1. MS Procedural Coding Prostaglandin Inhibitors MHA May 21, 2009 Irene Mueller, EdD, RHIA

2. Prostaglandins (type of NSAID) Misnomer – natural substances widely distributed in many tissues and body fluids, but 1st isolated from prostate Act on smooth muscle Named alphabetically –Prostaglandin A, B, C, ( PGA, PGB) Some older drugs are now known to be prostaglandin inhibitors - Aspirin

3. Actions of Prostaglandins Reproductive tract –Aid in ejaculation –Induction of contractions for elective abortions Not effective for inducing labor at end of pregnancy Circulatory system –Increase cardiac output –PGE keeps ductus arteriosus open in congenital heart disease –Prostin VR Pediatric should not be used in infants with RDS

4. Prostaglandins Inhibitors Analgesic and anti-inflammatory Mechanism of action of many of the anti- inflammatory agents is to prevent prostoglandin synthesis at inflammation site

5. Aspirin (Prostaglandin Inhibitor) Aspirin (Acetylsalicylic Acid) Very old drug –Relieves mild/moderate pain –Headaches –Anti-inflammatory in arthritis Juvenile rheumatoid arthritis –Reduces platelet aggregation Prevents blood clots

6. Other Prostaglandin Inhibitors Indocin- arthritis, closing ductus arteriosus Tolectin - arthritis, bursitis Motrin - anti-inflammatory, menstral cramps Feldene - long half-life, one-a-day dosing Toradol - IM for acute pain, postop –Orally for headaches, dental, and chronic recurrent pain Naprosyn, Ibuprofen, Indomethacin, Naproxen, Piroxicam

7. Side effects of Prostaglandin Inhibitors Gastric irritation, best taken 1/2 hour BEFORE meals Bleeding disorders –Bleeding gums, black stools, petechiae –Discontinue before surgeries Allergies Fluid retention, maybe indicated by  blood pressure Reye’s syndrome w/aspirin in viral infections –Often fatal; encephalopathy and liver damage