Which drug is indicated for pain related to acute renal calculi?
A. Narcotic analgesics
B. Nonsteroidal anti-inflammatory drugs (NSAIDS)
C. Muscle relaxants
D. Salicylates
Correct Answer: A. Narcotic analgesics
Narcotic analgesics are usually needed to relieve the severe pain of renal calculi. Narcotic analgesics act at the central nervous system (CNS) mu receptors and are commonly used in the treatment of renal colic. They are inexpensive and proven effective. Disadvantages include sedation, respiratory depression, smooth muscle spasm, and potential for abuse and addiction.
Option B: Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit pain and inflammatory reactions by decreasing the activity of cyclooxygenase, which is responsible for prostaglandin synthesis. Both properties are beneficial in the management of renal (ureteral) colic.
Option C: Muscle relaxants are typically used to treat skeletal muscle spasms. Muscle relaxants are used to treat muscle spasm, which may play a role in patient discomfort. Skeletal muscle relaxant used in conjunction with other therapies to treat pain and discomfort associated with musculoskeletal conditions. Reduces nerve impulse transmission from spinal cord to skeletal muscle.
Option D: Salicylates are used for their anti-inflammatory and antipyretic properties and to treat less severe pain. Aspirin is a cyclooxygenase-1 (COX-1) inhibitor. It is a modifier of the enzymatic activity of cyclooxygenase-2 (COX-2). Unlike other NSAIDs (ibuprofen/naproxen), which bind reversibly to this enzyme, aspirin binding is irreversible. It also blocks thromboxane A2 on platelets in an irreversible fashion preventing platelet aggregation.
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