ACTIVITY 1: Name:_________________________________

DRUGS USED TO TREAT PAIN Date of Submission: _____________________

AND INFLAMMATION Instructor: Ms. Juliny Grace Bautista________
Score:_________________________________
Rating:________________________________

MATERIALS/RESOURCES
• Pharmacology in Rehabilitation; Ciccone, C.; 4th ed.
• Pharmacology for the Physical Therapist; Panus, P.

OBJECTIVES
At the end of the activity, the students should be able to:
1. Identify the different drugs used to treat pain and inflammation.
2. Explore the mechanism of action, the clinical application and the adverse effect of these group
of drugs.
3. Determine the pharmacologic management for rheumatoic arthritis and osteoarthritis.
4. Identify the clinical relevance for rehabilitation.

INSTRUCTIONS:
Read the Pharmacology in Rehabilitation, Section 4 – Drugs Used to Treat Pain and
Inflammation, page 181 to 247. After reading, answer the following questions with brief and concise
sentences.

A. Opioid Analgesics
1. What is an opioid analgesic?

Opioid analgesics are a group of naturally occurring, semisynthetic, and synthetic agents
that are characterized by their ability to relieve moderate to severe pain.

2. Compare and Contrast: Endogenous versus Exogenous Opioid.

Endogenous Opioid is involved in key physiological functions such as pain and mood control.
It is often assisted in these functions by the endogenous cannabinoid system, which
appeared much later in evolution.

Exogenous opioids is to release opioid peptides via activation of leukocyte opioid receptors,
were equally analgesic in wild-type and opioid peptide-knockout mice.

3. Classifications of Opioid Analgesics.

 Opioid analgesics are classified as strong agonists, mild-to-moderate agonists, mixed
agonist-antagonists, and antagonists according to their interaction with opioid receptors.

4. Explain the pharmacokinetics.

Pharmacokinetics is the study of the time course of drug absorption, distribution,

metabolism, and excretion.

5. Trace the mechanism of action.

Opioid receptors are concentrated on the neurons responsible for transmitting nociceptive
input to higher (supraspinal) levels.

6. Identify the rehabilitation concerns.

One side effect that should be taken into account during therapy is the tendency of these
drugs to produce respiratory depression.

B. Nonsteroidal Anti-Inflammatory Drugs (NSAID)

1. What are the distinct pharmacologic properties?

Distinct pharmacologic properties are these properties include 1 the ability to decrease
inflammation, 2 (analgesia), 3 (antipyresis), and 4 (anticoagulation). These drugs are
commonly referred to as nonsteroidal antiinflammatory drugs (NSAIDs) to distinguish them
from the glucocorticoids

2. Explain the mechanism of NSAID action.

The main mechanism of action of NSAIDs is the inhibition of the enzyme cyclooxygenase
(COX).

3. Compare Aspirin with other NSAIDs.

Aspirin and ibuprofen contain different active ingredients, whereas aspirin is made with
salicylic acid, ibuprofen is made with propionic acid.

4. Explain the pharmacokinetics.

Aspirin is absorbed readily from the stomach and small intestine. Approximately 80 to 90
percent of aspirin remains bound to plasma proteins such as albumin. The remaining 10 to
 20 percent is widely distributed throughout the body. The unbound or free drug exerts the
therapeutic effects.

5. Identify the rehabilitation concerns.

When used for various types of musculoskeletal pain and inflammation, these drugs can
often provide analgesia without sedation and psychomimetic (hallucinogenic, etc.) effects
that are associated with opioid (narcotic) analgesics.

C. Pharmacologic Management of Rheumatoid Arthritis and Osteoarthritis

1. Compare and Contrast: Rheumatoid Arthritis and Osteoarthritis.

Osteoarthritis occurs when the smooth cartilage joint surface wears out. Osteoarthritis
usually begins in an isolated joint.
Rheumatoid arthritis is an autoimmune disease, which means that the immune system
malfunctions and attacks the body instead of intruders.

2. Identify the drugs used to treat Rheumatoid Arthritis, explain the mechanism of action
and the adverse effect.

Mechanism of action: Methotrexate calms your immune system, to help stop it attacking
your body's cells.

Adverse effect: The primary problems involve the gastrointestinal tract and include loss of
appetite, nausea, and other forms of gastrointestinal distress (including intra
gastrointestinal hemorrhage).

3. Identify the drugs used to treat Osteoarthritis, explain the mechanism of action and the
adverse effect.

Mechanism of action: Leflunomide acts primarily by inhibiting the synthesis of RNA

precursors in lymphocytes.

Adverse effect: Leflunomide’s primary side effects include gastrointestinal distress, allergic
reactions (skin rashes), hair loss, and can also affect the liver.

4. Identify the rehabilitation concerns.

Care must also be taken to prevent skin breakdown, especially when splints and other
protective orthotic devices are employed.