UNDER REVIEW (April 2017)
Mechanism of Action:
Non-selective cyclo-oxygenase (COX) inhibitor; antiinflammatory antipyretic analgesic. Inhibition of COX reduces the production of proinflammatory eicosanoids (prostalandins and thromboxanes). Certain PGs (PGE2 and PGI2) sensitize the nociceptive terminals to endogenous algogens, so by reducing the production of these prostanoids, aspirin removes the sensitizing action and so causes analgesia. PGs and TXs are formed de novo in the periphery and CNS (including spinal cord) – they are not stored in cells.
Lecture and CAL materials:
- Lecture: Pharmacodynamics I and II
- Lecture: Introduction to Cardiovascular Pharmacology
- Lecture: Drugs used in Ischaemic Heart Disease
- Lecture: Pain and Analgesia (Lecture 2): Analgesics and other drugs used to treat pain
- Lecture: Pain and Analgesia (Lecture 3): Anti-inflammatory Drugs
- Lecture: Venous Thrombo-Embolism: Pathogenesis, prevention and treatment
- CAL: Coronary Circulation
- CAL: Haemostasis
- CAL: Pharmacology of Inflammation
Drug specifics
| Alternative drug name | Acetylsalicylic acid (ASA) |
| Effects | Antiinflammatory Analgesics: Reduces pain and inflammation by reducing inflammatory actions of eicosanoids, particularly the prostanoid PGE2 - COX-2 is upregulated in inflamed tissue. Antipyretic in fever. Antiplatelet agents: |
| Adverse actions | Antiinflammatory Analgesics: GI disturbance - nausea, dyspepsia. Skin reactions, itching; Chronic = risk of peptic ulcer from inhibition og COX-1; inhibit thromboxane synthesis increasing bleeding by preventing platelet agreggation; induces asthma in many asthmatics via bronchospasm; tinnitus in high doses, also confusion, hyperexia (normally acts as antipyretc in febrile states) and acid-base disturbance leading to hyperventilation, reduced renal blood flow and glomerular filtration rate (COX-2 promotes production of vasodilator PGE2 - inhibition of the enzyme stops this), Reye's syndrome in under 16s. see eBNF . Antiplatelet agents: |
| Dose | Antiinflammatory Analgesics: see eBNF Antiplatelet agents: |
| Interactions | Antiinflammatory Analgesics: see eBNF Antiplatelet agents: |
| Contraindications | not specified |
| Comments | Antiinflammatory Analgesics: Indometacin (indomethacin) is a methylated indole derivative and a member of the arylalkanoic acid class of NSAIDs, which includes diclofenac. It is a non-selective COX inhibitor. Antiplatelet agents: |
| Contributors |
eDrug by