6. 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
7. Actions
Inhibit 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.
8. 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.
9. 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
10. Cont..
oNon-opioid analgesics are used treat pain from
arthritis, osteoarthritis, rheumatoid arthritis,
minor injuries and trauma pain .
headaches, including tension headaches and
migraines
Some types of eye pain and ear pain
Joint pain
Toothaches and other types of dental pain
menstrual cramps and other types of pelvic pain
trauma, arthritis, surgery, cancer
11. Generic name Uses Adverse reaction Dosage
Acetaminophen(p headache, toothache, joint Fatal liver, kidney Po (adult)325-
aracetamol) pain, damage, stomach 650mg q4-6hrs or
bleeding 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, Hearing loss, tinnitus, 325-500mg q3hrs
fever, prophylaxis of Gi bleeding, epigasteric Or 325-650mg
transit ischemia distress, hurt burn, q4hrs
nausea, abdominal pain,
vomiting, anorexia,
hypotoxity, anemia,
hemolysis,
Diclofenac Inflammatory disorders, Dizziness, Drowsiness, Po 100mg-50mg
rheumatoid arthritis, Haedache.HTN, TID, 25mg TID
osteoarthritis, ankylosing Diarrhea, Abdominal
spondylitis , dysmenorrhea, pain, Heartburn, Acute
mild to moderate pain renal failure,
hematauria,nephritis
and so on
Nefopam Moderate pain Sweating, tachycardia, Po 30-90mg
dry mouth, difficulty IM 20mg
12. Generic name Uses Adverse reaction Dosage
Ibuprofen Dysmenorrhea Headache, dizziness, drowsiness, Po 400-800mg 3-
, inflammatory blurred vision, tinnitus, 4times daily (not
disorders arrhythmias, edema, GI bleeding, exceed 3600mg/day
including Hepatitis, constipation, dyspepsia, Po(children)20-
rheumatoid nausea, vomiting, abdominal 40mg/kg/day in 3-4
arthritis, discomfort , hematauria .renal r
divided doses( not
osteoarthritis failure, allergic reactions exceed
50mg/kg/day)
Etodolac Osteoarthritis Dizziness, drowsiness, depression, Po (adults) 200-
, rheumatoid insomnia, malaise, nervousness, 400mg q 6-8hrs
arthritis, mild syncope, weakness (not exceed
to moderate 1200mg/day)
pain
Flurbiprofen Inflammatory Dizziness, drowsiness, headache, Po 200-300mg BID
disorders, insomnia, mental depression, Not exceed
including, psychic disturbances, blurred 300mg/daily
rheumatoid vision, change in blurred vision,
arthritis, nausea, diarrhea, chills fever,
osteoarthritis constipation
13. Generic name Uses Adverse reaction Dosage
Indomethacin Inflammatory Po 25-50mg 4xdaily
disorders including, Rect 50mg 4x daily
rheumatoid Same as Flurbiprofen
arthritis, gouty
arthritis,
osteoarthritis
Inflammatory
Ketoprofen disorders including Anti inflammatory po
, rheumatoid 150-300mg/day
arthritis, Same as Indomethacin Anti pain 12.5 q4-
osteoarthritis, mid 6hrs
to moderate pain
including
dysmenorrhea and
fever.
Ketorolac Short term Drowsiness, abnormal Po 10mg q4-6hrs prn
management of thinking, dizziness, euphoria, not exceed 40mg/day
pain(not exceed for headache, asthma, dysepnea,
five days) edema polar vasodilatation,
abnormal test, GI pain,
nausea, urinary frequency,
renal toxity injection.
Meclofenamate
14. Generic name Uses Adverse reaction Dosage
Naproxen Mild to moderate pain , Po 250-500mg bid
dysmenorrhea, fever,
inflammatory Same as Ketorolac
disorders, rheumatoid
arthritis,
osteoarthritis
Oxaprozin Rheumatoid arthritis, Abdominal pain, insomnia, Po 1200mg once daily
osteoarthritis abnormal liver function,
duodenal ulcer, n/v/d,
gastritis, prolonged
bleeding time, jaundice,
agitation,
Piroxicam Management of Drowsiness, headache , Po 10-20mg /day
inflammatory disorders dizziness, blurred vision,
including rheumatoid tinnitus, N/V/D
arthritis, ,constipation, renal failure
osteoarthritis, , allergic reactions
dysmenorhea
Rofecoxib Rheumatoid arthritis, fatigue HTN, lower Po 12.5mg once daily
osteoarthritis, extremity edema, GI initially , may be
dysmenorhea bleeding, anemia, allergic increased 25mg once
reaction including daily
anaphylaxis
15. Adverse reaction
Platelet Dysfunction
Gastritis and peptic ulceration with bleeding
.Acute Renal Failure in susceptible Sodium+
water retention and edema
Analgesic nephropathy
Prolongation of gestation and inhibition of labor.
Hypersensitivity.
GIT bleeding and perforation
Common 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
16. Contraindications
Hypersensitivity 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 medicines
Have stomach ulcers or a history of ulcers
Have kidney problems
Will have surgery within a week
