ABSTRACT
Piroxicam is well absorbed after oral administration with a terminal half-life of about 50 h. Metabolism is by hydroxylation and conjugation and less than 5% is excreted unchanged. Nabumetone is a prodrug; 30% is converted to the active metabolite 6methoxy-2-naphthylacetic acid (6MNA); 6MNA is more than 99% bound to plasma proteins and its half-life is about 25h. Tenoxicam is well absorbed after oral administration, has a prolonged half-life (about 72h) and is cleared almost completely
Warfarin ? warfarin effect
Hypertensive and cardiac failure treatment
? effectiveness, Na+, and water retention
ACE inhibitors and K+-sparing diuretics Hypokalaemia
Tolbutamide ? hypoglycaemia
Phenytoin ? free phenytoin concentration, ? metabolism
Methotrexate ? plasma methotrexate
Lithium ? lithium clearance, ? plasma lithium
Elderly people
Diabetes
Asthma
Widespread vascular disease
Cardiac, hepatobiliary major vascular surgery
Concomitant administration of:
Angiotensin-converting enzyme inhibitors
Potassium-sparing diuretics
ß-Adrenergic blockers
Cyclosporin
Methotrexate
Paracetamol (acetaminophen) The mechanism of action of paracetamol (active derivative of phenacetin) still has to be elucidated, but it may inhibit brain prostaglandin synthesis. It has no significant effect on peripheral COX and therefore has no anti-inflammatory activity; it does not cause gastric ulceration and bleeding. Paracetamol is rapidly and almost completely absorbed after oral administration with a plasma half-life of 2-3 h. It is metabolized in the liver, chiefly by conjugation. In contrast to the NSAIDs, plasma protein binding is only 20-50% and, at recommended doses, side effects are rare.