Pharmacology of Acetaminophen, Nonsteroidal Antiinflammatory Drugs, and Steroid Medications: Implications for Anesthesia or Unique Associated Risks

Anesthesiology Clinics
Kenneth D CandidoNebojsa Nick Knezevic

Abstract

Acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), and corticosteroids, historically used in perioperative management, are potent analgesic medications. They primarily inhibit the cyclooxygenase (COX) enzyme, decreasing the synthesis of prostaglandins, and modulating pain and temperature. Acetaminophen does not inhibit this synthesis at the inflammatory site. The primary mechanism of action of corticosteroids involves regulation of nuclear expression of genes involved in inflammatory pathways and other systemic effects. Metaanalyses have added purposeful perioperative indications, clarified misconceptions, and established protocols for administering these drugs. Some indications, doses, clinical considerations, and adverse effects need to be further studied.

Citations

Oct 20, 2017·Anesthesia and Analgesia·Nebojsa Nick KnezevicTony L Yaksh
Oct 6, 2018·Journal of Clinical Laboratory Analysis·Bao-Yum ChanChloe Miu Mak
Apr 3, 2020·The Korean Journal of Pain·Kyung-Hoon KimBilly Huh
Jul 3, 2021·Sensors·Yojana J P CarreónRoberto Zenit
Nov 15, 2021·Pain Practice : the Official Journal of World Institute of Pain·Qinqin CaoHaihong Meng

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