anti – inflammatory

1. ANTI – INFLAMMATORY DRUGS
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.

2. 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.
CHEMICAL MEDIATORS
Histamine – dilates arterioles, increase capillary
permeability allowing fluid to leave the capillary
and flow to the injured area.

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

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

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

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

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

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

9. 3. Instruct patient not to drink alcohol during therapy.
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.

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

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

12. Side Effects: Gastric irritation
Clients with peptic ulcer should not take this drugs.
6. Oxicams – for long term treatment of arthritic
conditions such as rheumatoid arthritis and
osteoarthritis
Piroxicam (feldene)
7. 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)

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

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

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

16. Anti gout drugs
Gout – an inflammatory conditin that attacks joints,
tendons, and other tissues. 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.

17. 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