ANSWER :
1)Uses of anti-inflammatory agents :
- As analgesic : For headache, myalgia, joint pains , backache ,
neuralgias , toothache etc
- As antipyretic : Effective in reducing fever of any origin.
Paracetamol is generally preferred.
- Rheumatoid arthritis and gout : Produces relief of pain ,
swelling , and morning stiffness, but progress of disease process
is not efffected
- Acute rheumatic fever : Gives symptomatic relief. Aspirin is
preferred
- Osteoarthritis : Paracetamol is the drug of choice , it gives
symptomatic relief
- Postmyocardial infarction and poststroke patients : Aspirin
inhibits platelet aggregation and lowers the incidence of
reinfarction
2)Risks of long term NSAID's ingestion :
- Gastrointestinal : Esophagitis ,gastric erosions, peptic
ulcers, gastric bleeding or perforation
- Renal : Water retention , chronic renal failure, and
interstitial nephritis
- Hematological : Thrombocytopenia, hemolytic anemia ,bleeding
etc
- CVS : Except for aspirin , all NSAID's have increased risk for
heart attack and stroke
- Hepatic : Hepatic failure (rare), if underlying liver damage is
present chances of hepatic failure is more
3)Uses of corticosteriods :
▪︎Replacement therapy :
- Acute and chronic adrenal insufficiency
- Congenital adrenal hyperplasia
▪︎Pharmacotherapy :
- Rhematoid arthritis, osteoarthritis, rheumatic fever and
gout
- Severe allergic reactions : anaphylaxis , angioneurotic edema
etc
- Collagen diseases : systemic lupus erythematosis , nephrotic
syndrome , glomerulonephritis etc
- Bronchial asthma
- Autoimmune diseases : Idiopathic thrombocytopenic purpura ,
autoimmune hemolytic anemia etc
- Infective diseases : Leprosy , tuberculosis , bacterial
meningitis etc
- Skin diseases : pemphigus vulgaris, Stevens - Johnson syndrome
etc
- Intestinal diseases : Ulcerative colitis , Crohn's disease,
coeliac disease etc
- Eye diseases : allergic conjunctivitis ,iridocyclitis etc
- Cerebral edema
- Malignancies : combined chemotherapy of acute lymphatic
leukemia, Hosgkin's lymphoma etc
- Septic shock
- Thyroid storm
- Organ tranplantation and skin allograft
Adverse effects :
- Fragile skin , purple striae
- Muscular weakness
- Delayed healing
- Susceptibility to infections
- Hyperglycemia
- Osteoporosis
- Peptic ulcers
- Glaucoma, cataract
- Growth retardation
- Fetal abnormalities in pregnancy
- Supression of HPA axis
4)Alcohol is a source of purines, these purines produce uric
acid in body.
Hyperuricemia caused by alcohol intake can lead to gout or flare
up gout
Advise :
Moderate alcohol intake : 2 drinks per day for men age less than
or equal to 65, 1drink per day for men >65 yrs and 1 drink per
day for all women
Diet : Avoid purine rich foods like meat , fish, added sugars
and sugary beverages.
Eat plenty of fruits, vegetables, nuts , milk , eggs , whole
grains , legumes etc