NSAID's.pptx

1. NSAIDS
(Non-steroidal Anti Inflammatory Drugs)
• Also called Non narcotics or non Opioids or COX inhibitors.
• They have following effects (3A’s)
• Anti-inflammatory, (high dose)
• Antipyretic,
• Analgesics.
• Primary action peripheral pain mechanism
• Secondary action on CNS
By:- Ravikant Sir

2. NSAIDS
• They inhibit synthesis of Prostaglandin by blocking
cyclo-oxygenase (COX) enzyme. COX is found in
Endoplasmic reticulum of cells.
• COX - I :- It is constitutive enzyme found in stomach,
GI, kidney and platlets. (Normal constituent).
• COX – II :- It is Inducible enzyme that induce pain
inflammation by forming prostaglandins.
• COX- III :- It is found in brain, heart aorta.

3. MECHANISM OF ACTION
Cell -Injury/Phospholipids releases
Arachidonic acid
Cyclo oxygenase enzyme (COX-II) NSAIDS BLOCK COX RECEPTORS
pathway
Prostaglandin
Inflammation/pain/swelling Thromboxane
formed by platlets
• Along with this mechanism mast cell release Histamin that increases capillary
permeability, and due to clotting mechanism RBC Rouleaux formation started

4. ANTI- INFLAMMATORY EFFECT
They inhibit cyclo-oxygenase enzyme, that produce
Arachidonic acid into prostaglandins at injury site.

5. ANALGESIC EFFECT
• They inhibit peripheral production of prostaglandin.
• They also inhibit pain stimuli at sub cortical region.
• They prevent action of prostaglandin on peripheral
nerve stimulation.

6. ANTI- PYRETIC EFFECT
• They inhibit production of prostaglandin induced by
interleukins at hypothalamus.
• Hypothalamus have centers for thermal regulation.
• It results in Vasodilation and increased heat loss.

7. NSAID’S EXAMPLES
TYPES OF NSAIDS
Non – Selective
Cox inhibitor
Semi selective
Cox inhibitor
Selective
Cox – 2
Inhibitor
Poor Anti Inflammatory
 Aspirin (Acetyl
salicylate)
 Ibuprofen
 Piroxicam
 Ketorolac
 Ketoprofen
 Mefenemic acid
 Diclofenac
 Nimusalide
 Acelofenac
 Celecoxib
 Parecoxib
 Etoricoxib
Paracetamol
Also known as
Acetaminophen
(Tylenol)
N-Acetyl-para-
aminophenol

8. NSAIDS – SIDE EFFECTS
• Irritates gastric mucosa
• Gastric ulcer
• Epigastric distress
• Nausea
• Vomiting
• Dyspepsia
• Dizziness
• Confusion.

9. ASPIRIN
• Aspirin is also called as Acetyl Salicylate
• It has Analgesic, Antipyretic & Anti-Inflammatory
effects.
• It also act as Anti-Platelet medicine. It interferes the
aggregation of platlets, so it can increase Bleeding
time Twice of normal values.

10. USES OF ASPIRIN
• ANALGESIC :- 300-600 mg for headache, neuralgias.
• ANTI INFLAMMATORY :- Rheumatic fever & Rheumatic
Arthritis :- 75 to 100 mg/kg/day
• ANTI PYRETIC :- 300-600 mg for low grade fever.
• ANTI PLATLET :- 75 to 100 mg daily aspirin. Used in case of
heart attack or heart failure to prevent blood clotting.

11. ASPIRIN : contraindication
• Aspirin is strictly contraindicated for children under
15 year of age.
• It may cause a rare hepatic encephalopathy in
childrens (Known as Reye’s Syndrome)