Drugs

How should a clinician proceed if one NSAID fails to provide sufficient pain relief? If an adequate trial of one class of NSAID does not cause analgesia, the clinician should switch to an alternative class of NSAID. For example, if an agent from a salicylate group is considered ineffective, it is recommended to change to …

How should a clinician proceed if one NSAID fails to provide sufficient pain relief Read More »

Which agent is considered to be the drug of choice for pain control? There is no conclusive evidence supporting one NSAID over another for analgesia. Frequency of dosing, cost, and side-effect profile should be considered when deciding on a specific NSAID agent for pain control. Following a review of the overall efficacy of the NSAIDs …

Drug of choice for pain control Read More »

adequate trials of nonsteroidal antiinflammatory drugs for pain control An analgesic should not be considered a failure unless it has been given an adequate trial. For non-cancer-related pain, 2 weeks of treatment with a maximum scheduled dose constitutes an adequate trial. For cancer-associated pain, a 1-week duration of continuous dosing is considered sufficient. However, ketorolac …

Adequate trials of NSAIDS for pain control Read More »

What is the risk of nephrotoxicity with nonsteroidal antiinflammatory drugs? Aspirin and NSAIDs at therapeutic doses generally do not cause renal disease in patients with normal renal function. However, problems such as nephrotic syndrome, acute interstitial nephritis, and acute renal failure have been observed when aspirin and other nonsteroidals are given to patients with abnormal …

Risk of nephrotoxicity with NSAIDS Read More »

What are the risks of combining nonsteroidal antiinflammatory drugs with acetaminophen? The risk of analgesic nephropathy appears to increase when different NSAIDs are used together or in combination with acetaminophen. This effect is generally seen in long-term use. The primary lesion is papillary necrosis with secondary interstitial nephritis.

Clinical presentation for acute acetaminophen overdose Symptoms of acetaminophen overdose include vague abdominal pain during the first week, followed by signs of hepatic failure. Acetaminophen, at doses of 400 mg/kg, can be fatal.

most common side effects associated with the traditional nonsteroidal antiinflammatory drugs. Gastrointestinal (GI) irritation, nausea, and impairment of platelet aggregation are the most common side effects associated with the traditional NSAIDs. These side effects may lead to dyspepsia, GI ulcers, and bleeding. Some of the nonacetylated salicylates (e.g., choline magnesium trisalicylate) do not inhibit platelet …

Most common side effects of NSAIDS Read More »