Analgesics and Antiinflammatory Agents

Rheumatoid arthritis is a disease that involves inflammation in joints and causes severe pain and immobility. The worldwide scenario indicates that the elderly population suffers the most from this disease. The drugs of choice for treatment of this condition are nonsteroidal antiinflammatory drugs (NSAIDs), which include acetylsalicylic acid, diclofenac sodium, piroxicam, nimesulide, celecoxib, and refecoxib. Therapeutic doses, adverse effects, and precautions are given in the foifowing pages. 

NSAIDs are groups of unrelated organic acids such as mefenamic acid, which have analgesic, antiinflammatory, and antipyretic activities. NSAIDs are used to relieve mild to moderate pain, raised temperature, and acute and chronic inflammatory disorders such as osteoarthritis, rheumatoid arthritis, juvenile chronic arthritis, and ankylosing spondylitis. NSAIDs are applied locally for the relief of muscular pain and are useful in ophthalmic preparations for inflammatory eye disorders.1-4 NSAIDs have been used to relieve pain, particularly in cancer patients, forming a cornerstone in pain management. NSAIDs also are used 

The major problem of NSAIDs is gastrointestinal (GI) irritation, leading to ulceration. Recent drugs such as celecoxib (a cyclooxygenase-II inhibitor) have a mild effect on the GI tract and have proven to be the drugs of choice for the treatment of rheumatoid arthritis. 

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Magnesium sahcylate, an analgesic and antiinflammatory agent, appears to have exceptional abihty to reheve backaches. It is also used for the symptomatic rehef of arthritis. Magnesium sahcylate is prepared in a similar manner as sodium sahcylate, using the appropriate magnesium carbonate salt. 

Amino-4-mercapto-6-methylpyridazine (10) (pyridazine Sj CAS 18591-81-6) represents another newly discovered antipyretic, analgesic and antiinflammatory agent [72], It was the most effective compound among several mercaptopyridazines tested in the German Democratic Republic [73-75] the acute toxicity was found to be low (LD50 x 10 mmol/kg p.o. mouse) [74]. 

Fry SW, Seeff LB. Hepatotoxicity of analgesics and antiinflammatory agents. Gastroenterol Clin North Am 1995 24(4) 875-905. 

Tubulointerstitial nephritis can be either acute or chronic in nature. Acute interstitial nephritis is characterized by an acute renal interstitial inflammatory response with urinary eosinophils and nonoliguric acute renal failure. The more common drugs that induce acute interstitial nephritis include penicillins, rifampicin, sulfonamides, and cimetadine. Chronic tubulointerstitial nephritis is most commonly associated with the long term use of large amounts of analgesics and antiinflammatory agents (e.g., NSAIDs). 

In addition to chlorpromazine, phenylbutazone (an analgesic and antiinflammatory agent), sulfonamides (chemotherapeutic agents), chlorothiazide (a diuretic), thiouracil and methima-zole (antithyroid drugs), phenytoin (an anticonvulsant), pyribenzamine (an antihistaminic), and chloramphenicol... 

Useful as intermediates analgesic and antiinflammatory agents (mice rats). 

Amidopyrine agranulocytosis or pancytopenia is extremely rare and transient (Flandrin et al. 1971). Although it is an excellent antipyretic, analgesic, and antiinflammatory agent, amidopyrine should be employed only after safer drugs and other measures have proven ineffective. 

In modem medicine, the medicinal plant-derived products are increasingly being sought after as pharmaceuticals and nutraceuticals for the treatment of several ailments due to their efficacy and cost-effectiveness. Rubiaceae family, consisting of 13,200 species, is of special interest as they contain economically and medicinally important members [1]. Coffee from Cojfea spp. is considered as second most economically precious commodity after oil worldwide. Furthermore, Rubiaceae family is also often regarded as coffee family. Quinine is the first and most effective antimalarial which is also used as antipyretic and analgesic and antiinflammatory agent, discovered from Cinchona spp. provides evidence for the cmcial role of Rubiaceae family members in the medicinal field [2]. Yohimbe is an aphrodisiac derived from Pausinystalia yohimbe available as prescribed medicine and recently received an exploration as remedy for type 2 diabetes [3]. 

Antipyretic and antineuralgic. Cryst. Other metal salts of salicylic acid are used mainly as analgesics and antiinflammatory agents e.g. Magnesium salicylate, USAN. 

ANALGESICS,ANTIPYRETICS,AND ANTIINFLAMMATORY AGENTS] (Vol2) Buprenorphme [52485-79-7]... 

See Analgesics, antipyretics, and antiinflammatory agents Chemotherapeutics, anticancer Immunotherapeutic agents. 

Nonsteroidal Antiinflammatory Drugs. Nonsteroidal antiinflammatory dmgs (NSAIDs) include, among the numerous agents of this class, aspirin (acetylsaflcyhc acid), the arylacetic acids indomethacin and sulindac, and the arylpropionic acids, (5)-(147) and (R)-(148) ibuprofen, (5)-(149) and (R)- (150), flurbiprofen naproxen (41), and fenoprofen (see Analgesics, antipyretics, and antiinflammatory agents Salicylic acid and related compounds). 

Many 1,2,3,5-benzenetetrol derivatives are used mediciaaHy. For example, khellin [82-02-0] (65), which is a naturally occurring benzopyranone, is used as a coronary vasodilator and bronchodilator (233). Derivatives of khellin are effective local anesthetics and antiarrythmics (234). Similarly, amine derivatives (68) that are prepared from khellinone oxime (66) exhibit hypnotic, sedative, anticonvulsant, antiinflammatory, cardiac analeptic, diuretic, and antiulcerous activity (235) (see Analgesics, antipyretics, and antiinflammatory agents). 

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