5 Anti - Inflammatory Drugs, Anti-Gout Drugs

Anti – inflammatory
Drugs
NONSTEROIDAL ANTI- INFLAMMATORY
A. Salicylate (aspirin)  Fenamates
B. Non- salicylates  meclofemanate
 parachlorobenzoic acid (Meclofen)
 indomethacin (Indocin)  mefenamic acid (ponstan)
 sulindac  Oxicam
 tolmetin  meloxicam (Mobic)
 pyrazolone derivatives  Phenylacetic acid
 phenylbutazone derivatives
 Propionic acid  diclofenac Na (Voltaren,
Cataflam)
derivatives
 ketorolac (Toradol)
 ibuprofen (Alaxan,
Advil)  Selective COX2 inhibitors
 naproxen (Flanax)  celecoxib
 ketoprofen (Orudis)
 MOA: inhibits the enzyme cyclooxygenase
(COX) that is needed for the biosynthesis of
prostaglandin
 USES: reduce inflammatory process

: relieve pain
: reduce fever
 CI: severe renal and hepatic disease. GI bleed,

hypersensitivity (**** aspirin: tinnitus, vertigo,
bronchospasm esp asthmatic)
SE: GI irritation, anorexia, N/V, dizziness,
confusion, hearing loss, heartburn,
drowsiness
AE: GI bleed, tinnitus, life threatening ( BM
depression, hepatotoxicity, bronchospasm,
cardiac dysrhythmias)
DI: + anticoagulants, anti platelets,
thrombolytics = increase GI bleed
NURSING RESPONSIBILITIES
 Take with meals
 Check hypersensitivity
 Monitor bleeding
 Avoid alcohol
 Inform client that it may take several weeks to
experience the desired effect of some NSAIDs
 Direct client to inform the dentist or surgeon
before a procedure when taking ibuprofen or
other NSAIDs for a continuous period
STEROIDAL ANTI- INFLAMMATORY
CORTICOSTEROIDS
MOA: suppress the intensity of the
inflammatory process; can control
inflammation by suppressing or preventing
many of the components of inflammatory
process at the injured site
USES:
Myocarditis, pericarditis, arthritis, tendonitis,
bursitis, ulcerative colitis, dermatitis
Major side effects
 Buffalo hump- accumulation of fat on the back of the
neck
 Moon face- rounded, puffy face
 Immunosuppressant effect- inability of the immune
system to respond to antigenic stimulation
 Growth retardation
 Mood swing
 Acne
 Trunkal obesity
 Sterility
 Cardiac dysrrhythmias – tachycardia most common
 Inhibited CHON synthesis
Hypokalemia, hypocalcemia, hyperglycemia,

hypernatremia, hypertension
NURSING CONSIDERATIONS
 Usually recommended for short term use
 Taper off slowly to prevent adrenal insufficiency
 High CHON, potassium, calcium, low sodium
intake
 Daily weight, report weight gain > 5 lbs
 Check CBC. Strengthen immune system
 Take with food
 Avoid vaccines without APs approval
Eg:
cortisone acetate (Corstitan)
hydrocortisone (Cortisol)
prednisone (Deltasone)
fluticasone (Flixotide)
dexamethasone (Decadrone)
betamethasone (Celestone)
budesonide (Budecort)
Anti – gout agents
Common drugs
 colchicine (Novovolchine)
Anti inflammatory
Inhibits migration of leukocytes at inflamed
site
Does not inhibit uric acid, does not promote
uric acid excretion
 probenecid (Benemid)
Uricosuric agent
Increase rate of uric acid excretion by
inhibiting its reabsorption
Should not be used in acute attack
 sulfinpyrazone (Anturane)
More potent than probenecid
 allopurinol (Zyloprim)
Uric acid inhibitor, not anti inflammatory
Inhibits final step of uric acid biosynthesis
Useful for client who do not respond well to
uricosurics
USES:
 control acute inflammation of the attack
 Increase excretion of uric acid
 Decrease production of uric acid
USES:
 Gouty arthritis
 Control uric acid production with antineoplastic
drug therapy
SE: kidney stones, N/V, diarrhea, HA, flushed skin
& rash, metallic taste, drowsiness
AE: BMD
NURSING RESPONSIBILITIES
 Fluid intake ( at least 2L/day)
 Alkaline urine: Milk, Fruits except cranberries,
plums, prunes, Most vegetables, Small amount
of beef
 Compliance, low purine foods: (high) beer, wine,
shellfish, legumes, gravy, organ meat, salmon,
sardines
 CBC
 Acetaminophen instead of ASA ( elevate uric
acid)
 Avoid large doses of Vit C
 Take with food

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Anti – inflammatory

 USES: reduce inflammatory process

 CI: severe renal and hepatic disease. GI bleed,

Hypokalemia, hypocalcemia, hyperglycemia,

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