04b_11_11 The Pharmacology of NSAIDs in Children

The Pharmacology of NSAIDs in Children
Session Overview
Description
This session will explore the analgesic effect and toxicity of non-steroidal anti-inflammatory drugs in children.

Learning Objectives
By the end of this session you will be able to:

• Describe the mechanism of action of NSAIDs in children
• Review available dose-response relationships
• Balance analgesic effect against adverse effects

Prerequisites
Before commencing this session you should complete the following:

• NSAIDs and paracetamol (001-0409)

The archetype non-steroidal anti-inflammatory drug (NSAID) is aspirin.

Salicylic acid is an analgesic/antipyretic described by both the ancient Egyptians (extracted from myrtle leaves) and the Greeks (willow bark and leaves). Gastric irritation, its main adverse effect, was reduced by buffering with sodium and acetyl chloride to create acetylsalicylic acid. The German pharmaceutical company, Bayer, named the drug Aspirin (1899). The ‘a’ stands for acetyl chloride, the ‘spir’ comes from the plant spiraea ulmaria (meadowsweet) that salicylic acid was derived from, and the ‘in’ because it is a cool ending for a drug name.

The drug rapidly became a panacea (and remains so) for a multitude of ills that range from analgesia and fever control through to prevention of myocardial infarction, cerebrovascular accidents and eclampsia.

Aspirin remains the best selling pain killer in the world. Use in children is limited because of its association with Reye’s syndrome.