Editing Pathophysiology of Urinary Tract Obstruction (section)

=== Pain control ===
* '''NSAIDs'''
** '''Reduce the pain associated with renal colic by reducing collecting system pressure and distention.'''
*** '''Mechanisms of action:'''
**** '''Reduces renal blood flow (primary effect)'''
**** '''Prevent the downregulation in aquaporin and major sodium channels in the renal tubule.'''
** '''Superior to opioids'''
*** '''Associated with a greater reduction in pain scores, less need for “rescue” analgesia, and less emesis than with opioids'''
** '''Should not be used in patients with renal insufficiency'''
*** '''Renal dysfunction can be exacerbated by the decrease in RBF induced by NSAIDs'''
*** Opiods are preferred in patients with renal insufficiency
** '''COX-1 inhibitors also should not be used in patients at risk for gastrointestinal bleeding or when optimal platelet function is needed'''
** '''COX-2 inhibitors have been linked to an increased risk for myocardial infarction and stroke''' as a result of an adverse effect on blood vessels
* '''Opiods'''
** Although opioids have adverse side effects, they still provide excellent analgesia and remain an important tool in the management of the patient with renal colic
* '''α1-blockers'''
** '''May facilitate stone passage'''
** '''Reduces the requirement for analgesics'''