NSAIDS-COMPARISON

ANTI INFLAMMATORY PROPERTIES 

〰〰〰〰〰〰〰〰〰〰〰〰〰

✨BETTER THAN NAPROXEN :

🔹Flurbiprofen

🔹Indomethacin

✨GOOD:

🔹Naproxen

🔹Fenoprofen

🔹Ketoprofen

🔹Tiaprofenic acid

🔹Diclofenac

🔹Aceclofenac

🔹Etodolac

🔹Nabumetone

🔹Piroxicam

🔹Tenoxicam

🔹Etoricoxib

✨WEAK:

🔹Ibuprofen

🔹Mefenamic acid

SIDE EFFECTS 

〰〰〰〰〰

✨FEWER SIDE EFFECTS 

🔹 Ibuprofen 

✨GREATER THAN IBUPROFEN

🔹 Naproxen

🔹 Fenoprofen(GI)

🔹 Flurbiprofen(GI)

🔹 Ketoprofen

🔹 Diclofenac

🔹 Aceclofenac

🔹 Sulindac

🔹 Tenoxicam

✨HIGH

🔹 Indomethacin

🔹 Piroxicam 

✨HIGH RISK OF RASH

🔹 Fenbufen

✨SEVERE CYSTITIS

🔹 Tiaprofenic Acid

✨DIARRHOEA & HEMOLYTIC ANEMIA

🔹 Mefenamic acid

✨LOW G.I.; BUT HIGH C.V. EFFECTS

🔹 Celecoxib

🔹 Etoricoxib

Reference: 

Medicines Optimisation Academy 

British National Formulary

PAIN IN GUILLAIN BARRE SYNDROME

✔️GBS a number of different subtypes

✔️The most common is an acute inflammatory demyelinating polyradiculoneuropathy 

✔️More than half of patients report severe pain. 

✔️Severe widespread neuropathic pain may be described, often without the features of a peripheral neuropathy, as well as musculoskeletal pain. 

✔️May sometimes have severe acute pain, 

✔️Treatment with systemic ketamine and/or lidocaine as well as gabapentin/pregabalin and carbamazepine may be of benefit in the acute phase (ANZCA and FPM, 2010).

Ref: Acute Pain Management: A practical guide,4/e, Pamela E. Macintyre , Stephan A. Schug

ADVERSE EFFECTS OF UNDER TREATED SEVERE ACUTE PAIN

(Reference: Pamela E. Macintyre,Stephan A. Schug. ACUTE PAIN MANAGEMENT; A PRACTICAL GUIDE)

👹Tachycardia, hypertension

👹increased myocardial oxygen consumption, myocardial ischemia

👹 Decreased lung volumes, atelectasis, decreased cough, sputum retention, infection, hypoxemia

👹Decreased gastric and bowel motility 

👹Urinary retention 

👹Increased catabolic hormones: glucagon, growth hormone, vasopressin, aldosterone, renin, and angiotensin 

👹Reduced anabolic hormones: insulin, testosterone 

👹Catabolism leads to hyperglycemia, increased protein breakdown and negative nitrogen balance; ➡️impaired wound healing and muscle wasting 

👹 Muscle spasm, immobility (increasing risk of deep-vein thrombosis-->pulmonary embolism) and muscle wasting 

👹 Chronic (persistent) pain due to central sensitization 

👹 Anxiety, fear, helplessness, sleep deprivation—leading to increased pain and potential long-term psychological effects