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Nonsteroidal antiinflammatory drugs (NSAIDs)

  • NSAIDs have antiinflammatory properties by virtue of their inhibition of prostaglandin synthesis and a number of other mechanisms.
  • All NSAIDs should be used with caution (if at all) in patients with underlying renal or cardiovascular disease.
  • Individual patients have varying responses and side effects depending on the NSAID structural class.
  • The cyclooxygenase (COX)-2 specific inhibitors are associated with fewer gastrointestinal adverse events

Beneficial effects of NSAIDs:

Analgesia: some studies have shown equivalent reductions in acute pain compared with narcotics.

Antipyresis: NSAIDs inhibit prostaglandins in the central nervous system (CNS), which reduces fever.

Antiinflammatory: probably achieved by a number of mechanisms (prostaglandin inhibition is the most understood and thought to represent the main mechanism of action).

Antiplatelet: most NSAIDs decrease platelet aggregation by inhibiting COX-1, thus preventing thromboxane A2 (TXA2) production, which is important in platelet activation and clotting.


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