Therapeutics of NSAIDs and Muscle Relaxants

Therapeutics of NSAIDs and Muscle Relaxants - Therapeutics...

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Therapeutics of NSAIDs and Muscle Relaxants Side Effects of Rx of NSAIDs - Nephrotoxity - CV risks - GI side effects - Bleeding risks Ketorolac (Toradol) has the greatest relative risk of GI complications, OTC proprionic acids have the least GI SE Risk factors for NSAID induced GI injury - > 65 y/o - Alcohol/tobacco use - Use of steroids (prednisone) - Hx of peptic ulcers - Use of anticoagulants - Hx of GI bleeding - High dose or multiple NSAIDs - Poor fxnal status Prophylaxis Algorithm 1. Identifyn high risk patient 2. Use the lowest dose of NSAID/use non-NSAID analgesic/non acetylated salicylate 3. Treat high risk patient with misoprostol (inhibits secretion of gastric acid) 4. If misoprostol is not well tolerated, administer histamine blocker (zantac/pepcid) or omeprazole (PPI) Prophylaxis Risk factors for NSAID induced renal problems - > 65y/o - Dehydration - CHF - HTN - Cirrhosis - Underlying renal disease - DM Distinctive characteristics of NSAIDs Analgesic effects atb lower doses and anti-inflammatory at higher doses - Sulindac o Lower renal side effects , but same or higher GI side effects compared to other NSAIDs - Naproxen has the lowest CV risk - Diclofenac has the greatest CV risk Selective COX II Inhibitors - As effective as traditional NSAIDs - Safe to use in ptn with asthma - ↓ GI bleeding - Use in care with ptn w/ renal dysfxn - Minimal effects on platelets - Celecoxib has sulfur moiety (CI in ptn with S allergy)
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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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Therapeutics of NSAIDs and Muscle Relaxants - Therapeutics...

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