Pain and inflammation + drugs use for pain and inflammation
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Nouman Azmat MinhasSenior Professional Services Representative
Pfizer Pakistan LTD.
Base Town - Rawalpindi
– Presented By :-
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DRUGS USE FOR THE TREATMENT OF
PAIN & INFLAMATION
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An unpleasant sensation occurring in varying degrees of severity as a consequences of injury, disease, or emotional disorder.
Suffering or distress. Pain is a feeling or a perception it varies from
person to person and its intensity depends upon individual response to stimuli.
Informal a source of annoyance; A nuisance.
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TYPES OF
Acute pain
Chronic pain
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Having a rapid onset and following a short but severe course.
Afflicted by a disease exhibiting a rapid onset followed by short, severe course.
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Lasting for a long period of time or marked by frequent recurrence, as certain
disease.
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Types Of PainInitiators
Chemical
Mechanical
Thermal
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Cell Membrane Thermal
Chemical
Phospholipids
OtherInfection
Trauma
Lipoxygenase
Mechanical
Cycloxygense
Phospholipase
Arachidonic Acid
Disruptions
Leukotrins Prostaglandins
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PROSTGLANDINS Basic Facts
Prostaglandins are unsaturated fatty acids.
PG are of nine types, A,B,C,D,E,F,G,H and I.
PG are formed on demand.
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Reaction of living tissue to all forms of injury.
The body’s major defenses against injury and infection in an attempt to localize and heal it.
It may vary in timing and intensity , depending on its cause & the type of tissue.
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Agents Causing
Can broadly classify into four major types:
1) Biological
2) Chemical
3) Physical
4) Immunological
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Types Of
An inflammation that lasts for a few minutes, several hours or one to two days.
An inflammation that persists for months or years.
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Signs Of
1) Pain
2) Heat
3) Redness
4) Swelling
5) Loss of function
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TISSUE INJURY
MAST CELL RELEASE HISTAMINE,KININS,SEROTININ & PROSTAGLANDINS
INCREASED PERMEABILITY
EXDUATE PASSES THROUGHCAPILLART WALL TO INJURED AREA
MIGRATION OF LEUKOCYTESINCREASED BLOOD FLOW
SWELLINGHEAT AND REDNESS
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• Enzyme that catalyze the synthesis of PGs• Purified in 1976 and cloned in 1988.• A second COX-2 was discovered in 1991.• The two known COX forms are similar in
size and kinetics but vary in theira) Expression
b) Distribution
COX ( Cycloxygenase )
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COX-1 ( The Good COX )
• Cox-1 is present in most cells throughout the body and produce PGs which involved in the physiological processes known as “housekeeping function” also called Good COX.
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COX-2 “The Bad COX”• Inducible form, found in inflammatory and
immune cells.• At the sight of inflammation, COX-2 is
responsible for the generation of the hyperalgesic (pain causing) and pro-inflammatory PGs.
• COX-2 is also present in the CNS, where it involved in fever and Neuro-transmission of pain.
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• The drug concentration that inhibits the activity of the enzyme by 50%.
• The lower the IC-50 the stronger is the drug.
• Cox-1/Cox-2 are determined in ratio.• Ratio more than 1 = Cox1 selective• Ratio less than 1 = Cox2 selective
Concept Of IC-50
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• Arthritis.• Rheumatoid Arthritis.• Osteoarthritis.• Ankylosing Spondilitis.
Pain Related Diseases
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Arthritis
• Any type of joint pain or inflammation is called arthritis.
• Multiple Etiology.• Treatment options includes NSAID and
selective And specific COX inhibitors.• If untreated will lead to complications.
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Rheumatoid Arthritis
• A systemic connective tissue disorder.• Involving multiple joints.• Usually Small joints.• Symmetrical joints.• Morning stiffness.• Positive RA factor.
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Osteoarthritis is a disease of joint characterized by cartilage loss with an accompanying periarticular bone response.
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Symptoms of
• Joint pain.
• Joint Instability.
• Loss of joint function.
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Signs of
• Joint tenderness.• Crepitus in movement.• Limitation of movement.• Joint Instability.• Joint effusion.• Bony swelling.• Wasting of muscles.
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Treatment Options of
• Simple Analgesics.
• NSAIDs.
• COX-2 Inhibitors.
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• Inflammatory disease of back especially effecting young.
• There is white cells infiltration.
• Erosion of bone at the place of ligament attachment.
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Symptoms of
• Episodic sacroiliac pain.• Buttock Pain.• Stiffness in morning.• Low stiffness after exercise.• Para spinal muscle wasting.
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Treatment of
• Simple Analgesics.
• NSAIDs.
• COX-2 Inhibitors
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DRUGS USED IN PAIN & INFLAMMATION
NON-NARCOTICS ANALGESICS
NARCOTIC ANALGESICS
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ROLE OF IN PAIN & INFLAMMATION
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This is a group of medicine which are usedfor the treatment of pain and inflamation.These medicines are also used inosteoarthritis, rheumatoid arthritis and otherconditions associated with pain.
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CARBOXYLIC ACID ENOLIC ACIDNON ACID COMPOUNDS
SALICYLIC ACID & ESTERS
ACETIC ACID PROPIONIC ACID FENAMIC ACID
PHENYLACETIC ACIDS
CARBOCYCLIC &HETEROCYCLIC
ACETIC ACIDS
PYRAZOLONES OXICAMS
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ANY QUESTION ???
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