Anaesthesia | Pain | Step I: NSAIDS Drugs and Mechanisms, Side Effects and Contraindications

Step I: NSAIDS Drugs and Mechanisms, Side Effects and Contraindications
Session Overview
Description
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly prescribed to relieve acute and postoperative pain. It is therefore important to understand the mechanism of their action, side effects and complications of administration.

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

• Describe the mode of action common to all NSAID drugs
• Explain the clinical uses for NSAIDs
• Describe the common side effects of NSAIDs due to their action on COX
• Recognize the contraindications to using NSAIDs in clinical practice
• Distinguish between COX1 and COX2 inhibition side effects and state the indications for their use

Prerequisites
Before commencing this session you should:

• Module 02/Postoperative and Recovery Care/Postoperative care/Postoperative analgesia: basic principles and analgesic ladder (001-0231)
• Module 05a/Pharmacological Targets/Peripheral nervous system (001-0499)
• Module 05a/Pharmacological Targets/Ceentral nervous system (001-0500)
• Module 07c/Systematic Pharmacology/Analgesics/Simple Analgesia: aspirin and paracetamol (001-0774)
• Module 07c/Systematic Pharmacology/Analgesics/Non-Steroidal Anti-inflammatory Drugs (NSAIDs) (001-0775)

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) are commonly used to treat mild and moderate acute pain. Depending on the type of pain, they can be even more effective than a 10 mg IM dose of morphine.

Unfortunately there is a myriad of side-effects and contraindications to their use. This limits their appropriateness for postoperative use. The majority of these side effects are directly related to their action at the cyclooxygenase (COX) group of enzymes.

Fig 1 Shows the COX pathway

In this session you will review some of the history and pharmacology of the drug group, to enable you to develop a deep understanding of NSAIDs that can easily be translated into clinical practice.