藥學共筆
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翻譯[]

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機轉[]

  • 周邊抗發炎作用(局部抗發炎作用):藉由抑制周邊細胞中環氧化酶抑制周邊痛覺傳遞物質前列腺素而抑制發炎的產生
  • 周邊止痛作用(局部鎮痛作用)&中樞鎮痛作用:藉由抑制周邊&中樞細胞中環氧化酶抑制周邊&中樞痛覺傳遞物質前列腺素而抑制痛覺的產生
  • 中樞解熱作用:藉由抑制中樞細胞中環氧化酶抑制中樞痛覺傳遞物質前列腺素而抑制體溫的上升
  • NEJS 細菌性發燒的原理

例子[]

aniline and der.:解熱鎮痛藥(Antipyretic analgesics,無抗發炎效果[]

每包含有 500mg 的乙醯胺酚和 65mg 的咖啡因,成份跟「普拿疼加強錠」一樣,不過加了葡萄萃取物

glucocorticoids:類固醇消炎藥:解熱鎮痛消炎藥(antipyretic antiinflammatory analgesics[]

glucocorticoids

NSAIDs(NSAIAs):非類固醇消炎藥:解熱鎮痛消炎藥(antipyretic antiinflammatory analgesics[]

2016 aspirin NSAIAs besides aspirin
MOA inhibit COX I and II by irreversible mechanism of acetylation. inhibit COX I and COX II or COX II reversibly
antiinnflammation yeah yeah
cancer prevention yeah yeah
effect toward blood anticoagulate increase possibility of stroke (both COX II selective and nonselective)
ADR gastric, kidney gastric ( except for COX II selective:however, its coagulating effect act on heart ... .  ), kidney

pyrazolones:已不用於解熱鎮痛消炎,只用於抗痛風[]

  • antipyrin
  • aminopyrin
  • dipyrone
  • phenylbutazone
  • oxyphenbutazone
  • sulfinpyrazone:不止痛。抗痛風
  • apazone

carboxylic acid[]

salicylic acid and der.[]
N-arylanthranilic acid(fenamic acid)[]
  • mefenamic acid
  • meclofenamic acid
acetic acid[]
propionic acid(profen):more pottent and safer than acetate der., optic active[]
  • ibuprofen
  • fenoprofen
  • ketoprofen: inhibits lipooxygenase, too.
  • suprofen
  • ketorolac
  • flubiprofen
  • naproxen
  • carprofen
  • oxaprozin

oxicam(enocarboxamide)(4-hydroxy-1,2-benzothiazine carboxamide)[]

  • piroxicam
  • meloxicam: COX 2 inhibition
  • tenoxicam

COX 2 selective inhibitors[]

oxicam(enocarboxamide)(4-hydroxy-1,2-benzothiazine carboxamide)[]

  • meloxicam: COX 2 inhibition

carboxylic acid-acetic acid der.[]

etodolac

sulide[]

coxib[]

  • celecoxib
  • rofecoxib: withdrawal
  • raldecoxib: withdrawal
  • etoricoxib

中藥[]

  • 桂枝湯:有發汗時用
  • 葛根湯:項背強脊用

成藥基準表甲類成藥(一)解熱鎮痛劑:感冒、頭痛、解熱、鎮痛、風濕病、神經痛、齒痛、咽喉病、肩痛、鼻塞、流鼻水。[]

  • 乙醯水楊酸(Acetylsalicylic Acid)
  • 咖啡鹼(Caffeine)
  • 氯芬尼拉明(Chlorpheniramine)
  • 汎司(Acetaminophen)
  • 水楊酸胺(Salicylamide)
  • 乙氧基胺(Ethoxybenzamide)
  • 溴滑利尿素(Bromvalerylurea)
  • 葛根(Pueraria)
  • 麻黃(Ephedra)
  • 升麻(Cimicifugae)
  • 柴胡(Bupleurum)
  • 桂皮(Cinnamomum)
  • 芍藥(Paeonia)
  • 大棗(Zizyphus)
  • 生薑(Zingiber)
  • 甘草(Glycyrrhiza)
  • 桔梗(Platycodon)
  • 白芷(Angelica Glaurao)

NSAIAs臨床上分法[]

Nonselective NSAIAs[]

Aspirin

Preferentially COX II[]

Meloxicam, Nimesulide

Specific COX II[]

.

經痛[]

經痛吃止痛藥選哪種才有效?常見3大止痛藥效果、副作用比一比

延伸學習[]

藥品學名 year introduced dose COX2 selectivity Biotransformation & excretion duration 其他
salicylate pharmacophore: aspirin 1899
Acetic acid derivatives pharmacophore: indomethacine 1965
anthranilic acid pharmacophore: mefenamic acid 1967
Propionic acid derivatives pharmacophore: ibuprofen 1974
Propionic acid derivatives pharmacophore: fenoprofen 1976
Propionic acid derivatives pharmacophore: naproxen 1976
Acetic acid derivatives pharmacophore: tolmetin 1976 no antigout activity
Acetic acid derivatives pharmacophore: sulindac 1978
anthranilic acid pharmacophore: meclofenamate 1980
salicylate pharmacophore: diflunisal 1982
oxicam pharmacophore: piroxicam 1982
Propionic acid derivatives pharmacophore: ketoprofen 1986
Propionic acid derivatives pharmacophore: flubiprofen 1988
acetic acid derivatives pharmacophore: diclofenac 1989
acetic acid derivatives pharmacophore: etodolac 1991
acetic acid derivatives pharmacophore: nabumetone 1992
propionic acid derivatives pharmacophore: oxaprozin 1993
coxib pharmacophore: Celecoxib(Celebrex) (withdrawal) 1999
coxib pharmacophore: Rofecoxib(withdrawal) 1999
oxicam pharmacophore: meloxicam 2000

外部連結[]

  • [health.businessweekly.com.tw/AArticle.aspx?id=ARTL000006345 健康成人一天普拿疼劑量勿逾4公克 一顆止痛藥 會殘留體內5年?]
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