1. Pain treatment
How drugs work on pain

2. NSAIDs…
N : Non
S : Steroidal
A : Anti
I : Inflammatory
Ds : Drugs

3. The Action of drugs on pain…
These drugs have:-
analgesic
antipyretic
anti-inflammatory
effects

4. Indications… Used for complaints under prescription by G.P. :
Rheumatic pain
Severe pain for bone cancer
Used O.T.C. for self-treatment of pain:
Headaches
Dental pain
Muscularskeletal disorders

5. These drugs are not effective…
Visceral pain
Myocardial infarction ( aspirin has a more therapeutic anti-platelet effect)
Renal colic
Acute abdominal pain
These disorders require opioid analgesics

6. Mechanism of action… Action is exerted peripherally and centrally
Associated with its anti-inflammatory effects
( from the inhibition of prostaglandin in the inflamed tissue)
Anti-inflammatory effect is modest but gives relief
Antipyretic: prevents body temperature from rising

7. Adverse effects…
Common when given in high doses used in elderly patients who are more susceptible
Gastro-intestinal side-effects ( bleeding, ulceration)
Nephrotoxicity: action against prostaglandins results in sodium retention, reduced blood flow and renal failure
Bronchospasm
Rashes
allergies

8. Aspirin ®Acetylsalicylic acid
Cardiovascular disease (CVD), principally heart disease and stroke, is the leading cause of death for both males and females in developed countries. Aspirin is the most widely used and tested antiplatelet drug in CVD, and it is proven to be the cornerstone of antiplatelet therapy in treatment and prevention of CVD in clinical trials in various populations. In acute coronary syndrome,thrombotic stroke, and Kawasaki’s disease, acute use of aspirin can decrease mortality and recurrence of cardiovascular events. As secondary prevention, aspirin is believed to be effective in acute coronary syndrome, stable angina, revascularization, stroke, TIA,and atrial fibrillation. Aspirin may also be used for patients with a high risk of future CVD for primary prevention, but the balance between benefits and the possibility of side effects must be considered.

9. Review article
Clinical Use of Aspirin in Treatment and Prevention of Cardiovascular Disease
Yuxiang Dai and Junbo Ge
Shanghai Cardiovascular Institute and Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai , China
Hindawi Publishing Corporation
Thrombosis
Volume 2012, Article ID , 7 pages
doi: /2012/245037

10. pharmacokinetics
Oral administration salicylates are absorbed in stomach and upper part of small intestine
Absorbed readily in pure form
Food and antacids delay absorption
Rectal administration – slower absorption

11. Distribution, metabolism, excretion
Distributed throughout the body tissues and fluids including breast milk
Liver metabolizes salicylates into metabolites.
Kidney excretes metabolites

12. pharmacodynamics Mechanism of action.-
Relief of pain inhibiting synthesis of prostaglandin
Reduce inflammation by inhibition of prostaglandin
Reduce fever by stimulation hypothalamus- dilation of peripheral blood vessels increasing sweating
Inhibits platelet aggregation ( increases blood flow in M.I)