Non-Narcotic Analgesics

1. inhibits COX1 enzyme, inhibits PG production in response to inflammation
   1. more effective on throbbing pain- inflammation response ex. after an extraction.
2. mild-moderate pain
   1. reduces fever
      1. antiinflammatory
         1. ANTIPLATELET: irriversible, inhibits thromboxane
            1. used in prophylaxis of MI
3. DOSE: 325-650mg q4h (pain
   1. 3-6g daily for arthritis
   2. 75-325mg prevention MI
   3. children 10-15mg/kg q4-6hr
4. ADRs: GI: PG responsible for production of protective mucus in gut & inhibiting gastric acid secretion
   1. Blood clotting: prolongs bleeding 1.5-7 days (depending on dose)
      1. High doses: tinnitus, Nausa, vomitting. hyperventilation=death soon
   2. aggrivate ulcers, gastritis, hernia, GERD
   3. hypersensitivity triad: sensitivity, nasal polyps & athsma

Attachments:

• NSAIDs

1. Similar to ASA, but more POTENT. reversible platelet aggregation (only as long as its in the blood)
   1. uses: rheumatoid, gouty & osteoarthritis, fever, dysmenorrhea & assoc. pain
   2. COX1 present in body at all times, SE assoc w GI, remal function, fluid retention & platelet adhesion
      1. COX2 present only during trauma, high CV events assoc with COX2 inhibitors, only celebrex/celexicob available

1. Equipotent as ASA. Tylonel, Tempra, Panadol. Caffeine usually added
   1. Provides NO ANTIINFLAMMATORY,
      1. amtipyretic & analgesic. No effect on CV or resp. syste,.
   2. Metabolized in liver, avoid use with alcohol or in pts with liver problems
   3. DOSE: 325-650mg q4-6hr to max of 4g/24hr