NSAIDs

KP Magazine

    12:23 PM  -  Public

Aspirin, the only NSAID able to irreversibly inhibit COX-1, is also indicated for inhibition of platelet aggregation.

NSAIDs aside from (low-dose) aspirin are associated with a doubled risk of symptomatic heart failure in patients without a history of cardiac disease.

A 2005 study linked long term (over 3 months) use of NSAIDs, including ibuprofen, with a 1.4 times increased risk of erectile dysfunction.

NSAIDs are also associated with a relatively high incidence of renal adverse drug reactions (ADRs). The mechanism of these renal ADRs is due to changes in renal haemodynamics (blood flow), ordinarily mediated by prostaglandins, NSAIDs in combination with excessive use of phenacetin and/or paracetamol (acetaminophen) may lead to analgesic nephropathy.

Photosensitivity is a commonly overlooked adverse effect of many of the NSAIDs.

NSAIDs are not recommended during pregnancy, particularly during the third trimester.

http://en.wikipedia.org/wiki/Non-steroidal_anti-inflammatory_drug 

Non-steroidal anti-inflammatory drug - Wikipedia, the free encyclopedia »

KP Magazine

    12:16 PM  -  Public

Acetaminophen overdose is one the most common causes of OTC drug poisoning in the United States and Britain. Acetaminophen is extremely toxic to adults in single large doses of about 7000 mg. Most cases of acetaminophen poisoning occur because people take smaller doses over a long period of time. In this setting, doses of 4000 mg daily can be toxic. In children, daily maximum oral dosing is not to exceed 90 mg per kilogram of body weight.

Simple methods of reducing NSAID-induced gastric toxicity may enable those in chronic pain to continue using NSAIDS with minimal risk to the gastric mucosa. Some doctors prescribe the prostaglandin drug misoprostol, which was approved by the Food and Drug Administration for prevention of NSAID-induced ulcers.

http://www.lef.org/protocols/appendix/otc_toxicity_01.htm 

Acetaminophen and NSAID Toxicity - Ibuprofen, Aspirin, Acetaminophen Poisoning - Life Extension Health Concern »

Acetaminophen and NSAIDs commonly cause serious liver and gastrointestinal side effects, yet most people have no idea how dangerous they can be. Read on to learn more about OTC medications and Toxicit... 

KP Magazine

    12:31 PM  -  Public

How does anyone know if they are NSAID-sensitive? Well, they take ibuprofen and if it causes an asthma attack, then they are NSAID-sensitive.

if you have had problems with NSAIDs, stay away from them. And if you have not had problems with NSAIDs, you will likely be fine taking ibuprofen, even if you are an asthmatic.

Aspirin is another form of NSAID that can provoke asthma attacks in aspirin-sensitive asthmatics. Avoidance of aspirin, and aspirin-containing substances.

http://www.northernadvocate.co.nz/news/ask-dr-gary-ibuprofen-risks-for-asthmatics/1379122/

Ask Dr. Gary: Ibuprofen risks for asthmatics »

Doctors used to think ibuprofen was potentially dangerous for all asthmatics, period. Recent research has refined this a bit. 

KP Magazine

    12:27 PM (edited)  -  Public

3% to 6% of patients with osteoarthritis using NSAIDs have a decline in hemoglobin of 2 g/dL or more, which is not insignificant and doesn't include patients with an acute bleed.

http://www.medpagetoday.com/MeetingCoverage/DDW/32805

Medical News:%20NSAID-Related Anemia Doubles Arthritis Costs - in Meeting Coverage, DDW from MedPage Today »

This study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. A database study fo...

KP Wellness

 12:47 PM  -  Public

Narcotic Analgesics
1 NARCOTICS
TIER 1
Codeine Sulfate (Codeine Sulfate)
Duragesic (Fentanyl Transdermal) 
Hydromorphone HCl Tablet (Dilaudid)
Levorphanol Tartrate (Levo-Dromoran)
Methadone HCl (Dolophine HCl)
Meperidine HCl (Demerol)
Morphine Sulfate Solution, Oral (MSIR 20 mg/ml)
Morphine Sulfate Solution, Oral (Roxanol)
Morphine Sulfate Tablet, Sustained-Action (MS Contin) SL
Oxycodone HCl (Roxicodone, OxyIR)
Oxycodone HCl Concentrate, Oral (OxyFAST)
TIER 2
Codeine Phosphate (Codeine  Phosphate)
Fentanyl Citrate Lollipop (Actiq)   
Opana ER (Oxymorphone HCl Tablet,  Sustained-Release 12 Hour)
OxyContin (Oxycodone HCl Tablet,  Sustained-Release 12 Hour)
Oxymorphone HCl Tablet,  Sustained-Release 12 Hour (Opana ER) 
Oxymorphone Tablet (Opana) 
TIER 3
Avinza
Embeda
Exalgo
Fentanyl Transdermal (Duragesic) 
Fentora  
Kadian 
Onsolis  

2  COMBINATION NARCOTIC /ANALGESICS
TIER 1
Acetaminophen/Caffeine/Butalbital (Fioricet)  
Aspirin/Caffeine/Butalbital (Fiorinal)
Codeine Phosphate/Acetaminophen (Tylenol w/Codeine) 
Codeine Phosphate/Acetaminophen/ Caffeine/Butalbital
(Fioricet  w/Codeine) 
Codeine Phosphate/Aspirin/Caffeine/ Butalbital
(Fiorinal w/Codeine 30 mg)
Dihydrocodeine Bit/Acetaminophen/ Caffeine (Panlor SS, Panlor DC) 
Hydrocodone Bit/Acetaminophen (Vicodin) 
Hydrocodone Bit/Acetaminophen (Vicodin ES) 
Hydrocodone Bit/Acetaminophen (Vicodin HP) 
Hydrocodone Bit/Acetaminophen (Xodol) 
Hydrocodone Bit/Acetaminophen  Elixir, Tablet (Lortab, Lorcet) 
Ibuprofen/Hydrocodone (Vicoprofen)
Oxycodone HCl/Acetaminophen (Tylox)  
Oxycodone HCl/Acetaminophen Tablet (Percocet)  
Oxycodone HCl/Ibuprofen (Combunox)
Oxycodone/Aspirin (Percodan)
TIER 2
Hydrocodone Bit/Acetaminophen Solution, Oral (Hycet)  
TIER 3
Cocet Plus 
Synalgos-DC

KP Wellness

 12:43 PM  -  Public

Non-Narcotic Analgesics
1 NSAIDS
TIER 1
Diclofenac Potassium (Cataflam)
Diclofenac Sodium (Voltaren)
Diclofenac Sodium Tablet, Sustained-Release  24 Hour (Voltaren-XR)
Etodolac (Lodine)
Etodolac Tablet, Sustained-Release 24 Hour (Lodine XL)
Fenoprofen Calcium (Nalfon)
Flurbiprofen (Ansaid)
Ibuprofen (Motrin)
Indomethacin (Indocin)
Indomethacin Capsule, Sustained-Action (Indocin SR)
Ketoprofen (Orudis)
Ketoprofen Capsule, 24 Hour  Sustained-Release (Oruvail 200 mg)
Ketorolac Tromethamine (Toradol)
Meclofenamate Sodium (Meclomen)
Meloxicam (Mobic)
Nabumetone (Relafen)
Naproxen (EC-Naprosyn)
Naproxen (Naprosyn)
Naproxen Sodium (Anaprox, Anaprox DS)
Oxaprozin (Daypro)
Piroxicam (Feldene)
Sulindac (Clinoril)

TIER 2
Tolmetin Sodium (Tolectin)
Tolmetin Sodium (Tolectin DS)
Voltaren Gel (Diclofenac Sodium  Gel 1%)

TIER 3
Diclofenac/misoprostol (Arthrotec)
Diclofenac potassium for oral solution (Cambia)
Diclofenac Epolamine Topical Patch (Flector Patch)
Diclofenac Sodium Topical Solution (Pennsaid)
Diclofenac liquid-filled capsules (Zipsor)
Mefenamic Acid (Ponstel)
Naproxen Sodium  
Naproxen/Esomeprazole Magnesium Delayed Release Tablets (Vimovo ) 

NSAIDS–SPECIFIC COX-II INHIBITORS
TIER 3
Celecoxib : CELEBREX® 

2 SALICYLATES
TIER 1
SALSALATE - ORAL (Disalcid) 

3  MISCELLANEOUS ANALGESICS
TIER 1
Pentazocine HCl/Acetaminophen (Talacen)
Pentazocine HCl/Naloxone HCl  (Talwin NX)
Tramadol HCl (Ultram)
Tramadol HCl/Acetaminophen (Ultracet) SL
TIER 2
Butorphanol Tartrate Aerosol, Spray (Stadol) 
Tramadol HCl Tablet, Sustained-Release 24 Hour (Ultram ER) SL
TIER 3
Tapentadol hydrochloride (Nucynta)
Tramadol hydrochloride (Rybix)
Tramadol Hydrochloride Extended-Release Tablets (Ryzolt)

4  NARCOTIC ANTAGONISTS/OPIOID DEPENDENCE
TIER 1
Buphrenorphine Hydrochloride (Subutex)  
Naltrexone HCl (ReVia)
TIER 2
Suboxone (Buprenorphine HCl/ Naloxone HCl)

KP Wellness

 12:08 PM  -  Public

Migraine & Cluster Headache Therapy
1  HEADACHE THERAPY
TIER 1
Acetaminophen/Caffeine/Butalbital 
Aspirin/Caffeine/Butalbital  
Dihydroergotamine Mesylate (D .H .E .45)  
Naratriptan HCl   
Sumatriptan Succinate Tablet 
TIER 2
Cafergot (Ergotamine Tartrate/ Caffeine Tablet)
Ergomar (Ergotamine Tartrate)
Sumatriptan Succinate Nasal Spray  
TIER 3
Sumatriptan Injection (Alsuma)
Almotriptan Malate (Axert)
Frovatriptan (Frova)
Rizatriptan (Maxalt)
Dihydroergotamine Mesylate Spray (Migranal)
Sumatriptan Injection (Sumavel DosePro)
sumatriptan and naproxen (Treximet)
Zolmitriptan (Zomig)

2  ANTIVERTIGO & ANTIEMETIC DRUGS
TIER 1
Dronabinol (Marinol)
Ondansetron HCl (Zofran) 
Prochlorperazine Maleate Tablet 
Promethazine HCl (Phenergan)
Trimethobenzamide HCl Capsule (Tigan 250, 300 mg)
TIER 2
Meclizine HCl Tablet (Antivert 50 mg)
Aprepitant (Emend)
Granisetron HCl Tablet (Kytril) 
TIER 3
Dolasetron (Anzemet) 
Nabilone (Cesamet)
Granisetron, Chemo Patch, Granisetron Patch (Sancuso)
Scopolamine (Scopace)
Scopolamine (Transderm-Scop)
Ondansetron (Zuplenz)