n on - steroidal anti - inflammatory drugs. anti-inflammatory drugs a class of drugs that lower...
TRANSCRIPT
![Page 1: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/1.jpg)
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS
![Page 2: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/2.jpg)
ANTI-INFLAMMATORY DRUGS
A class of drugs that lower inflammation and that
includes NSAIDs and DMARDs.
![Page 3: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/3.jpg)
NSAID
NON SELECTIVE COX INHIBITOR
SELECTIVE COX 2 INHIBITOR
Salicylates Others
Propionic acid Derivatives
Oxicams Aryl acetic
Acid derivativesIndole
derivativesFenamates
![Page 4: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/4.jpg)
PHARMACOKINETIC
![Page 5: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/5.jpg)
MECHANISM OF ACTION OF NSAIDS
![Page 6: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/6.jpg)
![Page 7: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/7.jpg)
ASPIRIN IS IRREVERSIBLE INHIBITOR TO COX ENZYMES
![Page 8: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/8.jpg)
NON- SLECTIVE -NON -STEROIDAL ANTI-INFLAMMATORY DRUGS
Are group of drugs that share in common the capacity to induce:
Analgesic effect. Antipyretic effect. Anti-inflammatory effect. Antiplatelet effect
![Page 9: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/9.jpg)
MECHANISM OF ACTION
![Page 10: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/10.jpg)
MECHANISM OF ACTION ( CONTINUE)
![Page 11: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/11.jpg)
ANALGESIC
Drug that relieve pain.
![Page 12: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/12.jpg)
ANTIPYRETIC
Drug that lower the elevated body
temperature to normal.
![Page 13: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/13.jpg)
CONTINUE
Effect on GITInhibition of PGI2 &
PGE2 & PGF2 resulting in gastric upset up to gastric ulceration & bleeding
![Page 14: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/14.jpg)
CONTINUE
Kidney Inhibit PGE2 & PGI2 resulting in salt & water retention , edema , hyperkalemia & interstitial nephritis
![Page 15: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/15.jpg)
CONTINUE
Respiratory system With aspirinHigh dose act directly on respiratory
center causing hyperventilation & respiratory alkalosis
Toxic doses causing central respiratory paralysis& respiratory acidosis
![Page 16: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/16.jpg)
THERAPEUTIC USES SHARED BY
NS-NSAIDs
![Page 17: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/17.jpg)
Fever.Analgesic (Type of pain?)
Headache, Migraine, Dental painCommon cold.
![Page 18: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/18.jpg)
CONTINUE
Rheumatic / Rheumatoid arthritis
Dysmenorrhea
Muscular pain
![Page 19: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/19.jpg)
![Page 20: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/20.jpg)
ADVERSE EFFECTS
GIT upsets ( nausea, vomiting) GIT bleeding & ulceration Bleeding Hypersensitivity reaction Inhibition of uterine contraction Salt & water retention
![Page 21: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/21.jpg)
![Page 22: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/22.jpg)
CLINICAL USES
Acute rheumatic fever
Reducing the risk of myocardial infarction
Prevention of pre-eclampsia
![Page 23: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/23.jpg)
![Page 24: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/24.jpg)
Adverse Effects Related to (A)Therapeutic Doses Of
Aspirin
Gastric irritationHypersensitivity ( aspirin asthma)Acute Gouty arthritisReye's syndrome
![Page 25: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/25.jpg)
(B) TO HIGH DOSES &PROLONGED USE OF ASPIRIN Salicylism ( ringing of ears (tinnitus),
vertiog)
Hyperthermia
Gastric ulceration & bleeding
Metabolic acidosis
![Page 26: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/26.jpg)
SIDE EFFECTS RELATED TO HIGH DOSES
![Page 27: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/27.jpg)
CONTRAINDICATIONS Peptic ulcerPregnancyHemophilic patientsPatients taking anticoagulantsChildren with viral infectionsGout ( small doses )
![Page 28: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/28.jpg)
PARACETAMOL
A commonly used analgesic antipyretic instead of aspirin in cases of :
![Page 29: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/29.jpg)
Peptic or gastric ulcers. Bleeding tendency. Allergy to aspirin.Viral infections in children .
Pregnancy.
![Page 30: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/30.jpg)
ADVERSE EFFECTS Mainly on liver due to its active
metabolites
Therapeutic doses elevate liver enzymes
High doses cause liver & kidney necrosis
Treatment toxicity of paracetamol: N- acetylcysteine to neutralize the
toxic metabolites
![Page 31: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/31.jpg)
PROPIONIC ACID DERIVATIVES
IBUPROFEN
![Page 32: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/32.jpg)
CLINICAL USESTherapeutic uses shared by NS- NSAIDs
Acute gouty arthritis
Patent ductus arteriosus
More potent as an anti-inflammatory than aspirin
![Page 33: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/33.jpg)
PREPARATIONS OF IBUPROFEN
Oral preparations. Topical cream for osteoarthritis. A liquid gel for rapid relief of postsurgical
dental pain. Intravenous route as In patent ductus
arteriosus
![Page 34: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/34.jpg)
ADVERSE EFFECTS Adverse effects shared by NS-NSAIDs
(Gastric upset less frequent than aspirin)
Rare hematologic effects (agranulocytosis & aplastic anemia ).
Ocular disturbance
![Page 35: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/35.jpg)
CONTRAINDICATIONS Peptic ulcer Allergic patients to aspirin Kidney impairment Liver diseases Pregnancy Haemophilic patients The concomitant administration of
ibuprofen antagonizes the irrevesible platelet inhibition of aspirin( limit cardioprotective effect of aspirin ).
![Page 36: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/36.jpg)
OXICAM DERIVATIVESPiroxicam
Tenoxicam
![Page 37: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/37.jpg)
PIROXICAM
Half- Life 45 hours
Given once daily
![Page 38: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/38.jpg)
ADVERSE EFFECTS Less frequent gastric upset (20%) . Dizziness Tinnitus Headache Allergy
![Page 39: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/39.jpg)
ACETIC ACID DERIVATIVES
Diclofenac
![Page 40: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/40.jpg)
PREPARATIONS OF DICLOFENAC Diclofenac with misoprostol decreases
upper gastrointestinal ulceration ,but result in diarrhea.
Diclofenac with omeprazole to prevent recurrent bleeding.
.1% opthalmic preparation for postoperative opthalmic inflammation.
A topical gel 3% for solar keratosis. Rectal suppository
![Page 41: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/41.jpg)
CONTINUE
Oral mouth wash. Intramuscular preparations.
![Page 42: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/42.jpg)
CLINICAL USES Clinical uses shared by Ns-NSAIDs Acute gouty arthritis Locally to prevent or treat post
opthalmic inflammation A topical gel for solar keratosis
![Page 43: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/43.jpg)
ADVERSE EFFECTSAdverse effects shared by NS-NSAIDs
![Page 44: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/44.jpg)
SELECTIVE COX-2 INHIBITORS
General advantages :oPotent anti-inflammatoryoAntipyretic & analgesicoLower incidence of gastric upset
oNo effect on platelet aggregation ( COX-1)
![Page 45: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/45.jpg)
GENERAL ADVERSE EFFECTS
Renal toxicity Dyspepsia & heartburn Allergy Cardiovascular ( do not offer the
cardioprotective effects of non-selective group).
![Page 46: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/46.jpg)
CLINICAL USES
Postoperative patients undergoing bone repair
Acute gouty arthritis Acute musculoskeletal pain Ankylosing spondylitis
![Page 47: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/47.jpg)
CELECOXIB Half-life 11 hours ( Given twicw daily)
Food decrease its absorption
Highly bound to plasma proteins
Metabolized in liver to inactive metabolites
![Page 48: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/48.jpg)
MELOXICAMRelatively selective Cox2 inhibitors.
Safer than piroxicam.
![Page 49: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/49.jpg)
PHARMACOKINETICSGiven orally ,rectally, I.M.,I.V.Metabolized in liver to inactive
metabolites.Excreted in urine 50% and in feces
50%.Half-life 20 hours.Given once daily.
![Page 50: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/50.jpg)
CLINICAL USESShared by selective COX-2 inhibitors
![Page 51: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/51.jpg)
ADVERSE EFFECTSShared by selective COX-2 inhibitors
![Page 52: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/52.jpg)
DRUG INTERACTIONSCholestyramine increases the clearance of the drug .
![Page 53: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/53.jpg)
NABUMETONERelatively selective COX-2 inhibitor
Well absorbed orally.Metabolized in liver to active metabolites.
Half-life 26 hours.Taken once daily.
![Page 54: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/54.jpg)
CLINICAL USESShared by selective COX-2 inhibitors
![Page 55: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/55.jpg)
ADVERSE EFFECTSShared by selective COX-2 inhibitors
Headache TinnitusPhotosensitivity
![Page 56: N ON - STEROIDAL ANTI - INFLAMMATORY DRUGS. ANTI-INFLAMMATORY DRUGS A class of drugs that lower inflammation and that includes NSAIDs and DMARDs.NSAIDs](https://reader036.vdocuments.net/reader036/viewer/2022062806/56649c905503460f9494a035/html5/thumbnails/56.jpg)