Nsaid Guideline

Non-Steroidal Anti-
Inflammatory Drugs
(NSAIDs)
Disediakan Oleh : Nassruto

OBJEKTIF
1. Memberi definisi ‘Non-Steroidal

Anti-Inflammatory Drugs
(NSAIDs)’.
2. Menyatakan tujuan/ indikasi ubat.
3. Menyatakan dos dan contoh ubat.
4. Menyatakan kaedah pemberian
ubat.
5. Menyatakan tindakan ubat.
6. Menerangkan kesan sampingan
dan kontraindikasi ubat.
7. Memberikan nasihat spesifik
dalam pengambilan ubat.
NSAIDs
• Sejenis ubat analgesic (non-
narcotic)
• Tidak tergolong dalam
kumpulan ubat steroid.
• Maka tidak menghasilkan
kesan sampingan berkaitan
steroid.
• Walaupun bukan dari
kumpulan steroid, NSAIDs
mempunyai kesan
• Anti-inflammatory
• Analgesics
• Antipyretics
Tindakan ubat
• NSAIDs bertindak dengan

menghalang penghasilan
prostaglandin.
• Prostaglandin:
– A group of naturally
occurring fatty acids that
act within the body to:
• Regulate acid secretion in
stomach
• Regulate body temperature
• Regulate platelet aggregation
• Control inflammation
• Maka dengan pengurangan
prostaglandin, NSAIDs
menghasilkan kesan:
• Anti-Inflammatory
• Analgesics
• Antipyretics
General Indication
• Relief of symptoms of
- Osteoarthritis
- Rheumatoid arthritis
- Musculoskeletal disorders
• Mild to moderate pain relief
• Primary dysmenorrhea
• Fever reduction
Contoh ubat
• Diclofenac sodium
(Voltaren)
• Ibuprofen (Brufen)
• Indomethacin (Indocid)
• Ketoprofen (Orudis)
• Mefenamic Acid (Ponstan)
• Naproxen (Naprosyn)
• Piroxicam (Feldene)
1. Diclofenac sodium
(Voltaren)
Tindakan
• Antipyretics
• Analgesics
Indication
• Rheumatoid arthritis
• Osteoarthritis
• Spondylitis
• Acute gout
• Post operative inflammation
1(a). Diclofenac sodium
50mg tablet
(Voltaren)
Category: B
Dose
• Rheumatoid & Osteoarthritis:

• 100-150mg/d PO (divided
doses)
• Spondylitis:
• 100-125mg/d PO (divided
doses)
• Long term:
• 75-100mg/day PO (2-3 divided
doses)
• Max: 150mg/day
• Peads > 1yr:
• 1-3mg/kg/day (divided dose)
Note: Take this medicine after food

1(b). Diclofenac sodium
75mg/3ml Inj
(Voltaren)
Category: A
Dose
• 75mg once daily IM
• Severe cases: 75mg bd IM
• Max 2 days
1(c). Diclofenac sodium
1% Emulgel
(Voltaren)
Category: A
Dose
• Apply tds-qid & gently rub
1(c). Diclofenac sodium
12.5mg/ 25mg/ 50mg suppositories
(Voltaren)
Category: A
Dose
• Adult:
• 75-150mg/day (divided dose)
• Peads 1-12 yr:
• 12.5-25mg/day
2. Ibuprofen 200mg tablet
(Brufen)
Category: B
Tindakan
• Antipyretics
• Analgesics
Indication
• Mild to moderate pain

• Rheumatic & Arthritis
disorders
• Painful dysmenorrhea
Dose
• Adult:
• 200-400mg tds
• Max: 2.4g/day
• Peads:
• 20-30mg/kg/day (divided
dose)

3. Indomethacin
(Indocid)
Tindakan
• Antipyretics
• Analgesics
Indication
• Spondylitis
• Mild to moderate
osteoarthritis
• Acute gouty arthritis
• Acute shoulder pain
3(a). Indomethacin
25mg capsule
(Indocid)
Category: B
Dose
• Adult:
• 50-200mg/day (divided dose)
• Peads:
• Not recommended

3(b). Indomethacin
100mg suppository
(Indocid)
Category: B
Dose
• Adult:
• 100mg ON
• Peads:
• Not recommended
4. Ketoprofen
(Orudis)
Tindakan
• Analgesics
Indication

• Rheumatoid disorders
• Painful dysmenorrhea
4(a). Ketoprofen
100mg/2ml Inj
(Orudis)
Category: A*
Dose
• Adult:
• 50-100mg q 4 hr deep IM
• Max: 200mg/day for up to 3
days
• Peads:
• Not recommeded
4(b). Ketoprofen
200mg Slow Release capsule
(Orudis)
Category: A
Dose
• Adult:
• 100-200mg/day
• Peads:
• Not recommeded

4(c). Ketoprofen
2.5% gel (Orudis)
Category: A
Dose
• Apply twice daily
• Max: 20g/day
4(d). Ketoprofen
30mg transdermal patch (Orudis)
Category: A
Dose
• Apply 1 plaster to the
affected area bd
5. Mefenamic Acid
250mg capsule/ tablet
(Ponstan)
Category: B
Tindakan
• Antipyretics
• Analgesics
Indication
• Moderate pain (does

not exceed 1 week)
Dose
• Adult:
• 250-500mg tds PO (PRN)
• Limits to 7 consecutive
days

• Peads > 6 months:
• 6.5-25mg/kg tds-qid PO
(PRN)
• Limits to 7 consecutive
days

6. Naproxen 250mg tablet
(Naprosyn)
Category: A
Tindakan
• Analgesics
Indication

• Osteoarthritis
• Spondylitis
• Acute gout
Dose
• Arthritis & spondylitis:

• 500-1000mg/day (2 divided
dose)
• Acute gout:
• Initial: 750mg then 250mg q 8
hr (jika perlu)
• Musculoskeletal disorders &
dysmenorrhea:
• Initial: 500mg the 250mg q 6-8
hr (jika perlu)

7. Piroxicam 10mg capsule
(Feldene)
Category: A
Tindakan
• Analgesics
Indication
• Osteoarthritis
• Spondylitis
• Acute gout
• Primary dysmenorrhea
Dose
• Arthritis & spondylitis:
• 20mg/day
• Maintenance: 10-30mg/day
(single or divided dose)
• Acute gout:
• 40mg/day (single or divided
dose) for 4-6 days
• Musculoskeletal disorders:
• 40mg/day (single dose or
divided dose) for 2 days
• Then 20mg/day for 7-14
days

Kesan sampingan
• Gastrointestinal:
– Nausea
– Vomiting
– Diarrhea
– Epigastric distress
– Intestinal ulceration
– GI bleeding
• CNS:
– Dizziness
– Anxiety
– Insomnia
– Depression
• Renal:
– Hematuria
– Elevated blood urea
nitrogen
• Cardiovascular:
– Congestive heart failure
– Decreased or increased BP
• Hematologic:
– Pancytopenia
– Leukopenia
– Thrombocytopenia
– Aplastic anemia
• Skin:
– Rash
– Irritation
– Skin eruption
– Steven-Johnson syndrome
• Metabolic/ endocrinologic:
– Decreased appetite
– Weight increase or decrease
– Menstrual disorders
• Special senses:
– Visual disturbances
– Blurred vision
– Photophobia
– Tinnitus
– rhinitis
Contraindication
• Allergic to NSAIDs
• Pregnancy
• Lactation
• Labor
• Renal & hepatic impairment
• Bleeding disorders
Cautious
• Impaired hearing
• Cardiovascular disease
• GI condition
• Hypertension
• Elderly
Interactions
• Anti-coagulants, lithium
– Risiko pendarahan
• Diuretics, anti-hypertensives
– Kesan diuretics &
antihypertensives berkurang
• Paracetamol (long-term)
– Renal impairment
Nasihat
• Ubat diambil selepas sarapan
(kurangkan GI symptom)
• Periksa simptom pendarahan
salur GI (najis gelap)
• Elakkan pengambilan alkohol
• Monitor berat badan selalu
(kehadiran edema)
• Lapor kepada pegawai
perubatan & hentikan
pengambilan ubat jika berlaku
kesan sampingan seperti:
– Vertigo, ruam, hematuria,
gangguan pendengaran &
pengelihatan
Soalan
1. Berikan definisi ubat NSAIDs?
2. Terangkan cara tindakan ubat
NSAIDs?
3. Senaraikan contoh ubat NSAIDs
dan indikasinya?
4. Nyatakan kesan sampingan dan
kontraindikasi ubat NSAIDs?

Nsaid Guideline

Uploaded by

Copyright:

Available Formats

Nsaid Guideline

Uploaded by

Document Information

Original Description:

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Nsaid Guideline

Uploaded by

Copyright:

Available Formats

Non-Steroidal Anti-

Disediakan Oleh : Nassruto

1. Memberi definisi ‘Non-Steroidal

• NSAIDs bertindak dengan

• Rheumatoid & Osteoarthritis:

Note: Take this medicine after food

• Mild to moderate pain

Note: Take this medicine after food

Note: Take this medicine after food

• Mild to moderate pain

Note: Take this medicine after food

• Moderate pain (does

Note: Take this medicine after food

Note: Take this medicine after food

• Mild to moderate pain

• Arthritis & spondylitis:

Note: Take this medicine after food

Note: Take this medicine after food

You might also like