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INFLAMMATION – is a reaction to tissue injury caused by the release of chemical mediators that cause both vascular response and the migration of fluids and cells to the injured site.

CHEMICAL MEDIATORS Histamine – dilates arterioles. increase capillary permeability allowing fluid to leave the capillary and flow to the injured area. .INFLAMMATION – the process of protective mechanism in which the body attempts to neutralize and destroy harmful agents at the site of tissue injury and establish condition for tissue repair.

pain and fever Anti – inflammatory Agent – drugs that inhibit the biosynthesis of prostaglandin are called PROSTAGLANDIN INHIBITORS . increase capillary permeability.Kinins – dilate the arterioles and increase capillary permeability Prostaglandin – cause vasodilation.

NSAID Are aspirin and aspirin like drugs that inhibit the enzyme COX which is needed for the synthesis of prostaglandin. .

2. 7. 3.There are 8 groups of NSAIDS 1. Salicylates related to aspirin Parachlorobenzoic Acid derivatives or indoles Pyrazolone Derivatives Propionic Acid Derivatives Fenamates Oxicams Phenylacetic Acid Selective Cox 2 inhibitors . 4. 5. 8. 6.

ASPIRIN 4 A’s – anti inflammatory analgesic antipyretic anticoagulant Adverse Reaction GI: nausea. vomiting. G. G. distress. bleeding EENT: Tinnitus. occult bleeding. Thrombocytopenia . hearing loss HEMA: prolonged bleeding time.1.I.I.

2. gouty arthritis Dysmennorhea. 25mg/5ml Suppositories: 50 mg . PDA Dosage: 25 – 50 mg/ cap Oral susp. Para chlorobenzoic Acid Derivatives or Indoles Indomethacin (Indocin) Therapeutic Effect – relieves pain. fever and inflammation Indications – rheumatoid arthritis.

If patient has bleeding. and abdominal pain CNS: headache. and vertigo Hypersensitivity rxn. Urticaria Nursing Implication: 1. give oral form of drugs with food.Injection: 100 mg vial Side effects: GI: ANVD. dizziness. If G. or antacid. 2. stop giving the medication and notify the physician . milk.I. upset occurs.

. Instruct patient not to drink alcohol during therapy. 3.3. Pyrazolone Derivatives Phenylbutazone (butazolidin) Indications: Rheumatoid arthritis Acute gout Adverse Effect: blood dyscrasia such as agranulocytosis. and aplastic anemia 4. Propionic Acid Group These are aspirin like but have stronger effects and create less GI irritation.

drowsiness. tinnitus GI: epigastric distress. dizziness EENT: visual disturbance. and inflammation Side Effect: CNS: headache. nausea.Ibuprofen (advil) Naproxen (naprosyn) Suprofen (profenal) Ketoprofen (Orudis) Therapeutic Effect: relieves pain. fever. occult blood HEMA: prolonged bleeding time .

3. Fenamates – includes potent NSAIDS used for acute and chronic arthritic conditions Meclofenamate Na monohydrate (meclomen) Mefenamic Acid (Ponstan) . Give with meals or with milk to reduce adverse GI reactions. including peptic ulceration and bleeding despite absence of GI symptoms. 5. 2.Nursing Implication 1. Instruct patient not to drink alcohol during therapy. Serious GI toxicity.

6. Phenylacetic acid derivatives analgesic and anti – inflammatory effects are similar to those of aspirin but it has minimal or no antipyretic effect Diclofenac Na (voltaren) Ketorolac (toradol) . Oxicams – for long term treatment of arthritic conditions such as rheumatoid arthritis and osteoarthritis Piroxicam (feldene) 7.Side Effects: Gastric irritation Clients with peptic ulcer should not take this drugs.

Selective Cox 2 inhibitor Therapeutic effect: relieves pain and inflammation of joints and smooth muscle tissue. Celecoxib (celebrex) Rofecoxib (vioxx) .8.

For systemic inflammatory disorder that require a potent and aggressive therapy for control .CORTICOSTERIODS Steroidal agents or corticosteroids are most commonly used treatment of local inflammation disorders such as those affecting skin.

Betamethasone (celestone) Cortisone (cortone) hydrocortisone (solu cortef) Methylprednisolone (medrol) .

It is characterized by uric acid metabolism disorder and a defect in PURINE metabolism resulting in increase in urates and accumulation of uric acid or an ineffective clearance of uric acid by the kidneys. tendons. and other tissues. .Anti gout drugs Gout – an inflammatory conditin that attacks joints.

Anti inflammatory Gout drugs Colchicine – used to inhibit the migration of leukocytes to the inflamed site Uric Acid Inhibitor Allopurinol (Zyloprim) Not an anti inflammatory drug instead it inhibits the final steps of uric acid biosynthesis and lowers uric acid level Uricosurics Probenicid (Benemid) Increase the rate nor uric acid excretion by inhibiting the reabsorption .