Pain treatment

1
Pain treatment

• How drugs work on pain

2
NSAIDs

• N Non
• S Steroidal
• A Anti
• I Inflammatory
• Ds Drugs

3
The Action of drugs on pain

• These drugs have-
• analgesic
• antipyretic
• anti-inflammatory
• effects

4
Indications

• Used for complaints under prescription by G.P.
• Rheumatic pain
• Severe pain for bone cancer
• Used O.T.C. for self-treatment of pain
• Headaches
• Dental pain
• Muscularskeletal disorders

5
These drugs are not effective

• Visceral pain
• Myocardial infarction ( aspirin has a more
  therapeutic anti-platelet effect)
• Renal colic
• Acute abdominal pain
• These disorders require opioid analgesics

6
Mechanism of action

• Action is exerted peripherally and centrally
• Associated with its anti-inflammatory effects
• ( from the inhibition of prostaglandin in the
  inflamed tissue)
• Anti-inflammatory effect is modest but gives
  relief
• Antipyretic prevents body temperature from rising

7
Adverse effects

• Common when given in high doses used in elderly
  patients who are more susceptible
• Gastro-intestinal side-effects ( bleeding,
  ulceration)
• Nephrotoxicity action against prostaglandins
  results in sodium retention, reduced blood flow
  and renal failure
• Bronchospasm
• Rashes
• allergies

8
Aspirin Acetylsalicylic acid

• Cardiovascular disease (CVD), principally heart
  disease and stroke, is the leading cause of death
  for both males and females in developed
  countries. Aspirin is the most widely used and
  tested antiplatelet drug in CVD, and it is proven
  to be the cornerstone of antiplatelet therapy in
  treatment and prevention of CVD in clinical
  trials in various populations. In acute coronary
  syndrome,thrombotic stroke, and Kawasakis
  disease, acute use of aspirin can decrease
  mortality and recurrence of cardiovascular
  events. As secondary prevention, aspirin is
  believed to be effective in acute coronary
  syndrome, stable angina, revascularization,
  stroke, TIA,and atrial fibrillation. Aspirin may
  also be used for patients with a high risk of
  future CVD for primary prevention, but the
  balance between benefits and the possibility of
  side effects must be considered.

9
Review article

• Clinical Use of Aspirin in Treatment and
  Prevention of Cardiovascular Disease
• Yuxiang Dai and Junbo Ge
• Shanghai Cardiovascular Institute and Department
  of Cardiology, Zhongshan Hospital, Fudan
  University, Shanghai 200032, China
• Hindawi Publishing Corporation
• Thrombosis
• Volume 2012, Article ID 245037, 7 pages
• doi10.1155/2012/245037

10
pharmacokinetics

• Oral administration salicylates are absorbed in
  stomach and upper part of small intestine
• Absorbed readily in pure form
• Food and antacids delay absorption
• Rectal administration slower absorption

11
Distribution, metabolism, excretion

• Distributed throughout the body tissues and
  fluids including breast milk
• Liver metabolizes salicylates into metabolites.
• Kidney excretes metabolites

12
pharmacodynamics

• Mechanism of action.-
• Relief of pain inhibiting synthesis of
  prostaglandin
• Reduce inflammation by inhibition of
  prostaglandin
• Reduce fever by stimulation hypothalamus-
  dilation of peripheral blood vessels increasing
  sweating
• Inhibits platelet aggregation ( increases blood
  flow in M.I)