandin synthesis; blocks COX1 and COX-2
COX-1 turns to arachidonic acid into
prostaglandins (needed in protecting the
stomach lining, blood clotting, maintaining
sodium and water balance); COX-2: present at
injury sites
COX-2 Inhibitors affect only COX-2, not COX-1

USES: arthritis, pain, dysmenorrhea, fever

PHARMACOKINETICS: A- GIT; D cross placenta and

breast milk; M liver; E urine

ANTI-INFLAMMATORY AGENTS: NSAIDS

ADVERSE EFFECTS: Gastric irritation (n/v,
dyspepsia, pain) constipation administer
food, milk, water; stool-softeners,
laxatives; hydration; roughage, fruits,
vegetables, grains
GI bleeding; hepatotoxicity; nephrotoxicity;
rash, hives, swelling,
Others: headache, dizziness, fatigue

CONTRAINDICATIONS: same + cardiovascular

dysfunction/HTN, peptic ulcer, GI bleeding,

ANTI-INFLAMMATORY AGENTS:
ACETAMINOPHEN

- inhibits prostaglandin in CNS and blocks

pain impulses in the peripheral tissue
- inhibiting heat-regulating center in the
hypothalamus

USES: analgesic and pyretic; alternative to

aspirin; no anti-inflammatory response

THERAPEUTIC OUTCOME: reduced pain and

fever