Anti-inflammatoires non-stéroïdiens (AINS) et paracétamol:

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% 30 25 20 15 10 5 0 GI intolerability* 30 NSAIDs endoscopic ulcers [3] 10 * Range 20-50% based on - withdrawals for GI symptoms1 - community surveys for GI symptoms2 toxicity GI Mucosal Damage / Complications perforation or haemorrhage [4] Death [5] 1. Kiff et al, Eur J Rheumatol, 1994; 2. Hardo et al, BJCP, 1993; 3. Graham DY et al, Am J Gastroenterol 1988; 4. Silverstein et al, Ann Int Med, 1995; 5. Blower et al, Aliment Pharmacol, 1997 2009-2010 AINS et paracetamol 30 1.7 0.2
• • • • • NSAID Ulcers and Ulcer Complications Endoscopic ulcer point prevalence: 10-30% Ulcer complications: 2-4% per year Most (>80%) hospitalizations for GI bleed occur without previous symptoms Inhibition of prostaglandin synthesis is principal mechanism for GI damage Use of antacids or H2 antagonists do not prevent NSAID induced gastric ulcers Singh G et al. Am J Med 1998;105(1B):31S-8S. Geis GS et al. J Rheumatol 1991;18:11-14. 2009-2010 AINS et paracetamol 31
Page 1 and 2: Anti-inflammatoires non-stéroïdie
Page 3 and 4: • • • • • • • • •
Page 5 and 6: • • • Douleur ... propagation
Page 7 and 8: • • • Types de sensations dou
Page 9 and 10: Mécanismes de transduction des voi
Page 11 and 12: Contrôle du passage l'information
Page 13 and 14: • • Causes de l'inflammation Fa
Page 15 and 16: COX Activity 1600 1200 800 400 0 Ef
Page 17 and 18: O O O O Métabolisme OOH OH de l'ac
Page 19 and 20: • • • • Découverte des ant
Page 21 and 22: Filling up the enzyme with salicyli
Page 23 and 24: Mapping of the cyclooxygenase COX-1
Page 25 and 26: • • • • • • Classes d'A
Page 27 and 28: Upper - GI Renal Adverse Effects of
Page 29: X Support Renal and Platelet Functi
Page 33 and 34: *NSAIDs - Relative Risk of GI Compl
Page 35 and 36: COX-2: a new anti-inflammatory drug
Page 37 and 38: heme Kurumbail RG et al. Nature 199
Page 39 and 40: H3 CO hydrophilic group Pharmacoche
Page 41 and 42: Importance of the Ile Val change i
Page 43 and 44: Cox-1 vs flurbiprofene Picot et al.
Page 45 and 46: Clinical efficacy ? 2009-2010 AINS
Page 47 and 48: Celecoxib vs Diclofenac plus omepra
Page 49 and 50: Localization of COX-1 and COX-2 in
Page 51 and 52: The hypertension story starting in
Page 53 and 54: • F • F F Y-a-t-il un avenir po
Page 55 and 56: Making an irreversible linkage by a
Page 57 and 58: AINS et principales interactions m
Page 59 and 60: Metabolisme O O > 5-10 g hépatique
Page 61 and 62: Le paracétamol "en notice" … Pra
Page 63 and 64: • • • Principaux usages clini
Page 65: • • • • • Autres médicam

Anti-inflammatoires non-stéroïdiens (AINS) et paracétamol:

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