NSAIDs 2




(1)
Department of Anaesthesia, Royal Free Hospital, London, UK

 




19.1 Diclofenac


It is the most commonly used NSAID. It has analgesic, antipyretic and anti-inflammatory activity. There is an increased risk of cardiovascular events with prolonged use. It is rapidly absorbed and is extremely bound to plasma proteins. First-pass metabolism is to the extent of 50 %. The terminal half-life is 1.5–2 h. It is metabolised in the liver by the CYP2C enzyme. Metabolites are excreted in the urine and bile and less than 1 % is excreted unchanged. Daily dosage is between 100 and 200 mg given in equally divided doses. Common side effects include gastrointestinal upset, increase in hepatic transaminases, rash, allergic reactions and fluid retention.


19.2 Ketorolac


It is a potent analgesic but is limited by weak anti-inflammatory effect. It inhibits platelet aggregation and like other NSAIDs causes gastric ulceration. It has a rapid onset of action with short duration of action. Bioavailability is 80 % when taken orally. Most of the drug is excreted renally. It is used mainly for short-term treatment of moderate to severe pain. Side effects include headache, dizziness, dyspepsia and somnolence.

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Mar 20, 2017 | Posted by in PAIN MEDICINE | Comments Off on NSAIDs 2

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