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Non-steroidal anti-inflammatory drug

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Riding a bicycle, a 31 year old male, fell into a trench. This freak accident leads to a fracture in his leg. A cast was put around his broken bone and nonsteroidal anti-inflammatory drugs (NSAIDs) prescribed to relieve the pain. NSAIDs is a group of medications that are most widely used around the world. However, most of them have potential side-effects known to all. It is very important to note the benefits as well as the adverse effects of these easily available over-the-counter drugs.

What is Nonsteroidal Anti-inflammatory Drugs?

Non-steroidal anti-inflammatory drugs or NSAIDs are commonly used drugs that have an analgesic and antipyretic effect. These drugs are different from steroids and have anti-inflammatory effect. These pain killers effectively reduce the discomfort without having any narcotic or drowsy effect. The most commonly available NSAIDs include aspirin, ibuprofen and naproxen.

How Do Nonsteroidal Anti-inflammatory Drugs Work?

NSAIDs help in relieving pain, inflammation as well as fever. These drugs tend to reduce the production of a hormone called prostaglandins. This hormone plays a role in inflammation, fever and pain. On the other hand, prostaglandins also help in protecting the stomach lining from the effects of acids.

There are two types of cyclooxygenase (COX) enzymes that produce prostaglandins. COX-1 and COX-2 both produce the type of prostaglandins that have different functions in the body.   COX-1 is the type that produces prostaglandins that play a role in protection of the stomach lining. COX-2 is the type that produce prostaglandins that play a role in fever, pain and inflammation.

NSAIDs act on cyclooxygenase enzymes and block it from producing prostaglandins. Thus, helps in reducing pain, inflammation and fever. However, it also blocks COX-1, thus, leading reduce clotting acting, development of ulcers in the stomach, nausea, bruising and other side effects.

Are There NSAIDs That Specifically Block COX-2?

There are special drugs that act only on COX-2. They target COX-2 enzyme and help in the reduction of inflammation. These drugs do not lead to ulcers as they do not act on COX-1 enzyme . However, these drugs have a reduced effect in protecting one against heart diseases.

One should keep in mind, if they are taking COX-2 inhibitor NSAIDs, then they should never team along with the normal NSAIDs. Also, these drugs are not free from side effects. They lead to abdominal pain, nausea, upset stomach, etc.

Examples for specific COX-2 inhibitor is celecoxib

Uses of Nonsteroidal Anti-inflammatory Drugs

NSAIDs are prescribed for chronic and acute pain and inflammation. They are usually prescribed for:

  • Arthritic conditions like Rheumatoid arthritis, osteoarthritis, psoriatic arthritis, etc.
  • Menstrual pain
  • Postoperative pain
  • Reiter’s syndrome
  • Metastatic bone pain
  • Headache
  • Fever
  • Muscle stiffness due to Parkinson’s disease
  • Neonates whose ductusarteriosusare not closed within 24 hours of birth

Benefits of Nonsteroidal Anti-inflammatory Drugs

NSAIDs benefits include:

  • They are quick acting drugs and give relief from pain within a few hours of ingestion.
  • They provide relief from pain and stiffness.
  • They help reduce inflammation and fever.
  • One can try two or three different NSAIDs to find the one that provides them with maximum relief. (Remember; take only one type at a time.)

How to Administer Nonsteroidal Anti-inflammatory Drugs?

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NSAIDs can be taken orally in the form of a tablet or capsule. These drugs are also available as creams, sprays, injections, liquids as well as suppositories.

NSAIDs help provide relief form short term symptoms or management of chronic pain and stiffness. In some cases, they should be taken only when one suffers from pain.

One should first begin with a low dose NSAID to understand the body’s response to the drug. If it does not help, one can gradually increase the strength. The lowest dose taken ensures minimum side effects. Or else, one should follow the dosage prescribed by their doctor.

Commonly used Nonsteroidal Anti-inflammatory Drugs are

  • Asprin
  • Celecoxib
  • Diclofenac
  • Ibuprofen
  • Indomethacin
  • Naproxen
  • Fenoprofen
  • Ketoprofen
  • Piroxicam
  • Tolmetin

Side Effects of Nonsteroidal Anti-inflammatory Drugs

NSAIDs can lead to side effects. One should inform their doctor regarding these side effects to know if a change in dose or medication is needed. Some of the side effects include:

Most common side effects are

Less common side effects are

Patients with existing conditions can suffer from rare, but serious side effects like:

In some rare cases, patients develop Reye’s syndrome. It is associated with ingestion of aspirin by children suffering from a viral illness such as chickenpox, influenza. Reyes syndrome affects multiple organs. It affects the brain and liver leading to rash, vomiting and liver damage. This is one of the main reasons as to why aspirin is never recommended to be used in children.

This was a short summary related to non-steroidal anti-inflammatory drug. These drugs are widely used to ease pain, inflammation and fever. If one experiences any side effects, they should discontinue the drug. Do not take excessive NSAIDs without prescription. It could lead to severe complications in the long run. If you have any further query regarding these drugs, speak to your doctor for details.

Written by: Saptakee sengupta
Date last updated: March 13, 2015