Opioids and NSAIDs: Mechanisms, Actions, and Effects
Opioids: Neuroanatomic Basis of Pain
Pain stimulus, receptors, thermoreceptors, mechano, chemo, polymodal. Nerve fibers – A, C – SNC.
Analgesia
State of inhibition or suppression of pain without loss of sensory capacity; consciousness is unaltered.
Endogenous Opioid System
- Peptides endogenous antigens: proopiomelacortina derived from the proenkephalin and the prodynorphin.
- Widely distributed in the body.
Opioid Receptors
Mu (?), kappa (k), sigma (or), and delta (A) receptor subtypes exist. Present in CNS,
Read MorePediatric Kidney Conditions: Pyelonephritis, Cystitis, Nephrotic Syndrome, PSGN
Pyelonephritis: Diagnosis and Treatment
Diagnostic Criteria:
- Fever >38°C
- Pyuria (>5-10 WBC)
- Bacteriuria >105 CFU/ml
- Signs of bacterial infection in blood test (leukocytosis, CRP >20mg/l)
- Abdominal or flank tenderness
- Abnormalities in kidney ultrasound
Treatment:
- Gentamicin 7 days (not longer). After antibacterial sensitivity testing, other antibiotics should be continued for 10-14 days.
- Cefuroxime (second generation cephalosporin) 10-14 days.
- Amoxicillin alone is not recommended.
- If the fever has
NSAIDs, Glucocorticoids, and Immunosuppressants: Side Effects and Patient Care
Side Effects of NSAIDs
Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause a range of side effects, particularly affecting the gastrointestinal and renal systems.
Gastrointestinal System
- Dyspepsia
- Nausea
- Vomiting
- Ulcers and potential hemorrhagic risk with chronic use
Renal System
- Renal involvement/nephrotoxicity
- Renal failure may occur after years of chronic abuse
Other
- Bronchospasm
- Rashes
- Other allergic-type reactions
Drug Interactions: Anticoagulants and Flu Medications
Individuals taking anticoagulants
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