Amoud UniversityHealth science Institute

Faculty of Nursing Presentation

Non-opioid Analgesics

Group manes

Sadiiq Abdi ElmiMubaarik Mahamuud SaleebanUmulkhair Bashiir Mahamuud

Sadiiq Abdi ElmiMubaarik Mahamud saleebanUmulkhair bashir mahamuud

Group names

Pain relievers of Non-opioid Analgesics

pain

Pain is a sensory and emotional experience associated with actual or potential tissue damage. The perception of pain is apart of clinical presentation in many disorders and is one of the hardest sensations for patients to cope with during the course of disease or dysfunction

ActionsInhibit platelet aggregation, decrease the risk of thromboses and reduce the product at the site of injury of prostaglandin, They either stop pain signals from going to the brain or alter the brain’s interpretation of those signals. Non-opioid prevent the brain from processing pain signals, yet do not rely on anesthesia or loss of consciousness to achieve their pain-killing effect. . E.g. Acetaminophen provides relief from pain by elevating the amount of pain you can tolerate before you experience the feeling of pain.

Uses Non-opioid analgesics are a type of drugs used to treat pain fever, inflammation and reduction of platelet aggregation.Non-opioids are a quick and effective way of coping with mild to moderate pain. While these drugs do not treat the cause of the pain, they can provide enough relief to make people more comfortable and to allow them to carry out their daily routines. NSAIDs are part of non-opioids that indicated for pain that involves inflammation as an underlying pathologic process because of their ability to suppress production of inflammatory prostaglandins.

Cont…

NSAIDs are both analgesic and anti-inflammatory, and may be useful for the treatment of pain not involving inflammation as well .Aspirin is used for primary and secondary prevention of coronary artery disease, stroke, and some colorectal cancers. Acetaminophen and NSAIDs are useful for acute and chronic pain

Cont..

oNon-opioid analgesics are used treat pain fromarthritis, osteoarthritis, rheumatoid arthritis,minor injuries and trauma pain .headaches, including tension headaches and migraines Some types of eye pain and ear painJoint painToothaches and other types of dental painmenstrual cramps and other types of pelvic paintrauma, arthritis, surgery, cancer

Generic name Uses Adverse reaction Dosage

Acetaminophen(paracetamol)

headache, toothache, joint pain,

Fatal liver, kidney damage, stomach bleeding

Po (adult)325-650mg q4-6hrs or 1g 3-4times daily or 1300mg q 8hrs not to exceed 4g or 2.5g/day in pt with hepatic/renal impairment

Aspirin Inflammatory disorders, fever, prophylaxis of transit ischemia

Hearing loss, tinnitus, Gi bleeding, epigasteric distress, hurt burn, nausea, abdominal pain, vomiting, anorexia, hypotoxity, anemia, hemolysis,

325-500mg q3hrsOr 325-650mg q4hrs

Diclofenac Inflammatory disorders, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis , dysmenorrhea, mild to moderate pain

Dizziness, Drowsiness, Haedache.HTN, Diarrhea, Abdominal pain, Heartburn, Acute renal failure, hematauria,nephritis and so on

Po 100mg-50mg TID, 25mg TID

Nefopam Moderate pain Sweating, tachycardia, dry mouth, difficulty micturition,

Po 30-90mgIM 20mg

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Generic name

Uses Adverse reaction Dosage

Ibuprofen Dysmenorrhea, inflammatory disorders including rheumatoid arthritis, osteoarthritis

Headache, dizziness, drowsiness, blurred vision, tinnitus, arrhythmias, edema, GI bleeding, Hepatitis, constipation, dyspepsia, nausea, vomiting, abdominal discomfort , hematauria .renal failure, allergic reactions

Po 400-800mg 3-4times daily (not exceed 3600mg/dayPo(children)20-40mg/kg/day in 3-4 divided doses( not exceed 50mg/kg/day)

Etodolac Osteoarthritis, rheumatoid arthritis, mild to moderate pain

Dizziness, drowsiness, depression, insomnia, malaise, nervousness, syncope, weakness

Po (adults) 200-400mg q 6-8hrs (not exceed 1200mg/day)

Flurbiprofen Inflammatory disorders, including, rheumatoid arthritis, osteoarthritis

Dizziness, drowsiness, headache, insomnia, mental depression, psychic disturbances, blurred vision, change in blurred vision, nausea, diarrhea, chills fever, constipation

Po 200-300mg BID Not exceed 300mg/daily

Generic name

Uses Adverse reaction Dosage

Indomethacin Inflammatory disorders including, rheumatoid arthritis, gouty arthritis, osteoarthritis

Same as Flurbiprofen

Po 25-50mg 4xdailyRect 50mg 4x daily

KetoprofenInflammatory disorders including, rheumatoid arthritis, osteoarthritis, mid to moderate pain including dysmenorrhea and fever.

Same as Indomethacin

Anti inflammatory po150-300mg/dayAnti pain 12.5 q4-6hrs

Ketorolac Short term management of pain(not exceed for five days)

Drowsiness, abnormal thinking, dizziness, euphoria, headache, asthma, dysepnea, edema polar vasodilatation, abnormal test, GI pain, nausea, urinary frequency, renal toxity injection.

Po 10mg q4-6hrs prn not exceed 40mg/day

Meclofenamate

Mefanamic acid

Generic name

Uses Adverse reaction Dosage

Naproxen Mild to moderate pain , dysmenorrhea, fever, inflammatory disorders, rheumatoid arthritis, osteoarthritis

Same as Ketorolac

Po 250-500mg bid

Oxaprozin Rheumatoid arthritis, osteoarthritis

Abdominal pain, insomnia, abnormal liver function, duodenal ulcer, n/v/d, gastritis, prolonged bleeding time, jaundice, agitation,

Po 1200mg once daily

Piroxicam Management of inflammatory disorders including rheumatoid arthritis, osteoarthritis, dysmenorhea

Drowsiness, headache , dizziness, blurred vision, tinnitus, N/V/D ,constipation, renal failure , allergic reactions

Po 10-20mg /day

Rofecoxib Rheumatoid arthritis, osteoarthritis, dysmenorhea

fatigue HTN, lower extremity edema, GI bleeding, anemia, allergic reaction including anaphylaxis

Po 12.5mg once daily initially , may be increased 25mg once daily

Adverse reactionPlatelet Dysfunction Gastritis and peptic ulceration with bleeding.Acute Renal Failure in susceptible Sodium+ water retention and edemaAnalgesic nephropathyProlongation of gestation and inhibition of labor.Hypersensitivity.GIT bleeding and perforationCommon side effects of NSAIDs include: upset stomach, nausea, abdominal pain, diarrhea, heartburn, unusual bleeding, drowsiness, dizziness, skin rashes. More severe side effects of NSAIDs include: allergic reactions, high blood pressure, stomach bleeding, stomach ulcers (with long-term use), kidney or liver problems

ContraindicationsHypersensitivity and cross-sensitivity among NSAIDS may occur

precautions

oUse cautiously in patient with severe hepatic or renal disease, chronic alcohol use/abuse or malnutrion .oshould be avoided by people who:Are taking blood pressure medicinesHave stomach ulcers or a history of ulcersHave kidney problemsWill have surgery within a week

InteractionLong term use of acetaminophen with Nsaids may increase the risk of adverse renal effects. Nsaids may decrease the effectiveness of diuretics and antihypertensive .

Interaction

DuiticsAntihypertensive drugsCephalosporin's

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