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Amoud UniversityHealth science Institute
Faculty of Nursing Presentation
Non-opioid Analgesics
Group manes
Sadiiq Abdi ElmiMubaarik Mahamuud SaleebanUmulkhair Bashiir Mahamuud
Sadiiq Abdi ElmiMubaarik Mahamud saleebanUmulkhair bashir mahamuud
Group names
Pain relievers of Non-opioid Analgesics
pain
Pain is a sensory and emotional experience associated with actual or potential tissue damage. The perception of pain is apart of clinical presentation in many disorders and is one of the hardest sensations for patients to cope with during the course of disease or dysfunction
ActionsInhibit platelet aggregation, decrease the risk of thromboses and reduce the product at the site of injury of prostaglandin, They either stop pain signals from going to the brain or alter the brain’s interpretation of those signals. Non-opioid prevent the brain from processing pain signals, yet do not rely on anesthesia or loss of consciousness to achieve their pain-killing effect. . E.g. Acetaminophen provides relief from pain by elevating the amount of pain you can tolerate before you experience the feeling of pain.
Uses Non-opioid analgesics are a type of drugs used to treat pain fever, inflammation and reduction of platelet aggregation.Non-opioids are a quick and effective way of coping with mild to moderate pain. While these drugs do not treat the cause of the pain, they can provide enough relief to make people more comfortable and to allow them to carry out their daily routines. NSAIDs are part of non-opioids that indicated for pain that involves inflammation as an underlying pathologic process because of their ability to suppress production of inflammatory prostaglandins.
Cont…
NSAIDs are both analgesic and anti-inflammatory, and may be useful for the treatment of pain not involving inflammation as well .Aspirin is used for primary and secondary prevention of coronary artery disease, stroke, and some colorectal cancers. Acetaminophen and NSAIDs are useful for acute and chronic pain
Cont..
oNon-opioid analgesics are used treat pain fromarthritis, osteoarthritis, rheumatoid arthritis,minor injuries and trauma pain .headaches, including tension headaches and migraines Some types of eye pain and ear painJoint painToothaches and other types of dental painmenstrual cramps and other types of pelvic paintrauma, arthritis, surgery, cancer
Generic name Uses Adverse reaction Dosage
Acetaminophen(paracetamol)
headache, toothache, joint pain,
Fatal liver, kidney damage, stomach bleeding
Po (adult)325-650mg q4-6hrs or 1g 3-4times daily or 1300mg q 8hrs not to exceed 4g or 2.5g/day in pt with hepatic/renal impairment
Aspirin Inflammatory disorders, fever, prophylaxis of transit ischemia
Hearing loss, tinnitus, Gi bleeding, epigasteric distress, hurt burn, nausea, abdominal pain, vomiting, anorexia, hypotoxity, anemia, hemolysis,
325-500mg q3hrsOr 325-650mg q4hrs
Diclofenac Inflammatory disorders, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis , dysmenorrhea, mild to moderate pain
Dizziness, Drowsiness, Haedache.HTN, Diarrhea, Abdominal pain, Heartburn, Acute renal failure, hematauria,nephritis and so on
Po 100mg-50mg TID, 25mg TID
Nefopam Moderate pain Sweating, tachycardia, dry mouth, difficulty micturition,
Po 30-90mgIM 20mg
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Generic name
Uses Adverse reaction Dosage
Ibuprofen Dysmenorrhea, inflammatory disorders including rheumatoid arthritis, osteoarthritis
Headache, dizziness, drowsiness, blurred vision, tinnitus, arrhythmias, edema, GI bleeding, Hepatitis, constipation, dyspepsia, nausea, vomiting, abdominal discomfort , hematauria .renal failure, allergic reactions
Po 400-800mg 3-4times daily (not exceed 3600mg/dayPo(children)20-40mg/kg/day in 3-4 divided doses( not exceed 50mg/kg/day)
Etodolac Osteoarthritis, rheumatoid arthritis, mild to moderate pain
Dizziness, drowsiness, depression, insomnia, malaise, nervousness, syncope, weakness
Po (adults) 200-400mg q 6-8hrs (not exceed 1200mg/day)
Flurbiprofen Inflammatory disorders, including, rheumatoid arthritis, osteoarthritis
Dizziness, drowsiness, headache, insomnia, mental depression, psychic disturbances, blurred vision, change in blurred vision, nausea, diarrhea, chills fever, constipation
Po 200-300mg BID Not exceed 300mg/daily
Generic name
Uses Adverse reaction Dosage
Indomethacin Inflammatory disorders including, rheumatoid arthritis, gouty arthritis, osteoarthritis
Same as Flurbiprofen
Po 25-50mg 4xdailyRect 50mg 4x daily
KetoprofenInflammatory disorders including, rheumatoid arthritis, osteoarthritis, mid to moderate pain including dysmenorrhea and fever.
Same as Indomethacin
Anti inflammatory po150-300mg/dayAnti pain 12.5 q4-6hrs
Ketorolac Short term management of pain(not exceed for five days)
Drowsiness, abnormal thinking, dizziness, euphoria, headache, asthma, dysepnea, edema polar vasodilatation, abnormal test, GI pain, nausea, urinary frequency, renal toxity injection.
Po 10mg q4-6hrs prn not exceed 40mg/day
Meclofenamate
Mefanamic acid
Generic name
Uses Adverse reaction Dosage
Naproxen Mild to moderate pain , dysmenorrhea, fever, inflammatory disorders, rheumatoid arthritis, osteoarthritis
Same as Ketorolac
Po 250-500mg bid
Oxaprozin Rheumatoid arthritis, osteoarthritis
Abdominal pain, insomnia, abnormal liver function, duodenal ulcer, n/v/d, gastritis, prolonged bleeding time, jaundice, agitation,
Po 1200mg once daily
Piroxicam Management of inflammatory disorders including rheumatoid arthritis, osteoarthritis, dysmenorhea
Drowsiness, headache , dizziness, blurred vision, tinnitus, N/V/D ,constipation, renal failure , allergic reactions
Po 10-20mg /day
Rofecoxib Rheumatoid arthritis, osteoarthritis, dysmenorhea
fatigue HTN, lower extremity edema, GI bleeding, anemia, allergic reaction including anaphylaxis
Po 12.5mg once daily initially , may be increased 25mg once daily
Adverse reactionPlatelet Dysfunction Gastritis and peptic ulceration with bleeding.Acute Renal Failure in susceptible Sodium+ water retention and edemaAnalgesic nephropathyProlongation of gestation and inhibition of labor.Hypersensitivity.GIT bleeding and perforationCommon side effects of NSAIDs include: upset stomach, nausea, abdominal pain, diarrhea, heartburn, unusual bleeding, drowsiness, dizziness, skin rashes. More severe side effects of NSAIDs include: allergic reactions, high blood pressure, stomach bleeding, stomach ulcers (with long-term use), kidney or liver problems
ContraindicationsHypersensitivity and cross-sensitivity among NSAIDS may occur
precautions
oUse cautiously in patient with severe hepatic or renal disease, chronic alcohol use/abuse or malnutrion .oshould be avoided by people who:Are taking blood pressure medicinesHave stomach ulcers or a history of ulcersHave kidney problemsWill have surgery within a week
InteractionLong term use of acetaminophen with Nsaids may increase the risk of adverse renal effects. Nsaids may decrease the effectiveness of diuretics and antihypertensive .
Interaction
DuiticsAntihypertensive drugsCephalosporin's
Clinical Pharmacology is hard…
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