ⓘ Nonsteroidal anti-inflammatory drug

                                     

ⓘ Nonsteroidal anti-inflammatory drug

Nonsteroidal anti-inflammatory drugs are members of a drug class that reduces pain, decreases fever, prevents blood clots, and in higher doses, decreases inflammation. Side effects depend on the specific drug but largely include an increased risk of gastrointestinal ulcers and bleeds, heart attack, and kidney disease.

The term nonsteroidal distinguishes these drugs from steroids, which, having a similar eicosanoid-depressing, anti-inflammatory and have a wide range of other effects. First used in 1960, the term served to distance these drugs from steroids, which is particularly stigmatized in its time because of the connotations with the use of anabolic steroids.

NSAIDs work by inhibiting the activity of cyclooxygenase enzymes COX-1 and / or COX-2. In cells, these enzymes are involved in the synthesis of important biological mediators, namely prostaglandins, which are involved in inflammation, and thromboxanes, which are involved in blood clotting.

There are two types of NSAIDs available: non-selective and COX-2 selective. Most NSAIDs are nonselective and inhibit activity of both COX-1 and COX-2. These NSAIDs in reducing inflammation, and inhibit platelet aggregation, particularly aspirin and increase the risk of gastrointestinal ulcers / bleeding. COX-2 selective inhibitors have less gastrointestinal side effects but also contribute to thrombosis and significantly increase the risk of heart attack. As a result, COX-2 selective inhibitors are generally contraindicated due to high risk of vascular disease are diagnosed. These differential effects are due to the different roles and tissue localization of each isozyme COX. By inhibiting the physiological activity of COX all NSAIDs increase the risk of kidney disease and related mechanism of a heart attack. In addition, NSAIDs can blunt the production of erythropoietin, resulting in anemia because hemoglobin have this hormone produced. Prolonged use is dangerous and the case studies showed the health risk from celecoxib.

The most well known NSAID is aspirin, ibuprofen, and naproxen, all available without a prescription OTC in most countries. Paracetamol acetaminophen, usually are not considered NSAIDs because it has only minor anti-inflammatory activity. It treats pain mainly by blocking COX-2 and inhibition of reverse takeover endocannabinoid almost exclusively in the brain, but not in the rest of the body.