Paper I
2016 October (Supplementary) (2010 Scheme) · 40 marks · 120 min

Question

Classify NSAIDs. Mention the therapeutic uses and adverse effects of salicylates. (2+2+2=6)

Q16 marksEssays

Answer

Classification of NSAIDs

  • Salicylates: Aspirin
  • Propionic acid derivatives: Ibuprofen, Naproxen
  • Acetic acid derivatives: Diclofenac, Indomethacin
  • Selective COX-2 inhibitors: Celecoxib

Therapeutic uses of salicylates

  • Analgesic-antipyretic for mild-moderate pain, fever
  • Anti-inflammatory in rheumatic disorders (high dose — rheumatoid arthritis, acute rheumatic fever)
  • Antiplatelet — low-dose aspirin for secondary prevention of myocardial infarction/stroke
  • Kawasaki disease (high dose, with IVIG)

Adverse effects of salicylates

  • Gastric irritation, peptic ulceration, GI bleeding
  • Bronchospasm in aspirin-sensitive asthmatics
  • Reye’s syndrome (in children with viral infections)
  • Salicylism (tinnitus, vertigo, hyperventilation) with chronic high-dose use
  • Bleeding tendency
  • Salicylate poisoning — respiratory alkalosis followed by metabolic acidosis, hyperthermia

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