Nonsteroidal Anti-inflammatory Drugs (NSAIDs)
Nonsteroidal anti-inflammatory drugs, NSAIDs, have a substantial role in medical practice. They are commonly acquired as over-the-counter medications but may also be prescribed for their ability to relieve pain, alleviate inflammation, and reduce fever. NSAIDs work by inhibition of the cyclooxygenase enzymes (COX), affecting the production of mediators involved in pain pathways and inflammation. NSAIDs have become well known for a multitude of adverse effects, which stem from altering the homeostatic properties of cyclooxygenase in various organs. In an attempt to mitigate some of the adverse effects, COX-2 selective medications were introduced; however, there still remain undesired reactions and potential harm from their use.
Note: Although acetaminophen is not an NSAID, it is typically discussed alongside these compounds. In this text, acetaminophen is covered in the Cancer Pain chapter.
KeywordsPain Analgesia COX-1 COX-2 NSAIDs Prostaglandins Inflammation Side effects
- 11.Katzung & Trevor’s pharmacology: examination & board review 11e. Chapter 36: NSAIDs, Acetaminophen, & Drugs Used in Rheumatoid Arthritis & Gout. Copyright © 2015, 2013, 2010, 2008, 2005, 2002 by McGraw-Hill Education. All rights reserved. Printed in the United States of America.Google Scholar
- 12.Nonsteroidal anti-inflammatory drugs and cyclooxygenase-2 inhibitors. Steven D. Waldman. Pain Management, Second Edition. Chapter 121, 884–889. Copyright 2011, 2007 by Saunders, an imprint of Elsevier Inc. All rights reserved.Google Scholar
- 21.Practice advisory on low-dose aspirin and prevention of preeclampsia: updated recommendations. This practice advisory was developed by the American College of Obstetricians and Gynecologists in collaboration with Christopher M. Zahn, MD; Joseph R. Wax, MD; and T. Flint Porter, MD. July 11, 2016.Google Scholar
- 22.National Reye’s Syndrome Foundation. Reye’s syndrome bulletin, 2005. Accessed 20 Aug 2009.Google Scholar
- 36.Balancing Risks and Benefits: cardiovascular Safety of NSAIDs. Jul 22, 2016. Prashant Vaishnava, MD. American College of Cardiology.Google Scholar
- 38.FDA strengthens warning For NSAIDs. Jul 10, 2015 ACC News Story. American College of Cardiology.Google Scholar
- 39.Perry LA. Cardiovascular risk associated with NSAIDs and COX-2 inhibitors. US Pharm. 2014;39(3):35–8.Google Scholar