ANS Final SG

ANS Final SG - Non Prescription Analgesics...

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Non Prescription Analgesics - Acetaminophen (Not a NSAID) o Chronic overdose > 4 grams for several weeks o Acute overdose ≥ 10grams o Acute or chronic overdose with APAP Hepatic Necrosis Hepatotoxicity rare with dose < 10 grams Acute liver failure: Using with alcohol, Death rare with doses <15 grams using > 1 APAP containing product and 3 alcoholic drinks a day exceeding maximum recommended dose Nephrotoxity (pretty rare) Renal tubular necrosis Renal failure Death (15 grams in one time period) o Children Max Daily Dose 75mg/kg 106-375 mg/kg/day o Adverse Effects Rare ↓ GI irritation, erosion and bleeding compared to NSAID Dermatologic rxns rarely occur o No clinical significant drug interxns GOOD! - Salicylate NSAIDs o Asprin (acetylsalicylic acid) Acetylated Salicylate o Choline Salicylates o Magnesium Salicylates Non Acetylated Salicylates (Poor inhibitors of cyclooxygenase) o Sodium Salicylates - Proprionic Acids (Non Salicylates NSAIDs) o Ibuprofem o Ketoprofen o Naproxen/Naproxen Sodium - Buffered salicylates: Combo of 2 of the following: o Calcium carbonate ○ Magnesium carbonate o Magnesium hydroxide Aluminum hydroxide o Magnesium oxide o Examples: Bufferin, bayer buffered aspirin, Alka-Seltzer with asprin, arthritis pain formula, ascription **Avoid Alka-Seltzer in CHF ptn bc of Sodium Bicaronate content** Na causes H2O and fluid retention exacerbate problem - Adverse effects of NSAIDs o Cardiovascular No definitive evidence that ton aspirin NSAIDS have cardioprotective effect Naproxen 50% increase in CV event Supervised if taking > 10days o CNS
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Proprionic acids H/A Dizziness Drowsiness Excitation (ketoprofen only) ↑Ibuprofen & Naproxen cognitive dysfxn Nervousness o Gastrointestinal GI bleeding and peptic ulcers (best agent) Ibuprofen < Aspirin < Naproxen Ketoprofen (worse agent) o Due to inhibition of PGI2 AND PGE2 in GI o Prostaglandin ↓ acid secretion NSAIDs inhibit this, so ↑ mucus and bicarb production you get the opposite effect: Modulate mucosal blood flow **APAP or non-acetylated salicylates (choline, sodium, mg salicylates are preferred agents)** o Renal toxicity (Ibuprofen, Ketoprofen and Naproxen) ↓ Renal PG normally VD renal vessels to help maintain kidney perfusion and fxn NSAIDs cause renal PG to VC which causes retention of Na and fluid Common in elderly, dehydrated ptn (on diuretic therapy furosemide), renal impairment, HF, NTN
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This note was uploaded on 11/04/2010 for the course PHAR 3040 taught by Professor Pham,g during the Spring '10 term at UConn.

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ANS Final SG - Non Prescription Analgesics...

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