1. This class of drugs is contraindicated in those who are allergic to acetaminophen, analgin, aspirin or other NSAIDs. Anacin is prohibited for those who are allergic to sulfonamides.
2, most of the NSAID can cross the placental barrier, and secreted by the breast milk, the fetus or newborns have serious effects, so it is prohibited for pregnant and lactating women. nimesulide is prohibited for children under 12 years of age.
3. Aspirin is contraindicated in patients with gastrointestinal bleeding; Loxoprofen is contraindicated in patients with active peptic ulcers, severe hematologic abnormalities, severe hepatic and renal abnormalities, and severe cardiac abnormalities: indomethacin is contraindicated in patients with active ulcers, ulcerative colitis, and other upper gastrointestinal tract disorders or histories; diclofenac, nabumetazone is contraindicated in patients with active bleeding peptic ulcers; gastric ulcer, duodenal ulcer, chronic gastric disease or history of gastric ulcer, duodenal ulcer, or gastric ulcers. Piroxicam is contraindicated in patients with gastric ulcers, duodenal ulcers, chronic gastric disease or a history of such pain; nimesulide is contraindicated in patients with active peptic ulcers and moderate or severe liver damage and severe renal insufficiency; celecoxib is contraindicated in patients with severe liver damage.
4. Aspirin is contraindicated in patients with hemophilia or thrombocytopenia; Indomethacin can be exacerbated in patients with epilepsy, Parkinson's disease and psychiatric disorders; diclofenac is contraindicated in patients with anusitis who are given diclofenac rectally; Celecoxib is contraindicated in patients with a history of myocardial infarction or a history of stroke.
Drug interactions:
1, aspirin and other NSAIDs in combination with the efficacy is not enhanced, but can reduce the bioavailability of other NSAIDs, gastrointestinal side effects, including increased risk of ulceration, bleeding, platelet aggregation inhibition is enhanced, but also increase the risk of bleeding at other sites.
2, p-Acetamid Vinpocetine when combined with aspirin, salicylic acid preparations or other NSAIDs in large quantities for a long period of time, can significantly increase nephrotoxicity, including renal papillary necrosis, renal cancer and bladder cancer.
3, this class of drugs in addition to celecoxib, nabumetone and heparin, coumarin and other anticoagulants or antiplatelet agents can increase the risk of bleeding.
4, NSAIDs and diuretics should be supplemented with adequate water, before the start of treatment should monitor renal function. Avoid acute renal failure.
5, NSAIDs and angiotensin II receptor blockers have a synergistic inhibitory effect on glomerular filtration, when renal function is affected by the symptoms will be aggravated. For elderly patients and or dehydrated patients, the combination of the two due to the direct impact of glomerular filtration may cause acute renal failure. Renal function should be monitored at the start of treatment and patients should be rehydrated regularly. In addition, the combination reduces the antihypertensive effect of ACEI and angiotensin II receptor blockers, resulting in a partial loss of efficacy (due to inhibition of the vasodilatory effect of prostaglandins). receptor blockers in combination, so that the antihypertensive effect of the latter will be reduced due to the inhibition of the vasodilatory effect of prostaglandins.
6, through the renal prostaglandin-mediated effects, NSAIDs increase the nephrotoxicity of cyclosporine. Renal function should be measured during co-administration. Careful monitoring of renal function is especially needed in elderly patients.
7, NSAIDs and lithium salts in combination, can reduce lithium salts from urinary excretion, increase the plasma drug concentration of lithium salts, may reach the concentration of toxicity.
Single-choice questions
The drug that can be used as the first choice antipyretic, especially suitable for the elderly and children is
A. Anacin
B. Ibuprofen
C. Benoit
D. Aspirin
E. Acetaminophen
Answer E.