The document summarizes non-steroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen, naproxen, celecoxib, and acetaminophen. It discusses their mechanisms of action, therapeutic uses, and adverse effects. It also covers the treatment of gout with NSAIDs, colchicine, allopurinol, and uricosuric agents like probenecid and sulfinpyrazone.
NSAIDs are the chemically diverse class of drugs that have anti-inflammatory, analgesic & antipyretic properties.
They are also called as Non Narcotic, Non Opioid, Aspirin like analgesics.
They are among the widely used therapeutic agents world wide and often taken without prescription for minor aches and pain.
They are used to suppress the symptoms of inflammation associated with rheumatic disease.
NSAIDs are the chemically diverse class of drugs that have anti-inflammatory, analgesic & antipyretic properties.
They are also called as Non Narcotic, Non Opioid, Aspirin like analgesics.
They are among the widely used therapeutic agents world wide and often taken without prescription for minor aches and pain.
They are used to suppress the symptoms of inflammation associated with rheumatic disease.
Anti-inflammatory drugs
Inflammation is a normal, protective response to tissue injury caused by physical trauma, noxious chemicals, or microbiologic agents. Inflammation is the body's effort to inactivate or destroy invading organisms, remove irritants, and set the stage for tissue repair. When healing is complete, the inflammatory process usually subsides.
However, inflammation is sometimes inappropriately triggered by an innocuous agent, such as pollen, or by an autoimmune response, as in asthma or rheumatoid arthritis. Inflammation is triggered by the release of chemical mediators from injured tissues and migrating cells and include amines, such as histamine and 5-hydroxytryptamine; lipids, such as the prostaglandins; small peptides, such as bradykinin; and larger peptides, such as interleukin-l.
Anti-inflammatory drugs
Inflammation is a normal, protective response to tissue injury caused by physical trauma, noxious chemicals, or microbiologic agents. Inflammation is the body's effort to inactivate or destroy invading organisms, remove irritants, and set the stage for tissue repair. When healing is complete, the inflammatory process usually subsides.
However, inflammation is sometimes inappropriately triggered by an innocuous agent, such as pollen, or by an autoimmune response, as in asthma or rheumatoid arthritis. Inflammation is triggered by the release of chemical mediators from injured tissues and migrating cells and include amines, such as histamine and 5-hydroxytryptamine; lipids, such as the prostaglandins; small peptides, such as bradykinin; and larger peptides, such as interleukin-l.
Analgesic is a drug that relieves pain by acting on the CNS or on the peripheral pain mechanism without altering consciousness
Opioid analgesics
Non Opioid analgesics (NSAIDs)
NSAIDs are non-steroidal anti-inflammatory drugs. These are not only pain killers but also are anti-inflammatory drugs that are widely used in dentistry. These are weaker analgesics, also called nonnarcotic or aspirin-like or antipyretic analgesics. They do not depress CNS, do not produce physical dependence, and have no abuse liability. They act primarily on peripheral pain mechanisms.
9. NSAIDS.pptxNSAIDS inhibit the enzyme cyclooxygenase (COX) types 1 and 2, w...samiyamohammed284
Renal
Renally produced prostaglandins (PGE2 and PGI2) are essential
in maintaining adequate renal perfusion when the level of circulating vasoconstrictors Platelets
Impaired platelet function (reduced aggregation).
as a result of decreased thromboxane A2 (TXA2) production.
TXA2 is present in large amounts in activated platelets and acts locally as a chemo-attractant for other platelets, leads to the formation of a platelet plug and induces localized vasoconstric
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stockrebeccabio
Factory Supply Best Quality Pmk Oil CAS 28578–16–7 PMK Powder in Stock
Telegram: bmksupplier
signal: +85264872720
threema: TUD4A6YC
You can contact me on Telegram or Threema
Communicate promptly and reply
Free of customs clearance, Double Clearance 100% pass delivery to USA, Canada, Spain, Germany, Netherland, Poland, Italy, Sweden, UK, Czech Republic, Australia, Mexico, Russia, Ukraine, Kazakhstan.Door to door service
Hot Selling Organic intermediates
6. 1. Aspirin
• Anti-inflammatory actions
• Analgesic action
Inhibits synthesis of Prostaglandin E2 (PGE2) “thought to sensitize nerve endings to
the action of bradykinin, histamine, and other chemical mediators released locally by
the inflammatory process”.
Used for the management of pain of low to moderate intensity arising from
musculoskeletal disorders rather than that arising from the viscera
• Antipyretic action
• Fever occurs when the set-point of the anterior hypothalamic thermoregulatory center is
elevated. This can be caused by PGE2 synthesis, which is stimulated when an
endogenous fever-producing agent (pyrogen), such as a cytokine, is released from white
cells that are activated by infection, hypersensitivity, malignancy, or inflammation.
• The salicylates lower body temperature in patients with fever by impeding PGE2
synthesis and release
6
7. 1. Aspirin
• Respiratory actions
At therapeutic doses, aspirin increases alveolar ventilation
Higher doses work directly on the respiratory center in the medulla, resulting in
hyperventilation and respiratory alkalosis that usually is adequately compensated by
the kidney.
At toxic levels, central respiratory paralysis occurs, and respiratory acidosis results
due to continued production of CO2.
• Gastrointestinal effects
Epigastric distress, ulceration, haemorrhage, and iron-deficiency anaemia
Due to inhibition of PGE2 (stimulate synthesis of protective mucus in both the
stomach and small intestine
Misoprostol (PGE1-derivative) and the proton-pump inhibitors
(lansoprazole, omeprazole, pantoprazole) can also be used for the treatment of an
NSAID-induced ulcer
7
8. 1. Aspirin
• Effect on platelets (anticoagulant effect)
Low doses of aspirin can irreversibly inhibit thromboxane (enhances platelet
aggregation) production in platelets
Because platelets lack nuclei, they cannot synthesize new enzyme, and the lack of
thromboxane persists for the lifetime of the platelet (3-7 days).
As a result of the decrease in TXA2, platelet aggregation (the first step in thrombus
formation) is reduced, producing an anticoagulant effect
Aspirin also inhibits cyclooxygenase in endothelial cells, resulting in reduced PGI2
(decreases platelet aggregation) formation
Endothelial cells possess nuclei able to re-synthesize new cyclooxygenase.
Therefore, PGI2 is available for antiplatelet action.
8
9. 1. Aspirin
• Actions on the kidney
Cyclooxygenase inhibitors prevent the synthesis of PGE2 and PGI2-prostaglandins
that are responsible for maintaining renal blood flow
Decreased synthesis of prostaglandins can result in retention of sodium and water
and may cause edema and hyperkalemia in some patients
Therapeuutic indications
• Anti-inflammatory, antipyretic, and analgesic uses
The salicylic acid derivatives are used in the treatment of rheumatic
fever, osteoarthritis, and rheumatoid arthritis
• External applications
Salicylic acid is used topically to treat corns and warts.
• Cardiovascular applications
Aspirin is used to inhibit platelet aggregation.
9
10. 1. Aspirin
Adverse effects
• GIT
epigastric distress, nausea, and vomiting.
Aspirin is an acid and at stomach pH, aspirin is uncharged; consequently, it readily
crosses into mucosal cells, where it ionizes (becomes negatively charged) and
becomes trapped, thus potentially causing direct damage to the cells.
• Blood
inhibition of platelet aggregation and a prolonged bleeding time
aspirin should not be taken for at least 1 week prior to surgery.
• Respiration
In toxic doses, salicylates cause respiratory depression
10
11. 1. Aspirin
Adverse effects
• Reye's syndrome
Aspirin and other salicylates given during viral infections has been associated with an
increased incidence of Reye's syndrome (which is an often fatal, fulminating hepatitis
with cerebral edema)
This is especially encountered in children, who therefore should be given
acetaminophen or Ibuprofen .
11
12. 1. Aspirin
Adverse effects
• Drug interactions:
12
13. 2. Propionic acid derivatives
• Ibuprofen, naproxen, fenoprofen, ketoprofen, and oxaprozin
• All these drugs possess anti-inflammatory, analgesic, and antipyretic activity;
additionally, they can alter platelet function and prolong bleeding time.
• They have gained wide acceptance in the chronic treatment of RA and
osteoarthritis, because their GI effects are generally less intense than those of aspirin.
• These drugs are reversible inhibitors of the cyclooxygenases
3. Acetic acid derivatives
• Indomethacin, sulindac, and etodolac
• All have anti-inflammatory, analgesic, and antipyretic activity.
• They act by reversibly inhibiting cyclooxygenase.
13
14. 4. Oxicam derivatives
• Piroxicam and meloxicam are used to treat RA and osteoarthritis.
• They have long half-lives, which permit once-daily administration
5. Fenamates
• Mefenamic acid and meclofenamate have no advantages over other NSAIDs as anti-
inflammatory agents.
6. Heteroaryl acetic acids
• Diclofenac and tolmetin are approved for long-term use in the treatment of
RA, osteoarthritis
• Diclofenac is more potent than indomethacin or naproxen.
• Ketorolac is a potent analgesic but has moderate anti-inflammatory effects.
• for intramuscular use in the treatment of postoperative pain, and for topical use for
allergic conjunctivitis.
14
15. 7. Celecoxib
• Celecoxib is significantly more selective for inhibition of COX-2 than of COX-1
• Unlike aspirin, celecoxib does not inhibit platelet aggregation and does not increase
bleeding time.
• Detection of serious cardiovascular events associated with COX-2 inhibitors have led to
withdrawal of rofecoxib and valdecoxib from the market
15
16. 8. Acetaminophen
• Acetaminophen inhibits prostaglandin synthesis in the CNS. This explains its antipyretic
and analgesic properties.
• Acetaminophen has less effect on cyclooxygenase in peripheral tissues, which accounts
for its weak anti-inflammatory activity.
• Acetaminophen does not affect platelet function or increase blood clotting time.
• Therapeutic indications :
• Acetaminophen is a suitable substitute for the analgesic and antipyretic effects of aspirin
for those patients with:
gastric complaints,
Those in whom prolongation of bleeding time would be a disadvantage,
Those who do not require the anti-inflammatory action of aspirin.
• Acetaminophen is the analgesic/antipyretic of choice for children with viral infections or
chickenpox (recall that aspirin increases the risk of Reye's syndrome).
• Acetaminophen does not antagonize the uricosuric agents probenecid or sulfinpyrazone
and, therefore, may be used in patients with gout who are taking these drugs.
16
18. • Adverse effects
• With normal therapeutic doses, acetaminophen is virtually free of any significant adverse effects.
• With large doses of acetaminophen, the available glutathione in the liver becomes depleted, and
• N-acetylbenzoiminoquinone reacts with the sulfhydryl groups of hepatic proteins, forming
covalent bonds, hepatic necrosis, a very serious and potentially life-threatening condition, can
result.
18
20. Treating acute gout
• Acute gouty attacks can result from excessive alcohol consumption, a diet rich in
purines, or kidney disease. Acute attacks are treated with indomethacin to decrease
movement of granulocytes into the affected area
• NSAIDs other than indomethacin are also effective at decreasing pain and inflammation.
• Aspirin is contraindicated, because it competes with uric acid for the organic acid
secretion mechanism in the proximal tubule of the kidney
Treating chronic gout
• Chronic gout can be caused by a genetic defect, renal deficiency; or excessive
production of uric acid associated with cancer chemotherapy.
20
21. 1. Colchicine
• Colchicine a plant alkaloid, has been used for the treatment of acute gouty attacks as
well as chronic gout.
• Mechanism of action
• Colchicine binds to tubulin, a microtubular protein, causing its depolymerization. This
disrupts cellular functions, such as the mobility of granulocytes, thus decreasing their
migration into the affected area.
• Colchicine blocks cell division by binding to mitotic spindles.
• Colchicine also inhibits the synthesis and release of the leukotrienes
• Therapeutic uses
• The anti-inflammatory activity of colchicine is specific for gout, usually alleviating the
pain of acute gout within 12 hours.
• Colchicine is currently used for prophylaxis of recurrent attacks
21
22. 2. Allopurinol
• Allopurinol reduces the production of uric acid by competitively inhibiting the last two
steps in uric acid biosynthesis that are catalyzed by xanthine oxidase
• Uric acid is less water soluble than its precursors. When xanthine oxidase is
inhibited, the circulating purine derivatives (xanthine and hypoxanthine) are more
soluble and, therefore, are less likely to precipitate
Therapeutic uses
• Allopurinol is effective in the treatment of primary hyperuricemia of gout and
hyperuricemia secondary to other conditions, such as that associated with certain
malignancies
• Acute attacks of gout may occur more frequently during the first several weeks of
therapy; therefore, colchicine or NSAIDs should be administered concurrently.
22
23. 3. Uricosuric agents
• Probenecid and sulfinpyrazone
• The uricosuric drugs are weak organic acids that promote renal clearance of uric acid by
inhibiting the urate-anion exchanger in the proximal tubule that mediates urate
reabsorption.
23