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

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....

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Published in:	Anesthesiology clinics Vol. 35; no. 2; pp. e145 - e162
Main Authors:	Candido, Kenneth D., MD, Perozo, Oscar J., MD, Knezevic, Nebojsa Nick, MD, PhD
Format:	Journal Article
Language:	English
Published:	United States 01-06-2017
Subjects:	Acetaminophen - pharmacology Analgesics, Non-Narcotic - pharmacology Analgesics, Opioid - therapeutic use Anesthesia Anesthesia & Perioperative Care Anti-Inflammatory Agents, Non-Steroidal - pharmacology Humans Pain, Postoperative - prevention & control Postoperative Nausea and Vomiting - drug therapy Steroids - pharmacology Analgesia Perioperative Acetaminophen NSAIDs Intraoperative Anesthesia Steroids
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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.
AbstractList	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.
Author	Candido, Kenneth D., MD Perozo, Oscar J., MD Knezevic, Nebojsa Nick, MD, PhD
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Snippet	Acetaminophen, nonsteroidal antiinflammatory drugs (NSAIDs), and corticosteroids, historically used in perioperative management, are potent analgesic...
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SubjectTerms	Acetaminophen - pharmacology Analgesics, Non-Narcotic - pharmacology Analgesics, Opioid - therapeutic use Anesthesia Anesthesia & Perioperative Care Anti-Inflammatory Agents, Non-Steroidal - pharmacology Humans Pain, Postoperative - prevention & control Postoperative Nausea and Vomiting - drug therapy Steroids - pharmacology
Title	Pharmacology of Acetaminophen, Nonsteroidal Antiinflammatory Drugs, and Steroid Medications: Implications for Anesthesia or Unique Associated Risks
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