CLINICAL USES AND

IMPORTANT ADVERSE EFFECTS

OF NSAIDS, ACETAMINOPHEN
& CORTICOSTEROIDS
FATIN NADHIRAH BINTI KAMALUDIN LATIFI
2023464058
 CLINICAL USES
THREE MAIN THERAPEUTIC EFFECTS OF ALL NSAIDS,
INCLUDING SELECTIVE COX-2 INHIBITORS ARE:

 anti-inflammatory effect: modification of the inflammatory

reaction

 analgesic effect: reduction of certain types of (especially

inflammatory) pain

 antipyretic effect: lowering of body temperature when this is

raised in disease (i.e. fever).

11
 Fetal Circulatory System: Indomethacin and ibuprofen
have been used in neonates to close the inappropriately
patent ductus arteriosus.

 Cardioprotection: Aspirin reduces the risk of serious vascular

events in high risk patients.
• Irreversible acetylation of platelet COX → inhibition of
platelet function until sufficient numbers of new platelets
are released.
• Permanent and complete suppression of platelet COX-1–
dependent TxA2 formation → cardioprotective effect of
aspirin.
12
CLINICAL USES OF MOST COMMONLY USED NSAIDs
OTHER ADVERSE
EFFECTS Hypersensitivity:
 Vasomotor rhinitis

OF NSAIDS  Angioneurotic

CNS: edema
Headache
  Asthma

 Vertigo  Urticaria

 Dizziness  Flushing

 Confusion  Hypotension

 Hyperventilation (salicylates)  Shock

Platelets:
Uterus:
 Inhibited platelet activation
 Prolongation of gestation
 Propensity for bruising
 Inhibition of labor
7
 Increased risk of hemorrhage
CORTICOSTEROIDS
 Clinical Uses: synthetic drugs with corticosteroid-like effect are used in a variety of

conditions, ranging from brain tumors to skin diseases.

 Dexamethasone and its derivatives are almost pure glucocorticoids, while

prednisone and its derivatives have some mineralocorticoid action in addition to the
glucocorticoid effect.

 Fludrocortisone (Florinef) is a synthetic mineralocorticoid.

 Hydrocortisone (cortisol) is available for replacement therapy, example in adrenal

insufficiency and congenital adrenal hyperplasia.

Adverse Effects:

 Typical mineralocorticoid side effects are Hypertension, Hypokalemia, Hypernatremia without

causing peripheral edema, metabolic alkalosis and connective tissue weakness.
 Corticosteroids can cause permanent eye damage by inducing central serous retinopathy.
 A variety of steroid medications, from anti-allergy nasal sprays (Nasonex, Flonase) to topical
skin creams, to eye drops (Tobradex), to Prednisone  CSR