Nonsteroidal Antiinflammatory Drugs

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Information about Nonsteroidal Antiinflammatory Drugs

The nonsteroidal antiinflammatory drugs (NSAIDs) are a group of chemically heterogenous medications used widely in the therapy of mild-to-moderate pain and inflammation.

Mechanism of action of Nonsteroidal Antiinflammatory Drugs

NSAIDs act through inhibition of intracellular cyclo-oxygenase enzymes (Cox-1 and Cox-2), which cause a decrease in synthesis of the proinflammatory prostaglandins that are potent mediators of pain and inflammation. Most NSAIDs are nonselective and inhibit both Cox-1 and Cox-2. Recently, several selective inhibitors of Cox-2 have been developed that have the antiinflammatory and analgesic efficacy of other NSAIDs, but lack the effects on gastric and renal tissue that account for a majority of their adverse events (gastrointestinal bleeding and renal insufficiency).

Liver safety of Nonsteroidal Antiinflammatory Drugs

NSAIDS are among the most frequently prescribed drugs worldwide and rarely cause drug induced liver disease. However, an estimated 30 million Americans take NSAIDs every year, so that despite the overall low incidence of NSAID induced hepatotoxicity, their widescale use makes them an important cause of drug induced liver injury.

Clinical use of Nonsteroidal Antiinflammatory Drugs

NSAIDS are indicated in the treatment of various acute and chronic inflammatory conditions, headaches, and fever. The pharmacologic properties of the various NSAIDS are related to their molecular structure, which can be categorized into the five classes (Table). Not all of these agents are currently available either in the United States or elsewhere. Only ibuprofen and naproxen are available over-the-counter (in the United States); the rest are by prescription only. Carprofen and phenylbutazone are available in the United States as veterinary medications.

The drug Nonsteroidal Antiinflammatory Drugs was withdrawn from the US market

NSAIDs withdrawn from use or testing because of hepatotoxicity or other serious adverse events include benoxaprofen, sudoxicam, isoxicam, fluproquazone, bromfenac, oxyphenbutazone and phenylbutazone (aplastic anemia), indoprofen (gastrointestinal bleeding), suprofen and zomepirac (anaphylaxis).

NSAIDs in use in other countries of the world include acemetacin, azaproprazone, fenbufen, feprazone, floctafenine, flufenamic acid, nimesulide, pirprofen, and tiaprofenic acid.

List of Nonsteroidal Antiinflammatory Drugs

PROPIONIC ACIDS ACETIC ACIDS FENAMIC ACIDS PYRAZALONES OXICAMS
Carprofen

Benoxaprofen
Fenbufen
Fenoprofen*
Flurbiprofen*
Ibuprofen*
Indoprofen
Ketoprofen* 
Loxoprofen
Oxaprozin*
Naproxen*
Pirprofen
Tiaprofenic acid

Aceclofenac*

Acemetacin
Bromfenac
Diclofenac* 
Etodolac* 
Indomethacin* 
Ketorolac*
Nabumetone*
Sulindac*
Tolmetin*
Zomepirac

Floctafenine
Flufenamic
Meclofenamate*
Mefenamic acid*  

Azapropazone

Feprazone
Oxyphenbutazone
Phenylbutazone

Isoxicam
Lornoxicam 
Meloxicam*
Piroxicam*
Sudoxicam  

*Currently available for human use in the United States.

Nonsteroidal Antiinflammatory Drugs (NSAIDs)

Acetaminophen, Celecoxib, Diclofenac, Diflunisal, Etodolac, Fenoprofen, Flurbiprofen, Ibuprofen, Indomethacin, Ketoprofen, Ketorolac, Mefenamic Acid, Meloxicam, Nabumetone, Naproxen, Nimesulide, Oxaprozin, Phenylbutazone, Piroxicam, Rofecoxib, Sulindac, Tolmetin This article is a stub. YOU can help Wikimd by expanding it!

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