{"id":6566,"date":"2026-06-03T14:21:31","date_gmt":"2026-06-03T18:21:31","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&p=6566"},"modified":"2026-06-09T15:22:58","modified_gmt":"2026-06-09T19:22:58","slug":"anti-inflammatory-analgesic-and-antipyretic-therapies","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/anti-inflammatory-analgesic-and-antipyretic-therapies\/","title":{"raw":"Section 13:\u00a0 Anti-Inflammatory, Analgesic, and Antipyretic Therapies","rendered":"Section 13:\u00a0 Anti-Inflammatory, Analgesic, and Antipyretic Therapies"},"content":{"raw":"

PRICE Therapy<\/strong><\/span><\/h3>\r\nPRICE<\/strong> is a non-pharmacological first-line approach to inflammation and pain from minor injuries:\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
P = Protection<\/strong><\/span><\/td>\r\nProtect the damaged area from further injury (e.g., splint, cast, crutches)<\/td>\r\n<\/tr>\r\n
R = Rest<\/strong><\/span><\/td>\r\nReduces blood flow, limiting inflammation.\r\n\r\nTemporary rest is recommended; prolonged rest however may delay functional recovery.<\/td>\r\n<\/tr>\r\n
I = Ice<\/strong><\/span><\/td>\r\nInduces vasoconstriction, reducing exudate leakage and swelling.\r\n\r\nAlso depresses nerve activity, reducing pain.<\/td>\r\n<\/tr>\r\n
C = Compression\u00a0<\/strong><\/span><\/td>\r\nStops external bleeding and limits exudate accumulation and swelling.<\/td>\r\n<\/tr>\r\n
E = Elevation<\/strong><\/span><\/td>\r\nDrains excess fluid away from the damaged area, reducing swelling.<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n

*For muscle or joint injuries, alternating warm and cold compresses is often advised - heat improves circulation to remove excess fluid, pain-causing chemicals and cellular waste; cold reduces acute swelling and depresses nociceptors.\u00a0 Adequate nutrition and hydration support optimal healing.<\/p>\r\n\r\n\r\n[caption id=\"attachment_2371\" align=\"alignnone\" width=\"300\"]\"RICE:<\/a> RICE: rest, ice, compression, and elevation[\/caption]\r\n

Pharmacological Treatments:\u00a0 How They Work<\/strong><\/span><\/h3>\r\n

Mast cells and basophils convert phospholipids<\/strong> \u2192 arachidonic acid<\/strong> \u2192 prostaglandins<\/strong> using cyclooxygenase enzymes (COX-1 and COX-2).\u00a0<\/strong> Prostaglandins stimulate nociceptors<\/strong> to induce pain and also trigger blood vessels to vasodilate and increase in permeability as part of the inflammatory response<\/strong>.\u00a0 Many analgesics and most anti-inflammatory drugs therefore target this pathway:<\/p>\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
ASA (Aspirin) - NSAID<\/strong><\/span><\/td>\r\nBlocks COX-1 and COX-2<\/strong> \u2192 reduces production of many different prostaglandins\r\n\r\nPros:\u00a0<\/strong> Reduces pro-inflammatory prostaglandins \u2192 reduces inflammation, pain, and fever.\r\n\r\nCons of long-term use:<\/strong>\r\n
    \r\n \t
  • Reduces non-inflammatory prostaglandins (e.g. PG12<\/sub>) involved in the production of protective gastric mucus \u2192 gastric and peptic ulcers<\/strong>;<\/li>\r\n \t
  • Reduces thromboxane production required for platelet adhesion during hemostasis \u2192 excessive bleeding.<\/strong>\u00a0 <\/span><\/li>\r\n \t
  • Can be an allergen.<\/span><\/li>\r\n<\/ul>\r\nAt low doses, sometimes prescribed to reduce clotting risk<\/strong>.\r\n\r\nCaution:\u00a0 Never give to children\/teenagers with viral infection<\/strong> - risk of Reye's syndrome<\/strong> (potentially fatal liver and brain damage).<\/td>\r\n<\/tr>\r\n
Acetaminophen (Tylenol)<\/strong><\/span><\/td>\r\nBlocks part of the COX-2 downstream pathway<\/strong>, reducing prostaglandin E2<\/sub> \u2192 reduces fever and pain, but not inflammation<\/strong>.\r\n\r\nMust be taken as directed to avoid liver and kidney damage.\u00a0 Can be an allergen.<\/td>\r\n<\/tr>\r\n
NSAIDs (Ibuprofen, Advil)<\/strong><\/span><\/td>\r\nBlock COX-1 and COX-2<\/strong> (less COX-1 blockade than ASA) \u2192 reduce pro-inflammatory prostaglandins<\/strong> \u2192 decrease inflammation, fever, and pain.\r\n\r\nNot linked to Reye's syndrome, less gastric irritation, and less effect on platelet function than ASA.<\/td>\r\n<\/tr>\r\n
COX-2 Selective Drugs (Celecoxib)<\/strong><\/span><\/td>\r\nPreferentially block COX-2<\/strong>, targeting pro-inflammatory prostaglandins while sparing COX-1 (which produces protective gastric prostaglandins).\u00a0 An effective analgesic, anti-inflammatory<\/strong> and anti-pyretic.<\/strong>\r\n\r\nFewer side effects than ASA.<\/td>\r\n<\/tr>\r\n
Glucocorticoids (Corticosteroids)<\/strong><\/span><\/td>\r\nImmunosuppressive<\/strong> and anti-inflammatory:<\/strong> reduce WBC migration, proliferation, and activity; decrease production of pro-inflammatory mediators, vasodilation, capillary permeability, and swelling.\r\n\r\nNot<\/strong> analgesics or antipyretics.\r\n\r\nSide effects:\u00a0<\/strong>\r\n