Antiinflammatory drugs, nonsteroidal treatment

TABLE 1-1 Dosage Regimens of Nonsteroidal Antiinflammatory Drugs for Treatment of Acute Gouty Arthritis... 

FIGURE 1-1. Treatment algorithm for acute gouty arthritis. (NSAID, nonsteroidal antiinflammatory drug.)... 

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. 

FIGURE 2-1. Treatment for osteoarthritis. (COX, cyclooxygenase IA, intraarticular NSAID, nonsteroidal antiinflammatory drug OA, osteoarthritis PPI, proton pump inhibitor.)... 

FIGURE 4-1. Algorithm for treatment of rheumatoid arthritis. (DMARD, diseasemodifying antirheumatic drug MIX, methotrexate NSAID, nonsteroidal antiinflammatory drug Rx, therapy.)... 

Because of a significant incidence of side effects and a lack of compelling evidence, Nonsteroidal antiinflammatory drugs are not recommended for treatment or prevention of AD. 

Clinical use Ethenzamide is a nonsteroidal antiinflammatory drug used mainly in combination with other ingredients for the treatment of mild to moderate pain including musculoskeletal and joint disorders. 

Clinical use Flurbiprofen is a nonsteroidal antiinflammatory drug used for the treatment of pain and inflammation associated with musculoskeletal and joint disorders as well as neuralgias, dysmenorrhoea and postoperative pain. 

Asgari M, White E, Chren MM. Nonsteroidal antiinflammatory drug use in the prevention and treatment of squamous cell carcinoma. Dermatol Surg. 2004 30 1335-1342. 

The development of aspirin was a significant landmark in the history of medicine because it stimulated the development of a family of medicines, collectively known as the nonsteroidal antiinflammatory drugs (NSAIDs). NSAIDs such as ibuprofen, naproxen, and sulindac are valuable drugs used for the alleviation of pain, inflammation, and fever, and they are commonly prescribed for the treatment of rheumatoid disorders such as arthritis. The world market for NSAIDs now exceeds 6 billion (Vainio and Morgan, 1997). 

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. 

Chronic heart failure is typically managed by reduction in physical activity, low dietary intake of sodium (less than 1500 mg sodium per day), and treatment with vasodilators, diuretics and inotropic agents. Drugs that may precipitate or exacerbate CHF—nonsteroidal antiinflammatory drugs (NSAIDs), alcohol, (3-blockers, calcium channel-blockers and some antiarrhythmic drugs—should be avoided if possible. Patients with CHF complain of dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, fatigue, and dependent edema. 

Gotzsche PC (1989). Methodology and overt and hidden bias in reports of 196 doubleblind trials of nonsteroidal antiinflammatory drugs in rheumatoid arthritis. Control in Clinical Trials 10 31-56 Gruppo ItaUano per lo Studio della Streptochinasi nell Infarto Miocardico (GISSI) (1986). Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1 397-402 Gurwitz JH, Col NF, Avorn J (1992). The exclusion of elderly and women from clinical trials in acute myocardial infarction. Journal of the American Medical Association 268 1417-1422... 

Other potentially nephrotoxic drugs (e.g, nonsteroidal antiinflammatory drugs) should be used with caution in patients receiving gentamicin therapy, Data for once-daily dosing of aminoglycosides for children exist, but no data for treatment of infective endocarditis exist. 

Dachir, S., Cohen, M., Fishhine, E., Sahar, R., Kadar, T. (2008). Beneficial effect of treatment with nonsteroidal antiinflammatory drugs against sulfur mustard skin injury. Proceedings of the U.S. Army Medical Defense Bioscience Review, Hunt Valley, MD, 150 pp. 

Although most treatments for endometriosis are directed at the implant themselves, the symptoms can be also treated directly. Nonsteroidal antiinflammatory drugs (NSAID) such as diclofenac, ibuprofen, mefenamic acid, are often given to relieve the pain associated with endometriosis. These drugs are frequently the first-line treatment in women with pelvic pain whose cause has not yet been proved to be endometriosis. 

Kovarik JM, Mueller EA, Gerbeau C, Tarral A, Francheteau P, Guerret M. Cyclosporine and nonsteroidal antiinflammatory drugs exploring potential drug interactions and their imphcations for the treatment of rheumatoid arthritis. J Qin Pharmacol 1997 37(4) 336-43. 

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