Caffeine NSAIDs

Simple analgesic acetaminophen, acetaminophen/aspirin/caffeine NSAIDs aspirin, ibuprofen, naproxen... 

When linezolid is used with antiplatelet drugs such as aspirin or die NSAIDs (see Chap. 18) diere is an increased risk of bleeding and thrombocytopenia When administered widi die MAOIs (see Chap. 31) the effects of the MAOIs are decreased. There is a risk of severe hypertension if linezolid is combined widi large amounts of food containingtyramine (eg, aged cheese, caffeinated beverages, yogurt, chocolate, red wine, beer, pepperoni). 

Simple analgesics (alone or in combination with caffeine) and NSAIDs are the mainstay of acute therapy. 

Drugs fludrocortisone, NSAIDs, midodrine, pyridostigmine, caffeine... 

The most prominent mixed Ai/A2 receptor antagonist is caffeine which is currently used clinically as an adjunctive analgesic in combination with acetaminophen and other NSAIDs. Its adjuvant activity has been demonstrated in both clinical and preclinical studies and it is extremely successful on the OTC market. Other mixed Ai/A2 receptor antagonist are currently being investigated in preclinical studies (Akahane et al. (Fujisawa Pharm Co), 2001). 

Nonsteroidal anti-inflammatory drugs (NSAIDs) are helpful for early and mild headache. NSAIDs include acetaminophen, ibuprofen, naproxen, and others. A recent study concluded that a combination of acetaminophen, aspirin, and caffeine could effectively relieve symptoms for many migraine patients. One such over-the-counter preparation is available as Exedrin Migraine. 

Caffeine is used as an additional ingredient in analgesic tablets about 60 mg potentiates NSAIDs also as an aid in hypotension of autonomic failure and to enhance oral ergotamine absorption in migraine... 

Ginseng ASA, NSAIDs Antidiabetic agents Clopidogrel, ticlopidine CNS stimulants, caffeine Corticosteroids Digoxin MAO inhibitors Warfarin Additive antiplatelet effects Additive hypoglycemia Additive antiplatelet effects Additive CNS toxicity Additive CNS toxicity Falsely elevated levels Increased toxicity Increased risk of bleeding... 

ASA = aspirin NSAIDs = non-steroidal anti-inflammatory drugs, such as ibuprofen, naproxen, and diclofenac CNS stimulants include drugs such as pseudoephedrine, dextroamphetamine, theophylline, and caffeine MAO = monoamine oxidase CNS depressants include drugs such as benzodiazepines, barbiturates, and ethanol SSRIs = selective serotonin reuptake inhibitors, such as fluoxetine, sertraline, and paroxetine. Antidiabetic agents include drugs such as insulin, glipizide, glyburide, and metformin. 

The chronic progression of events that lead to NSAID/analgesic related papillary necrosis are well known since the days of the first descriptions of chronic combined analgesics abuse nephropathy and the subsequent extensive investigations which defined the consequences of chronic (5-20 years) exposure of the kidney to high doses of analgesic combinations such as salicylate and acetaminophen (the metabolite of phenacetin) often with the addition of caffeine [106]. 

Patients with PUD should eUminate or reduce psychological stress, cigarette smoking, and the use of nonselective NSAIDs (including aspirin). Although there is no antiulcer diet, the patient should avoid foods and beverages (e.g., spicy foods, caffeine, and alcohol) that cause dyspepsia or that exacerbate ulcer symptoms. If possible, alternative agents such as acetaminophen, nonacetylated... 

Nonsteroidal anti-inflammatory agents (NSAIDs) are the treatment of choice for dysmenorrhea, muscle aches, and headaches. Diuretics such as spironolactone may provide some relief for bloating and fluid retention if sodium restriction is not effective. Vitamin E supplementation may reduce fibrocystic breast changes if caffeine restriction is not helpful. 

Analgesics ASA (+/- caffeine, or butabarbital), other NSAIDS, acetaminophen (+/-caffeine), oral or injectable opioid-analgesics, and butorphanol (spray)... 

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