System Medications).
Inflammation
normal body response to tissue damage, body's attempt to remove damaging agent &
repair damaged tissue (pain, edema, redness, heat, loss of function)
Cyclooxygenase (COX)
is the enzyme responsible for synthesis of prostanoids
COX-1
good COX, present in all tissues, primarily mediates beneficial processes: protecting
gastric mucosa, supporting renal function, promoting platelet aggregation
Inhibition of COX-1
results largely in harmful effects: gastic erosion & ulceration, bleeding tendencies, &
renal impairment. Protection against MI & stroke
COX-2
bad COX, primarily mediates harmful processes
COX-2 sites of tissue injury
mediates inflammation & sensitizes receptors to painful stimuli
COX-2 brain
mediates fever & contributes to perception of pain
COX-2 kidney
supports renal function
COX-2 blood vessels
promotes vasodilation
COX-2 colon
contributes to colon cancer
Inhibition of COX-2 beneficial effects
suppression of inflammation, alleviation of pain, reduction of fever, protection against
colorectal cancer
Inhibition of COX-2 adverse effects
renal impairment, promotion of MI & stroke
NSAID
inhibit COX-1 (decreased platelet aggregation & kidney damage) & inhibit COX-2
(decreased inflammation, fever, & pain
NSAIDs therapeutic uses
inflammation suppression, analgesia for mild to moderate pain, fever reduction,
inhibition of platelet aggregation (aspirin)
NSAIDs adverse effects
GI discomfort, GI bleeding & perforation, renal dysfunction, increase risk of heart attack
& stroke
NSAIDs considerations
stop taking aspirin 1 week before elective surgery, take w. food, milk, or water, notify
provider if symptoms of gastric discomfort or salicylism occur
Salicylates medications