Transcript women
Drugs for Management of Fever
& Inflammation
Brenda B. Rowe
Prostaglandin Synthesis
COX –1 enzyme – synthesizes
prostaglandins involved in regulation of
normal cell activity
COX –2 enzyme – produces prostaglandins
at site of inflammation
Most NXAIDS are nonselective in targeting
COX-1 & COX-2
Nonsteroidal Anti-inflammatory Agents
(NSAIDS)
Salicylates
Acetylsalicylic acid (aspirin)
Has antipyretic, anti-inflammatory and antiplatelet
effects
AE – GI (Give with milk or food)
Contraindications – peptic ulcer disease, gout, renal
or hepatic impairment, bleeding disorders, children
with varicella or flu like illness, pregnancy, lactating
women
Teaching Points with aspirin
Watch for AEs
Avoid alcohol and smoking
Take as directed
Caution about OTC use with aspirin
Effects of long term aspirin use
Prostaglandin Synthetase Inhibitors
Subgroup of NSAIDS
Ibuprofen (Motrin, Advil)
Higher doses required for anti-inflammatory
effect than analgesia
AEs – GI – Give with milk or food
Cautious use with many diseases
COX-2 Inhibitors
Celecoxib (Celebrex)
Selective inhibit of COX-2 prostaglandin
synthesis but not platelet aggregation
Anti-inflammatory, analgesic, & antipyretic
Tx osteoarthritis & dysmenorrheal
Contraindicated if have sulfa allergy
AE – GI - but not as likely
Para-Aminophenol derivative
Acetaminophen (Tylenol)
No anti-inflammatory effect
Tx fever & pain
Use with caution with pregnancy & lactation
but safest antipyretic for children and
pregnancy
AEs – hepatic, renal, hematologic & GI
systems
Issues with self-administration
Antirheumatic drugs
(DMARDS)
Auranofin (Ridaura)
Tx RA when patient have not responded to NSAIDS
Many contraindications & precautions
AEs – most significant is bone marrow suppression,
most common is GI - diarrhea
Takes 8-12 weeks to get therapeutic response
Monitor CBC, platelets, renal & hepatic function
Antigout Drugs
Colchicine
Decreases inflammatory response caused by
hyperuricemia
Tx acute gout
AEs – GI
Many contraindications & precautions
Take at first sign of acute gout & d/c when symptoms
resolve
Avoid alcohol & diet high in purines
Uricosuric Drugs
Probenecid (Benemid)
Reduces uric acid level
Tx chronic gout
AEs – serious is blood dyscrasias, common
is headache, nausea, vomiting & anorexia –
take with milk or food
Do not take during acute attack
Limit taking with vitamin C or cranberry juice
Sample Question
Which of the following drugs is a prototype
drug for NSAIDS Prostaglandin Synthetese
Inhibitor?
A. aspirin
B. acetaminophen (Tylenol)
C. ibuprofen (Motrin)
D. celecoxib (Celebrex)
Sample Question
What is the drug of choice for pregnant
women & children with fever or mild to
moderate pain?
A. aspirin
B. acetaminophen (Tylenol)
C. ibuprofin (Motrin)
D. codeine
Sample Question
Patients taking colchicine should be
educated regarding limiting which of the
following foods?
A. liver
B. cheese
C. beef
D. citrus fruits