McKenna's Pharmacology for Nursing, 2e

16

Anti-inflammatory, antiarthritis and related agents

Learning objectives Upon completion of this chapter, you should be able to: 1. Describe the sites of action of the various anti-inflammatory agents.

2. Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse reactions and important drug–drug interactions associated with each class of anti-inflammatory agents. 3. Discuss the use of anti-inflammatory drugs across the lifespan. 4. Compare and contrast the prototype drugs for each class of anti-inflammatory drugs with the other drugs in that class. 5. Outline the care considerations and teaching needs for people receiving each class of anti-inflammatory agents.

Test your current knowledge of anti-inflammatory, antiarthritis and related agents with a PrepU Practice Quiz!

Glossary of key terms analgesic: compounds with pain-blocking properties, capable of producing analgesia anti-inflammatory agents: drugs that block the effects of the inflammatory response antipyretic: blocking fever, often by direct effects on the thermoregulatory centre in the hypothalamus or by blockade of prostaglandin mediators chrysotherapy: treatment with gold salts; gold is taken up by macrophages, which then inhibit phagocytosis; it is reserved for use in people who are unresponsive to conventional therapy, and can be very toxic inflammatory response: the body’s non-specific response to cell injury, resulting in pain, swelling, heat and redness in the affected area non-steroidal anti-inflammatory drugs (NSAIDs): drugs that block prostaglandin synthesis and act as anti-inflammatory, antipyretic and analgesic agents salicylates: salicylic acid compounds, used as anti-inflammatory, antipyretic and analgesic agents; they block the prostaglandin system salicylism: syndrome associated with high levels of salicylates—dizziness, ringing in the ears, difficulty hearing, nausea, vomiting, diarrhoea, mental confusion and lassitude stool guaiac: a test to detect occult blood in the stool

SALICYLATES aspirin balsalazide mesalazine olsalazine

ANTIARTHRITIS AGENTS Gold compounds auranofin sodium aurothiomalate Other antiarthritis drugs anakinra etanercept leflunomide penicillamine sodium hyaluronate

Oxicam derivatives meloxicam piroxicam Cyclooxygenase-2 inhibitor

ibuprofen ketoprofen naproxen tiaprofenic acid Acetic acids diclofenac indomethacin ketorolac sulindac Fenamates mefenamic acid

celecoxib etoricoxib parecoxib

NON-STEROIDAL ANTI-INFLAMMATORY AND RELATED AGENTS Non-steroidal anti- inflammatory agents (NSAIDs) Propionic acids flurbiprofen

Related agent paracetamol