Analgesic drugs NSAIDs

Nonnarcotic Analgesics Nonsteroidal Anti-inflammatory Drugs (NSAIDs)... 

Short courses of non-steroidal anti-inflammatory drugs (NSAIDs) can be used to treat CF-related arthritis and hypertrophic pulmonary osteoarthropathy.5 The impact on neutrophil recruitment in the lung with long-term NSAID therapy at lower analgesic doses is unknown. 

GC, a 28-year-old woman, complains of a "terrible headache that won t go away." She describes the pain as "on one side and throbbing." The pain began yesterday morning and caused her to leave work. She reports a history of similar headaches since the age of 16, but none that lasted this long. In the past, her headaches were relieved with the use of over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs). She often has to take analgesics multiple times per week. 

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be initiated if acetaminophen therapy fails. At equipotent doses, all NSAIDs elicit similar analgesic and anti-inflammatory responses. Selection is based on patient preference, dosing frequency, tolerability, and cost. 

Simple analgesics such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are first-line agents for treating OA (Table 55-2). 

An individualized approach to treatment is necessary (Fig. 2-1). For mild or moderate pain, topical analgesics or acetaminophen can be used. If these measures fail or if there is inflammation, nonsteroidal antiinflammatory drugs (NSAIDs) may be useful. Appropriate nondrug therapies should be continued when drug therapy is initiated. 

Acetylsalicylic acid and related non-steroidal anti-inflammatory drugs (NSAIDs) selectively inhibit the cyclooxygenase activity of prostaglandin synthase [2] and consequently the synthesis of most eicosanoids. This explains their analgesic, antipyretic, and antirheumatic effects. Frequent side effects of NSAIDs also result from inhibition of eicosanoid synthesis. For example, they impair hemostasis because the synthesis of thromboxanes by thrombocytes is inhibited. In the stomach, NSAIDs increase HCl secretion and at the same time inhibit the formation of protective mucus. Long-term NSAID use can therefore damage the gastric mucosa. 

Analgesics are divided into two groups opioids (morphine-like substances), which predominantly influence the central nervous system (CNS) and nonopioids (nonsteroidal antiinflammatory or fever-reducing drugs—NSAID), which act predominantly on the peripheral nervous system. 

Non-steroidal antiinflammatory drugs (NSAIDs) are also known as nonopioid analgesics. They relieve pain without interacting with opioid receptors and do not depress CNS and have no drug dependence or drug abuse property and possess antipyretic activity also. They act primarily on peripheral pain mechanisms and also in CNS to raise pain threshold. 

Reduction of inflammation with nonsteroidal anti-inflammatory drugs (NSAIDs) often results in relief of pain for significant periods. Furthermore, most of the nonopioid analgesics (aspirin, etc) have anti-inflammatory effects, so they are appropriate for the treatment of both acute and chronic inflammatory conditions. 

Almost all non-opioid analgesics are non-steroidal anti-inflammatory drugs (NSAIDs) and have varying degrees of analgesic, anti-inflammatory and antipyretic activity. Acetylsalicylic acid (Aspirin ), used to relieve mild to moderate pain and certain types of severe pain, is the archetypal NSAID and is probably the best known and most used therapeutic drug worldwide. 

Older and still widely-used analgesic compounds can cause unacceptable side-effects. This is especially the case for the traditional non-steroidal anti-inflammatory drugs (NSAIDs) which are associated with serious gastrointestinal complications such as bleeding, lesions and ulcers. Every year it is estimated that 16,500 NSAID-related deaths occur in the US alone, with 75,000 patients hospitalized. 

Nonsteroidal Antiinflammatory Drugs. Nonsteroidal antiinflammatory drugs (NSAIDs) include, among the numerous agents of this class, aspirin (acetylsalicylic acid), the arylacetic acids indomethacin and sulindac, and the arylpropionic acids, tS)-<8) and (/ )-(9) ibuprofen, (S)-(10) and (/ )-(11), flurbiprofen naproxen, and fenoprofen. See also Analgesics, Antipyretics, and Antiinflammatory Agents and Salicylic Acid and Related Compounds. 

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