It Covers different aspects of Pain and Inflammation. Including their: Types, Different initiators, Related Diseases and Drugs used for PAIN and INFLAMMATION

1. Nouman Azmat Minhas
Senior Professional Services Representative
Pfizer Pakistan LTD.
Base Town - Rawalpindi
–Presented By :-

3. DRUGS USE FOR THE TREATMENT OF
PAIN & INFLAMATION

5.  An unpleasant sensation occurring in varying
degrees of severity as a consequences of injury,
disease, or emotional disorder.
 Suffering or distress.
 Pain is a feeling or a perception it varies from
person to person and its intensity depends upon
individual response to stimuli.
 Informal a source of annoyance; A nuisance.

6. TYPES OF
 Acute pain
 Chronic pain

7. Having a rapid onset and following a short
but severe course.
Afflicted by a disease exhibiting a rapid
onset followed by short, severe course.

8.  Lasting for a long period of time or marked
by frequent recurrence, as certain disease.

9. Types Of Pain
Initiators
 Chemical
 Mechanical
 Thermal

10. Cell Membrane Thermal
Chemical
Phospholipids
Other
Infection
Trauma
Lipoxygenase
Mechanical
Cycloxygense
Phospholipase
Arachidonic Acid
Disruptions
Leukotrins Prostaglandins

11. PROSTGLANDINS Basic Facts
 Prostaglandins are unsaturated fatty acids.
 PG are of nine types, A,B,C,D,E,F,G,H and I.
 PG are formed on demand.

13. Reaction of living tissue to all forms of
injury.
The body’s major defenses against injury
and infection in an attempt to localize and
heal it.
It may vary in timing and intensity ,
depending on its cause & the type of tissue.

14. Agents Causing
Can broadly classify into four major types:
1) Biological
2) Chemical
3) Physical
4) Immunological

15. Types Of
An inflammation that lasts for a few
minutes, several hours or one to two days.
An inflammation that persists for months or
years.

16. Signs Of
1) Pain
2) Heat
3) Redness
4) Swelling
5) Loss of function

17. TISSUE INJURY
MAST CELL RELEASE HISTAMINE,KININS,SEROTININ & PROSTAGLANDINS
INCREASED PERMEABILITY
EXDUATE PASSES THROUGH
CAPILLART WALL TO INJURED AREA
MIGRATION OF LEUKOCYTES
INCREASED BLOOD FLOW
SWELLINGHEAT AND REDNESS

18. • Enzyme that catalyze the synthesis of PGs
• Purified in 1976 and cloned in 1988.
• A second COX-2 was discovered in 1991.
• The two known COX forms are similar in
size and kinetics but vary in their
a) Expression
b) Distribution
COX ( Cycloxygenase )

19. COX-1 ( The Good COX )
• Cox-1 is present in most cells throughout
the body and produce PGs which involved
in the physiological processes known as
“housekeeping function” also called Good
COX.

20. COX-2 “The Bad COX”
• Inducible form, found in inflammatory and
immune cells.
• At the sight of inflammation, COX-2 is
responsible for the generation of the
hyperalgesic (pain causing) and pro-
inflammatory PGs.
• COX-2 is also present in the CNS, where it
involved in fever and Neuro-transmission of
pain.

21. • The drug concentration that inhibits the
activity of the enzyme by 50%.
• The lower the IC-50 the stronger is the
drug.
• Cox-1/Cox-2 are determined in ratio.
• Ratio more than 1 = Cox1 selective
• Ratio less than 1 = Cox2 selective
Concept Of IC-50

22. • Arthritis.
• Rheumatoid Arthritis.
• Osteoarthritis.
• Ankylosing Spondilitis.
Pain Related Diseases

23. Arthritis
• Any type of joint pain or inflammation is
called arthritis.
• Multiple Etiology.
• Treatment options includes NSAID and
selective And specific COX inhibitors.
• If untreated will lead to complications.

24. Rheumatoid Arthritis
• A systemic connective tissue disorder.
• Involving multiple joints.
• Usually Small joints.
• Symmetrical joints.
• Morning stiffness.
• Positive RA factor.

25. Osteoarthritis is a disease of joint
characterized by cartilage loss with
an accompanying periarticular
bone response.

26. Symptoms of
• Joint pain.
• Joint Instability.
• Loss of joint function.

27. Signs of
• Joint tenderness.
• Crepitus in movement.
• Limitation of movement.
• Joint Instability.
• Joint effusion.
• Bony swelling.
• Wasting of muscles.

28. Treatment Options of
• Simple Analgesics.
• NSAIDs.
• COX-2 Inhibitors.

29. • Inflammatory disease of back especially
effecting young.
• There is white cells infiltration.
• Erosion of bone at the place of ligament
attachment.

30. Symptoms of
• Episodic sacroiliac pain.
• Buttock Pain.
• Stiffness in morning.
• Low stiffness after exercise.
• Para spinal muscle wasting.

31. Treatment of
• Simple Analgesics.
• NSAIDs.
• COX-2 Inhibitors

32. DRUGS USED IN PAIN &
INFLAMMATION
NON-NARCOTICS ANALGESICS
NARCOTIC ANALGESICS

33. ROLE OF IN
PAIN & INFLAMMATION

34. This is a group of medicine which are used
for the treatment of pain and inflamation.
These medicines are also used in
osteoarthritis, rheumatoid arthritis and other
conditions associated with pain.

35. CARBOXYLIC ACID ENOLIC ACIDNON ACID COMPOUNDS
SALICYLIC ACID &
ESTERS
ACETIC ACID PROPIONIC ACID FENAMIC ACID
PHENYLACETIC
ACIDS
CARBOCYCLIC &
HETEROCYCLIC
ACETIC ACIDS
PYRAZOLONES OXICAMS

36. ANY QUESTION ???