Anti-inflammatory drugs. By Dr Soha AlSayed Lecture of Pharmacology Faculty of Medicine Suez Canal University. Classifications of anti-inflammatory drugs. Steroids: Drugs which contain steroid nucleus They are glucocorticoids or mineralocorticoids
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Dr Soha AlSayed
Lecture of Pharmacology
Faculty of Medicine
Suez Canal University
2. Non-steroids anti-inflammatory drugs (NSAIDs) characterized by:
Types of COX enzyme:
1. COX-1 (constitutive) especially in stomach decrease HCl (prevent PU) & Kidney vasodilatation
2. COX-2 (inducible) by infection
a. hypothalamus ► elevates Heat regulatory centre► Fever
b. Thalamus► pain
a. Sensitize Nociceptors to histamine, Bradykinin & 5-HT ► pain
b. Potentiates effect of histamine & bradykinin
Types of NSAIDS:
1. Non-selective COX inhibitors (COX 1,2,3)
2. Selective COX-2 inhibitors (Celecoxib, Rofecoxib)
3. COX-3 inhibitors : paracetamol (not anti-inflammatory). Why?
Mechanism of action of NSAIDS
They inhibit cyclo-oxygenase enzyme ►▼Prostaglandins ► ▼Fever, pain, Inflammation.
1. Antipyretic action: decrease set point of heat regulatory centre in hypothalamus, increase sweating
A. Analgesic action: central and peripheral
B. Antipyretic Action: ▼PGE
2. Anti-inflammatory actions:
3. Respiration and Acid/Base balance:
4. Renal effects:▲ Na, water retention
5. Uric acid:
A. Small dose: Retention of UA
B. Large dose: Excretion of UA
A. Small dose (75-150 mg/day): ▼platelet aggregation and▲ bleeding time
B. In patients with G-6-PD defiiency ►hemolytic anemia (idiosncrasy).
Epigastric distress, nausea, vomiting, ulceration, bleeding.
5. Hepatic: Severe hepatic injury and encephalopathy in Reye’s syndrome (in children with viral infection especially influenza, Chicken pox)
6. Bronchospasm 7. Allergy
Acute salicylate poisoning:
Hallucination, restlessness, tremors, convulsions, vomiting, dehydration, hypotension, hyperglycemia, hyperpyrexia