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BY: KOMAL HALEEM PHARM-D
PARACETAMOL
OTC
Also known as,
ACETAMINOPHEN
DESCRIPTION
-Analgesic
-Antipyretic
-Central action> Peripheral action
-NO
GI disturbances
Acid-base imbalance
Electrolyte imbalance
Impairment of clotting
-ADR :
Extremely safe drug. But rarely produces …. Hepatic toxicity
Mechanism Of Action :
Inhibits the cycloxygenase
Enzyme
REDUCES PROSTAGLANDIN SYNTHESIS
MOST
IMPORTANT
MECHANISMS
BRAND NAMES
VANCOCIN
ELI LILLY PAKISTAN (PVT)
LTD.
VANCOMYCIN
ABBOTT LABORATORIES (PAKISTAN) LIMITED.
-acts primarily in the CNS
-increases the pain threshold by inhibiting both isoforms of cyclooxygenase,
-COX-1, COX-2 and COX-3 enzymes involved in prostaglandin (PG) synthesis.
When normal dose of
paracetamol is taken major amount is
metabolized by glucuronid e and
sulfate conjugation
Minor amount of highly reactive
quinones/epoxidesare formed
They combine with Glutathione
Converted to harmless products
NO Tissue damage
When large amount of drug is
taken(poisoning)
Large number of highly reactive
quinones/epoxidesare formed
Glutathione supply falls short.
Toxic intermediates are formed within tissue constituents
Tissue damage
NAC SUPPLIES
GLUTATHIONE
S
so detoxifies toxic
metabolites !!
NAC
“MAY”directly
conjugates with
quinones/epoxide.
MAY BE…
NAC has
additional
antioxidant and
antiinflammatory
activity
PERIPHERALLY: PGS sensitize the nerve endings to bradykinin and
histamine
CENTRALLY :
PGs Lower the threshold for central pain
circuits
PAINPCM
blocks..
7
REDUCES
THE
INTENSITY
OF PAIN
ANALGESIC ACTIVITY
Hypothalamus contains thermoregulatory centre
Maintains balance between heat production and heat
loss
It regulates heat dissipating mechanisms
When there is tissue
damage/inflamation/AG:A
B reaction/infec
tion
Neutrophilreleases IL-1
Stimulates COX-2
enzymes
Increased PGE2
synthesis in hypothalamus
PGE2 has two mechanisms :
1. Increases heat production.
2.shuts down HEAT LOSING MECHANISM
Raised body temperature FEVER
NSAIDS inhibits
PGE2 synthesis and
reduces fever
ANTIPYRETIC ACTIVITY
Normally hypothalamus is adjusted to a set
point
When temperatures is elevated beyond
level
Hypothalamus activates heat
losing mechanisms like sweating and
vasodilatation
So temperature is normalized
This set point it elevated in
FEVER
ANTIPYRETIC ACTIVITY
direct effects on heat-
regulating centres of the
hypothalamus
Sweating and
vasodilation,
heat dissipation
IBUPROFEN
WHAT IS IBUPROFEN?
Reduces:
• fever,
• pain
• inflammation
Caused by:
many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury
BRAND NAMES
Brufen®;
Calprofen®;
Nurofen®;
Orbifen®;
Fenbid®
PREPARATIONS
-Tablets:
- 100, 200, 400, 600, and 800 mg;
Suspension:
100 mg/5 ml and 40 mg/ml
-Chewable tablets:
50 and 100 mg;
ALSO AVAILABLE AS:
capsules,
granules,
oral liquid medicine,
modified-release tablets,
orodispersible (melt in the
mouth) tablets
local gel
USUAL ADULT DOSE FOR PAIN:
Oral: Mild to moderate pain:
200 to 400 mg orally every 4
to 6 hours as needed. Doses
greater than 400 mg have not
been proven to provide
greater efficacy
IV: (Patients should be well hydrated
before IV ibuprofen administration):
Pain: 400 to 800 mg intravenously
over 30 minutes every 6 hours as
needed.
USUAL ADULT ANTI-
INFLAMMATORY DOSE
for Osteoarthritis:
Initial dose: 400 to 800 mg
orally every 6 to 8 hours.
Maintenance dose: May be
increased to a maximum
daily dose of 3200 mg based
on patient response and
tolerance.
for Rheumatoid Arthritis:
Initial dose: 400 to 800 mg
orally every 6 to 8 hours.
Maintenance dose: May be
increased to a maximum
daily dose of 3200 mg based
on patient response and
tolerance.
REFERENCES
http://www.drugs.com/ibuprofen.htmlhttp://www.patient.co.uk/medicine/ibuprofen-for-pain-and-inflammationhttp://www.spine-health.com/treatment/pain-medication/nsaids-non-steroidal-anti-inflammatory-drugshttp://www.medicinenet.com/ibuprofen/article.htmhttp://www.medicinenet.com/acetaminophen/article.
htm
https://www=mechanism+of+action+of+paracetamol&tbm=isch&imgdiihttp://www.ncbi.nlm.nih.gov/pubmed/15662292
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