NSAIDS Dr.B.M.PUROHIT Assistant Professor (Pharmacology) P.D.U.MEDICAL COLLEGE, Rajkot (GUJARAT). 360001 [email_address]

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So both phenomenon are beneficial

PGG2 MEMBRANE PHOSPHOLIPID ARACHIDONIC ACID 12-HPETE PHOSPHOLIPASE CHEMICAL AND MECHANICAL STIMULIE 5-HPETE PGH2 ISOMERASE THROMBOXANE SYNTHEASE PROSTACYCLINE SYNTHEASE CYCLOXYGENASE PATHWAY LIPOXYGENASE PATHWAY 15-HPETE PGD2 PGE2 PGF2 α TXA2 TXB2 PGI2 LTB4 LTA4 LTC4 LTD4 LTE4 LTF4

PGG2 MEMBRANE PHOSPHOLIPID ARACHIDONIC ACID 12-HPETE PHOSPHOLIPASE CHEMICAL AND MECHANICAL STIMULIE 5-HPETE PGH2 ISOMERASE THROMBOXANE SYNTHEASE PROSTACYCLINE SYNTHEASE CYCLOXYGENASE PATHWAY LIPOXYGENASE PATHWAY 15-HPETE PGD2 PGE2 PGF2 α TXA2 TXB2 PGI2 LTB4 LTA4 LTC4 LTD4 LTE4 LTF4

They are Opposite !!! Store it in your mind !!!

It is not possible to remember everything !! Don’t worry !!

SOMATIC SENSORY CORTEX ` Amygdala Hypothalamus Midbrain periaqueductal gray matter Parabrachial nucleus Medullary Reticular formation Locus cerulous Raphe nuclei Dorsal horn of the spinal cord Anterolateral System

Pharmacological/Physiological Effects I. Cardiovascular System

II. PLATELETS

NORMALLY IN GIT… NSAIDS blocks this So PGS have PROTECTIVE effect on GIT

RESPIRATORY SYSTEM

GI TRACT

V. Reproductive Organs

PGS produce PAIN… how ?

PGs PRODUCES INFLAMMATION … HOW ? INFLAMMATION

Mechanism Of Action : NSAIDS MOST IMPORTANT MECHANISM Efficacy of these mechanisms is doubtful.. So you are not required to remember everything!! Just keep in mind that such mechanisms exist !!

SALICYLATES

NSAIDS blocks.. REDUCES THE INTENSITY OF PAIN

GIT

KIDNEY

REYE’S SYNDROME

Aspirin Toxicity - Salicylism

ANTIRHEUMATIC Antirheumatic action

NAC SUPPLIES GLUTATHIONES so detoxifies toxic metabolites !! NAC “MAY”directly conjugates with quinones/epoxide. MAY BE… NAC has additional antioxidant and antiinflammatory activity

Selection of NSAID