Aspirin

Aspirin (USAN), is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an antiinflammatory medication. Salicylic acid, the main metabolite of aspirin, is an integral part of human and animal metabolism. While much of it is attributable to diet, a substantial part is synthesized endogenously.[ Aspirin also has an antiplatelet effect by inhibiting the production of thromboxane, which under normal circumstances binds platelet molecules together to create a patch over damaged walls of blood vessels. Because the platelet patch can become too large and also block blood flow, locally and downstream, aspirin is also used long-term, at low doses, to help prevent heart attacks, strokes, and blood clot formation in people at high risk of developing blood clots.[2] It has also been established that low doses of aspirin may be given immediately after a heart attack to reduce the risk of another heart attack or of the death of cardiac tissue.

Medical uses
Aspirin is used for the treatment of a number of conditions including: fever, pain, rheumatic fever, inflammatory diseases such as rheumatoid arthritis, pericarditis, and Kawasaki disease. It is used in the prevention of transient ischemic attacks, strokes, heart attacks, pregnancy loss, and cancer

Central effects
Large doses of salicylate, a metabolite of aspirin, have been proposed to cause tinnitus (ringing in the ears) based on experiments in rats, via the action on arachidonic acid and NMDA receptors cascade.

Ibuprofen
is a nonsteroidal anti-inflammatory drug (NSAID) used for relief of symptoms of arthritis, fever,[1] as an analgesic (pain reliever), especially where there is an inflammatory component, and dysmenorrhea. Ibuprofen is known to have an antiplatelet effect, though it is relatively mild and short-lived when compared with aspirin or other better-known antiplatelet drugs. In general, ibuprofen also acts as a vasodilator, having been shown to dilate coronary arteries and some other blood vessels. Ibuprofen is a core medicine in the World Health Organization's "WHO Model List of Essential Medicines", which is a list of minimum medical needs for a basic healthcare system.[2][3][4][5] Originally marketed as Brufen, ibuprofen is available under a variety of popular trademarks, including Motrin, Nurofen, Advil, and Nuprin.

Medical uses
Ibuprofen is used primarily for fever, pain, dysmenorrhea and inflammatory diseases such asrheumatoid arthritis.[7] It is also used for pericarditis and patent ductus arteriosus

Miscarriage
A Canadian study published in the Canadian Medical Association Journal of thousands of pregnant woman suggests that those taking any type or amount non-steroidal anti-inflammatory drugs including ibuprofen, diclofenac and naproxen were 2.4 times more likely to miscarrythan those not taking the drugs.

Chemistry
Ibuprofen is only very slightly soluble in water. Less than 1 mg of ibuprofen dissolves in 1 ml water (< 1 mg/mL).[36] However, it is much more soluble in alcohol/water mixtures as well as carbonated water.

Voltaren Voltaren may cause life-threatening heart or circulation problems such as heart attack or stroke, especially if you use it long term. Do not use Voltaren just before or after heart bypass surgery (coronary artery bypass graft, or CABG). Get emergency medical help if you have chest pain, weakness, shortness of breath, slurred speech, or problems with vision or balance. Voltaren may also cause serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and can occur without warning while you are taking Voltaren, especially in older adults. Call your doctor at once if you have symptoms of stomach bleeding such as black, bloody, or tarry stools, or coughing up blood or vomit that looks like coffee grounds. Ask a doctor or pharmacist before using any cold, allergy, or other pain medicine. Medicines similar to diclofenac are contained in many combination medicines. Taking certain products together can cause you to get too much of this type of medication. Check the label to see if a medicine contains aspirin, ibuprofen, ketoprofen, or naproxen. Avoid drinking alcohol. It may increase your risk of stomach bleeding

Contraindications

Hypersensitivity against diclofenac History of allergic reactions (bronchospasm, shock, rhinitis, urticaria) following the use of aspirin or another NSAID Third-trimester pregnancy Active stomach and/or duodenal ulceration or gastrointestinal bleeding Inflammatory intestinal disorders such as Crohn's disease or ulcerative colitis Severe insufficiency of the heart (NYHA III/IV) Recently, a warning has been issued by the FDA not to use for the treatment of patients recovering from heart surgery Severe liver insufficiency (Child-Pugh Class C) Severe renal insufficiency (creatinine clearance <30 ml/min) Caution in patients with preexisting hepatic porphyria, as diclofenac may trigger attacks Caution in patients with severe, active bleeding such as cerebral hemorrhage NSAIDs in general should be avoided during dengue fever.

narcotic analgesics
Uses For This Medicine Narcotic analgesics are used to relieve pain. Some of these medicines are also used just before or during an operation to help the anesthetic work better. Codeine and hydrocodone are also used to relieve coughing. Methadone is also used to help some people control their dependence on heroin or other narcotics. Narcotic analgesics may also be used for other conditions as determined by your doctor. Narcotic analgesics act in the central nervous system (CNS) to relieve pain. Some of their side effects are also caused by actions in the CNS. If a narcotic is used for a long time, it may become habit-forming (causing mental or physical dependence). Physical dependence may lead to withdrawal side effects when you stop taking the medicine. These medicines are available only with your medical doctor's or dentist's prescription. For some of them, prescriptions cannot be refilled and you must obtain a new prescription from your medical doctor or dentist each time you need the medicine. In addition, other rules and regulations may apply when methadone is used to treat narcotic dependence. These medicines are available only with your doctor's prescription. Once a medicine has been approved for marketing for a certain use, experience may show that it is also useful for other medical problems. Although not specifically included in product labeling, morphine by injection is used in certain patients with the following medical conditions:

Pain, during mechanical ventilation, neonatal Pain, postoperative, neonatal

Paracetamol
is a widely used over-the-counter analgesic (pain reliever) and antipyretic(fever reducer). It is commonly used for the relief of headaches, other minor aches and pains, and is a major ingredient in numerous cold and flu remedies. In combination with opioid analgesics, paracetamol can also be used in the management of more severe pain such as post surgical pain and providing palliative care in advanced cancer patients.[4] The onset of analgesia is approximately 11 minutes after oral administration of paracetamol,[5] and its half-life is 14 hours

Fever
Paracetamol is approved for reducing fever in people of all ages.[13] The World Health Organization (WHO) recommends that paracetamol only be used to treat fever in children if their temperature is greater than 38.5 C (101.3 F).[14] The efficacy of paracetamol by itself in children with fevers has been questioned[15] and a meta-analysis showed it to be less effective than ibuprofen.[16] Paracetamol has a well-established role in pediatric medicine as an effective analgesic and antipyretic.

Pain
Paracetamol is used for the relief of pains associated with many parts of the body. It hasanalgesic properties comparable to those of aspirin, while its antiinflammatory effects are weaker. It is better tolerated than aspirin in patients in whom excessive gastric acid secretion or prolongation of bleeding time may be a concern. Available without a prescription, it has in recent years increasingly become a common household drug.

Adverse effects
In recommended doses, the side effects of paracetamol are mild to nonexistent.[22] In contrast to aspirin, it is not a blood thinner (and thus may be used in patients where coagulation is a worry), and it does not cause gastric irritation.[23] Comparing with Ibuprofen which has adverse effects like diarrhea, vomiting and abdominal pain, Acetaminophen is well tolerated with fewer side effects.[24] Prolonged daily use increases the risk of upper gastrointestinal complications such as stomach bleeding,[25] and may cause kidney or liver damage.[23][26]Paracetamol is metabolized by the liver and is hepatotoxic; side effects may be more likely in chronic alcoholics or patients with liver damage