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Nonsteroidal Anti-Inflammatory Drugs
By
M.H.Farjoo M.D. , Ph.D.Shahid Beheshti University of Medical Science
Nonsteroidal Anti-Inflammatory Drugs
Introduction & Classification Mechanism of Action Adverse Effects Acetylsalicylic acid (ASA) Acetaminophen Other Non-Selective COX Inhibitors COX-2 Selective Inhibitors Drug Pictures
Introduction & Classification
NSAIDs: nonsteroidal anti-inflammatory drugs
The cyclooxygenase pathway of arachidonate metabolism produces prostaglandins
COX-1 isoform tends to be homeostatic in function
COX-2 is induced during inflammation Highly selective COX-2 inhibitors have been
developed
Acetylsalicylic acid (ASA) Aspirin inhibits both COX isozymes Analgesic effects Antipyretic effects Antiplatelet effects Clinical uses
Mild to moderate pain Transient ischemic attacks Unstable angina Coronary artery thrombosis
Contraindication: Patients with hemophilia
Toxicity
Irreversible inhibition of platelet COXAntiplatelet effect lasts 8–10 days (the life of the platelet)
Acetaminophen Treatment of mild to moderate pain No significant antiinflammatory effects Equivalent to aspirin as an analgesic and antipyretic
agent Lacks anti-inflammatory and platelet-inhibiting
properties Is the preferred drug in patients allergic to aspirin Is preferable to aspirin in patients with hemophilia or
a history of peptic ulcer Preferred to aspirin in children with viral infections
Other Non-Selective COX Inhibitors
Ibuprofen With aspirin may decrease the total anti-inflammatory
effect Antagonizes the irreversible platelet inhibition
induced by aspirin
Mefenamic acid Should not be used for longer than 1 week Should not be given to children
Other Non-Selective COX Inhibitors
Indomethacin Gout Ankylosing spondylitis Patent ductus arteriosus (PDA) Has the greatest toxicity among NSAIDs Is slightly selective for COX-1
COX-2 Selective Inhibitors
Celecoxib and rofecoxib preferentially inhibit COX-2
Fewer gastrointestinal side effects
No impact on platelet aggregation
Do not offer the cardioprotective effects
SummaryIn English
Thank youAny question?
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