non-steroidal anti-inflammatory drugs
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non-steroidal anti-inflammatory drugs
A range of drugs with painkilling and inflammation-reducing properties that act by inhibiting the enzyme cyclo-oxygenase that converts the fatty acid arachidonic acid to PROSTAGLANDINS. The latter are a common cause of pain and the inhibition of their production relieves pain, but prostaglandins also have desirable effects, hence some of the unwanted side-effects of NSAIDs. Long-term use of these drugs has been found to be associated with a reduced incidence of oral cancer but with an increased risk of death from cardiovascular disease. The range of NSAIDs includes ASPIRIN, BENORYLATE (benorilate), DIFLUNISAL, FENBUFEN, FENOPROFEN, IBUPROFEN, NAPROXEN, DICLOFENAC, INDOMETHACIN (indometacin), PHENLYBUTAZONE and PIROXICAM.Non-steroidal anti-inflammatory drugs (NSAIDs)
Aspirin, ibuprofen, naproxen, and many others.
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non-steroidal anti-inflammatory drugs
; NSAIDs group of anti-inflammatory and analgesic drugs that include aspirin, propionic acid derivatives (e.g. ibuprofen, fenbrufen, ketoprofen) and similar drugs (e.g. diclofenac, difusinal, etodolac, indometacin, meloxicam, prioxicam, sulindac, ketorolac and mefenamic acid); action: NSAIDs suppress inflammation and pain by inhibiting the cyclooxygenase pathway and preventing release of inflammatory mediators (e.g. prostacyclins, prostaglandins and thromboxanes); used to control acute inflammation and pain (e.g. soft-tissue or bone injury), chronic inflammation (e.g. associated with osteo- or rheumatoid arthritis); side-effects of long-term use include reduced healing, compromised immunity, increased susceptibility to infections, epidermal atrophy (thinning of skin), peripheral oedema, bruising and bleeding tendency (i.e. antiplatelet effect), gastric irritation and/or ulceration, tinnitus and anaemia (secondary to gastrointestinal bleeding) (Table 1); NSAIDs are contraindicated in ischaemic heart disease, cerebrovascular disease, peripheral arterial disease and heart failure; patients with angina or ischaemic heart disease, or those at risk of cerebrovascular accident (stroke) are advised to take 75mg aspirin daily; NSAIDs alone may be inadequate to control postoperative pain (see Table 2)| System | Effect |
| Gastrointestinal | Nausea; dyspepsia; diarrhoea; peptic ulceration or perforation; bleeding |
| Renal | Fluid retention; peripheral oedema; renal failure; papillary necrosis; interstitial fibrosis |
| Respiratory | Bronchoconstriction; pulmonary eosinophilia; alveolitis |
| Coagulation | Reduced platelet aggregation; increased bleeding time; easy bruising |
| Skin | Severe allergic reactions (e.g. Stevens–Johnson syndrome); toxic epidermal necrolysis; angioedema; skin thinning; reduced healing |
| Visceral | Congestive heart failure; hepatitis; pancreatitis; aseptic meningitis |
| System | Effect |
| Gastrointestinal | Nausea; dyspepsia; diarrhoea; peptic ulceration or perforation; bleeding |
| Renal | Fluid retention; peripheral oedema; renal failure; papillary necrosis; interstitial fibrosis |
| Respiratory | Bronchoconstriction; pulmonary eosinophilia; alveolitis |
| Coagulation | Reduced platelet aggregation; increased bleeding time; easy bruising |
| Skin | Severe allergic reactions (e.g. Stevens–Johnson syndrome); toxic epidermal necrolysis; angioedema; skin thinning; reduced healing |
| Visceral | Congestive heart failure; hepatitis; pancreatitis; aseptic meningitis |