第二十章 解热镇痛抗炎药（The twentieth chapter is antipyretic, analgesic and anti-inflammatory drugs）.docVIP

第二十章 解热镇痛抗炎药（The twentieth chapter is antipyretic, analgesic and anti-inflammatory drugs） 4.1 pharmacological actions, mechanisms of action and common adverse reactions of antipyretic analgesics 4.1.1 pharmacological action (I) antipyretic effect 1. only the high body temperature dropped to normal, no effect on normal body temperature. 2., only affect the heat dissipation process, without affecting the heat production process. 3., the antipyretic mechanism is to inhibit the hypothalamic temperature and regulate the activity of central oxygenase (prostaglandin synthetase), thereby inhibiting the synthesis of prostaglandin (PG). (two) analgesic effect 1., non narcotic (non addictive) analgesics, without euphoria, tolerability, and respiratory depression. 2., the intensity of pain is weaker than pethidine, which is effective for chronic blunt pain, and is not effective for traumatic pain and visceral colic. 3. the main site of analgesic action is peripheral. 4. the analgesic mechanism is to inhibit the synthesis of local PG, alleviate the pain caused by PG, and reduce the sensitivity of pain receptors to bradykinin. (three) anti inflammation and anti rheumatic action In addition to aniline, other drugs have this effect, can inhibit local PG synthesis, so that inflammation ease or disappear. (four) other NSAIDs inhibits PG synthase and reduces thromboxane A2 (TXA2) formation, thereby inhibiting platelet aggregation and thrombosis. The occurrence, development and metastasis of tumor may be inhibited. In addition to inhibiting the production of PGs, the anti-tumor effect is related to the activation of Caspase-3 and caspase-9, the induction of tumor cell apoptosis, the inhibition of tumor cell proliferation, and the formation of anti angiogenesis. In addition, it can prevent and delay the onset of Alzheimers disease and delay corneal aging. 4.1.2 mechanism The anti-inflammatory effect of NSAIDS is mainly related to inhibiting the activity of COX and inhibiting the format