Question

1. What can anti-inflammatory agents be used for?

2. What are the risks of long-term NSAID ingestion?

3. What have you heard about corticosteroid use? What are some of the side effects?

4. What advice to avoid gout do you give to a person who drinks alcohol daily?

Answer 1

1. Anti - inflammatory agents are the substances that reduce or suppress INFLAMMATION. For example - NSAID used to treat moderate to severe pain, rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, menstrual disorders, and headaches.

2. Chronic NSAID use increases the risk of peptic ulcer disease, acute renal failure, and stroke/myocardial infarction.

3. 2 categories of use for corticosteroids:

1. Replacement therapy when secretions of the pituitary or adrenal glands are deficient, as in the tx of Addison's disease= ↓ cortisol - as adrenals do not produce enough corticosteroids.

2. Anti-inflammatory and immunosuppressant agents as below.

uses for corticosteroids:

- Used with other drugs to treat a condition.

- Use in allergic reactions to reduce inflammation in anaphylaxis

- Can use corticosteroids for collagen/connective tissue disorders, rheumatic disorders - where only a few inflamed joints can be injected to ↓ crippling or life-threatening situations - rheumatic carditis or lupus

- Acute flare ups of skin conditions not responding to conservative therapy - topical tx preferable to keep side effects to a minimum

- Acute respiratory disorders - asthma attacks, sarcoidosis, premie infants

- Use prednisone/betamethasone injection to mother 24 hours before delivery to ↑ surfactant in the newborn's alveoli

- Long-term prevention of sx in severe persistent asthma or management of COPD - oral inhalants are preferable with ↓ dose.

#. side effects of corticosteroids:

Prolonged use can impair production of GH and ACTH

*Delayed wound healing and ↑ susceptibility to infection.

*muscle pain or weakness

Fluid and electrolyte imbalance, possibly resulting in edema, K loss and HTN and HF.

*ospo with fx esp in older women

*stunting of growth in children (b/c of premature closure of epiphyseal plates

- Increased

intraocular pressure or cataracts

N/V/D or constipatio

* Cushing's disease d/t ↑steroids (or adrenals produce too much corticosteroids) obesity of the trunk, moon face, acne, hirsutism = ↑ facial hair, amenorrhea and hyperglycemia

*gastric or esophageal irritation, ulceration or hemorrhage

*CNS effects = h/a, vertigo, insomnia, euphoria, psychosis, or anxiety

*petechiae, easy bruising and skin thinning and tearing

4.Modifying one's diet is key to prevent gout such as eating less purine-rich food, in addition to losing weight, limiting alcohol, and changing or stopping medications associated with hyperuricemia