PEngenalan asas mengenai Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

1. Non-Steroidal Anti-
Inflammatory Drugs
(NSAIDs)
Disediakan Oleh : Nassruto

2. 1. Memberi definisi ‘Non-Steroidal
Anti-Inflammatory Drugs
(NSAIDs)’.
2. Menyatakan tujuan/ indikasi ubat.
3. Menyatakan dos dan contoh ubat.
OBJEKTIF

3. 4. Menyatakan kaedah pemberian
ubat.
5. Menyatakan tindakan ubat.
6. Menerangkan kesan sampingan
dan kontraindikasi ubat.
7. Memberikan nasihat spesifik
dalam pengambilan ubat.

4. • Sejenis ubat analgesic (non-
narcotic)
• Tidak tergolong dalam
kumpulan ubat steroid.
• Maka tidak menghasilkan
kesan sampingan berkaitan
steroid.
NSAIDs

5. • Walaupun bukan dari
kumpulan steroid, NSAIDs
mempunyai kesan
• Anti-inflammatory
• Analgesics
• Antipyretics

6. • NSAIDs bertindak dengan
menghalang penghasilan
prostaglandin.
Tindakan ubat

7. • Prostaglandin:
–A group of naturally
occurring fatty acids that
act within the body to:
• Regulate acid secretion in
stomach
• Regulate body temperature
• Regulate platelet aggregation
• Control inflammation

8. • Maka dengan pengurangan
prostaglandin, NSAIDs
menghasilkan kesan:
• Anti-Inflammatory
• Analgesics
• Antipyretics

9. • Relief of symptoms of
- Osteoarthritis
- Rheumatoid arthritis
- Musculoskeletal disorders
• Mild to moderate pain relief
• Primary dysmenorrhea
• Fever reduction
General Indication

10. • Diclofenac sodium
(Voltaren)
• Ibuprofen (Brufen)
• Indomethacin (Indocid)
Contoh ubat

11. • Ketoprofen (Orudis)
• Mefenamic Acid (Ponstan)
• Naproxen (Naprosyn)
• Piroxicam (Feldene)

12. 1. Diclofenac sodium
(Voltaren)
• Antipyretics
• Analgesics
• Anti-inflammatory
Tindakan

13. • Rheumatoid arthritis
• Osteoarthritis
• Spondylitis
• Acute gout
• Post operative inflammation
Indication

14. 1(a). Diclofenac sodium
50mg tablet
(Voltaren)
Category: B

15. • Rheumatoid & Osteoarthritis:
• 100-150mg/d PO (divided
doses)
• Spondylitis:
• 100-125mg/d PO (divided
doses)
Dose

16. • Long term:
• 75-100mg/day PO (2-3 divided
doses)
• Max: 150mg/day
• Peads > 1yr:
• 1-3mg/kg/day (divided dose)
Note: Take this medicine after food

17. 1(b). Diclofenac sodium
75mg/3ml Inj
(Voltaren)
Category: A

18. • 75mg once daily IM
• Severe cases: 75mg bd IM
• Max 2 days
Dose

19. 1(c). Diclofenac sodium
1% Emulgel
(Voltaren)
Category: A
• Apply tds-qid & gently rub
Dose

20. 1(c). Diclofenac sodium
12.5mg/ 25mg/ 50mg suppositories
(Voltaren)
Category: A

21. • Adult:
• 75-150mg/day (divided dose)
• Peads 1-12 yr:
• 12.5-25mg/day
Dose

22. 2. Ibuprofen 200mg tablet
(Brufen)
• Antipyretics
• Analgesics
• Anti-inflammatory
Tindakan
Category: B

23. • Mild to moderate pain
• Rheumatic & Arthritis
disorders
• Painful dysmenorrhea
Indication

24. • Adult:
• 200-400mg tds
• Max: 2.4g/day
• Peads:
• 20-30mg/kg/day (divided
dose)
Dose
Note: Take this medicine after food

25. 3. Indomethacin
(Indocid)
• Antipyretics
• Analgesics
• Anti-inflammatory
Tindakan

26. • Rheumatoid arthritis
• Spondylitis
• Mild to moderate
osteoarthritis
• Acute gouty arthritis
• Acute shoulder pain
Indication

27. 3(a). Indomethacin
25mg capsule
(Indocid)
Category: B

28. • Adult:
• 50-200mg/day (divided dose)
• Peads:
• Not recommended
Dose
Note: Take this medicine after food

29. 3(b). Indomethacin
100mg suppository
(Indocid)
Category: B

30. • Adult:
• 100mg ON
• Peads:
• Not recommended
Dose

31. 4. Ketoprofen
(Orudis)
• Analgesics
• Anti-inflammatory
Tindakan

32. • Mild to moderate pain
• Rheumatoid disorders
• Painful dysmenorrhea
Indication

33. 4(a). Ketoprofen
100mg/2ml Inj
(Orudis)
Category: A*

34. • Adult:
• 50-100mg q 4 hr deep IM
• Max: 200mg/day for up to 3
days
• Peads:
• Not recommeded
Dose

35. 4(b). Ketoprofen
200mg Slow Release capsule
(Orudis)
Category: A

36. • Adult:
• 100-200mg/day
• Peads:
• Not recommeded
Dose
Note: Take this medicine after food

37. 4(c). Ketoprofen
2.5% gel (Orudis)
Category: A
• Apply twice daily
• Max: 20g/day
Dose

38. 4(d). Ketoprofen
30mg transdermal patch (Orudis)
Category: A
• Apply 1 plaster to the
affected area bd
Dose

39. 5. Mefenamic Acid
250mg capsule/ tablet
(Ponstan)
Category: B

40. • Antipyretics
• Analgesics
• Anti-inflammatory
Tindakan

41. • Moderate pain (does
not exceed 1 week)
Indication

42. • Adult:
• 250-500mg tds PO (PRN)
• Limits to 7 consecutive
days
Dose
Note: Take this medicine after food

43. • Peads > 6 months:
• 6.5-25mg/kg tds-qid PO
(PRN)
• Limits to 7 consecutive
days
Note: Take this medicine after food

44. 6. Naproxen 250mg tablet
(Naprosyn)
• Analgesics
• Anti-inflammatory
Tindakan
Category: A

45. • Mild to moderate pain
• Rheumatoid arthritis
• Osteoarthritis
• Spondylitis
• Acute gout
Indication

46. • Arthritis & spondylitis:
• 500-1000mg/day (2 divided
dose)
Dose

47. • Acute gout:
• Initial: 750mg then 250mg q 8
hr (jika perlu)
• Musculoskeletal disorders &
dysmenorrhea:
• Initial: 500mg the 250mg q 6-8
hr (jika perlu)
Note: Take this medicine after food

48. 7. Piroxicam 10mg capsule
(Feldene)
• Analgesics
• Anti-inflammatory
Tindakan
Category: A

49. • Mild to moderate pain
• Rheumatoid arthritis
• Osteoarthritis
• Spondylitis
• Acute gout
• Primary dysmenorrhea
Indication

50. • Arthritis & spondylitis:
• 20mg/day
• Maintenance: 10-30mg/day
(single or divided dose)
Dose
• Acute gout:
• 40mg/day (single or divided
dose) for 4-6 days

51. Note: Take this medicine after food
• Musculoskeletal disorders:
• 40mg/day (single dose or
divided dose) for 2 days
• Then 20mg/day for 7-14
days

52. • Gastrointestinal:
–Nausea
–Vomiting
–Diarrhea
–Epigastric distress
–Intestinal ulceration
–GI bleeding
Kesan sampingan

53. • CNS:
–Dizziness
–Anxiety
–Insomnia
–Depression
• Renal:
–Hematuria
–Elevated blood urea
nitrogen

54. • Cardiovascular:
–Congestive heart failure
–Decreased or increased BP
• Hematologic:
–Pancytopenia
–Leukopenia
–Thrombocytopenia
–Aplastic anemia

55. • Skin:
–Rash
–Irritation
–Skin eruption
–Steven-Johnson syndrome
• Metabolic/ endocrinologic:
–Decreased appetite
–Weight increase or decrease
–Menstrual disorders

56. • Special senses:
–Visual disturbances
–Blurred vision
–Photophobia
–Tinnitus
–rhinitis

57. • Allergic to NSAIDs
• Pregnancy
• Lactation
• Labor
• Renal & hepatic impairment
• Bleeding disorders
Contraindication

58. • Impaired hearing
• Cardiovascular disease
• GI condition
• Hypertension
• Elderly
Cautious

59. • Anti-coagulants, lithium
–Risiko pendarahan
• Diuretics, anti-hypertensives
–Kesan diuretics &
antihypertensives berkurang
• Paracetamol (long-term)
–Renal impairment
Interactions

60. • Ubat diambil selepas sarapan
(kurangkan GI symptom)
• Periksa simptom pendarahan
salur GI (najis gelap)
• Elakkan pengambilan alkohol
• Monitor berat badan selalu
(kehadiran edema)
Nasihat

61. • Lapor kepada pegawai
perubatan & hentikan
pengambilan ubat jika berlaku
kesan sampingan seperti:
–Vertigo, ruam, hematuria,
gangguan pendengaran &
pengelihatan

62. Soalan
1. Berikan definisi ubat NSAIDs?
2. Terangkan cara tindakan ubat
NSAIDs?
3. Senaraikan contoh ubat NSAIDs
dan indikasinya?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat NSAIDs?