NSAIDs: An Overview

NSAIDs: An Overview

This article will provide detailed information on NSAIDs, a group of non-steroidal anti-inflammatory drugs widely used to treat pain, fever and inflammation.

1. Is Paracetamol an NSAID?

The answer is no. Paracetamol is a pain reliever and fever reducer but does not possess anti-inflammatory properties like NSAIDs.

2. What are the effects of NSAIDs?

NSAIDs have four main effects:

• Fever reduction: By inhibiting the production of prostaglandins (PG) E1 and E2, NSAIDs help to reduce body temperature.

• Pain relief: NSAIDs act on pain receptors, decreasing pain sensitivity and reducing pain intensity.

• Anti-inflammation: NSAIDs inhibit the synthesis of PGs, especially PG F2 alpha, which helps reduce inflammation and swelling.

• Anti-platelet aggregation: Aspirin and some other NSAIDs have the effect of inhibiting platelet aggregation, helping to prevent blood clot formation.

3. Anti-inflammatory/analgesic ratio of NSAIDs:

• Aspirin and most other NSAIDs: Anti-inflammatory/analgesic ratio >= 2

• Indomethacin, Piroxicam: Anti-inflammatory/analgesic ratio = 1

4. Mechanism of action of NSAIDs:

• Pain relief: NSAIDs inhibit the synthesis of PG F2 alpha, reducing sensitivity at the tips of sensory nerve fibers.

• Anti-inflammation:

• Inhibition of COX (cyclooxygenase) reduces the synthesis of PG E2, F1 alpha.

• Stabilization of lysosomal membranes prevents the release of degradative enzymes.

• Antagonism of chemical mediators of the inflammatory response, inhibition of leukocyte migration, inhibition of antigen + antibody binding.

5. Mechanism of action of anti-platelet aggregation of NSAIDs:

• Low dose: Acts on platelets, reducing the synthesis of thromboxane A2.

• High dose: Acts on blood vessels, reducing the synthesis of PG (PGI2).

6. Classification of NSAIDs:

• Salicylic acid derivatives: Aspirin (acetylsalicylic acid), salicylic acid, methyl salicylic.

• Indole derivatives: Indomethacin.

• Enolic acid derivatives (oxicam): Piroxicam, tenoxicam, meloxicam.

• Phenyl acetic derivatives (diclofenac): Diclofenac.

• Propionic derivatives: Ibuprofen, naproxen.

• Selective COX-2 inhibitors: Celecoxib, etoricoxib, parecoxib.

7. Side effects of NSAIDs:

• Peptic ulcer disease: NSAIDs inhibit the production of PG E2, leading to decreased protection of the gastric mucosa.

• Salicylate syndrome: Nausea, tinnitus, deafness, confusion.

• Overdose: High doses (>10g) can cause liver cell necrosis, leading to death.

• Effects on the fetus: NSAIDs can cause delayed labor and fetal malformations.

8. Precautions when using NSAIDs:

• NSAIDs should only be used as prescribed by a doctor.

• Always read the instructions carefully before using.

• Do not increase the dose or duration of use without consulting a doctor.

• Inform your doctor if you experience any unusual symptoms while using NSAIDs.

9. Conclusion:

NSAIDs are an effective group of drugs for the treatment of pain, fever and inflammation. However, they can also cause some serious side effects. Therefore, use NSAIDs cautiously and always as directed by a doctor.