Medicines Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed medicines. Although these compounds represent a very effective class of drugs, their use is associ-... 

Thalidomide would fall into this category due to its inadequate testing but most commonly improper use refers to off-label use. Use of off-label pediatric medicines has been discussed earlier in this chapter. An example of off-label adult use is with Bromfenac (Duract), a nonsteroid anti-inflammatory drug. Duract was developed for short term therapy (<10 days) in 1997 butwith longer term, off-label, use elevated liver enzymes were evident and it was withdrawn approximately 1 year later. In its time on the market Duract generated approximately 90 million dollars in sales. 

Whelton A, Whelton A. Renal aspects of treatment with conventional nonsteroidal anti-inflammatory drugs versus cyclooxyge-nase-2-speciflc inhibitors. American Journal of Medicine 2001 110 SuppI 3A 33S-42S. 

Perez GS, Garcia Rodriguez LA, Raiford DS et al. Nonsteroidal anti-inflammatory drugs and the risk of hospitalization for acute renal failure.. Archives of Internal Medicine 1996 156 2433-2439. 

Pope JE, Anderson JJ, Eelson DT, Pope JE, Anderson JJ, Eelson DT. A meta-analysis ofthe effects of nonsteroidal anti-inflammatory drugs on blood pressure. Archives of internal Medicine 1993 153 477-484. 

BenderWL,Whelton A, BeschornerWEetal. Interstitial nephritis, proteinuria, and renal failure caused by nonsteroidal anti-inflammatory drugs. Immunologic characterization of the inflammatory infiltrate. American Journal of Medicine 1984,-76 1006-1012. 

SturmerT, Erb A, Keller F et al. Determinants of impaired renal function with use of nonsteroidal anti-inflammatory drugs the importance of half-life and other medications. American Journal of Medicine 2001 111 521-527. 

Fischer LM, Schlienger RG, Matter CM et al. Discontinuation of nonsteroidal anti-inflammatory drug therapy and risk of acute myocardial infarction. Archives of Internal Medicine 2004 64 2472-2476. 

Feenstra J, Heerdink ER, Grobbee DE et al. Association of nonsteroidal anti-inflammatory drugs with first occurrence of heart failure and with relapsing heart failure the Rotterdam Study. Archivesof Internal Medicine 2002 62 265-270. 

Kahn L H, Styrt B A 1997 Necrotizing soft tissue infections reported with nonsteroidal anti-inflammatory drugs. Annals of Pharmacotherapy 31 1034-1039 Karcher L R Dill S G, Anderson W I et al 1990 Right dorsal colitis. Journal of Veterinary Internal Medicine 4 247-253... 

Reimer M E, Johnston S A, Leib M S et al 1999 The gastroduodenal effects of buffered aspirin, carprofen and etodolac in healthy dogs. Journal of Veterinary Internal Medicine 13 427-477 Ricketts A P, Lundy K M, Seibel S B 1998 Evaluation of selective inhibition of canine cyclooxygenase 1 and 2 by carprofen and other nonsteroidal anti-inflammatory drugs. American Journal of Veterinary Research 59 1441-1446... 

At this stage, an assessment is made as to whether the medicine that could result is likely to be palliative or disease-modifying . Diseasemodifying drugs (DMD) are those which directly and beneficially deflect the natural history of the disease. Nonsteroidal anti-inflammatory drugs and methotrexate are examples of each of these in patients with rheumatoid arthritis. Then probability of one or the other can alter economic assessments of the research program, and lead to a go-no-go decision in some cases. 

Hamor GH. Nonsteroidal anti-inflammatory drugs. In Foye WO, ed. Principles of Medicinal Chemistry. 3rd Ed. Philadelphia Lea Febiger, 1989 503-530. 

Historical At the beginning of the 1930 s U. S. von Euler and M. W. Goldblatt independently detected a substance with activity in smooth musculature in seminal fluid, the structure of this compound was elucidated by Beigstrdm in 1958-1964. Further key data 1968 total synthesis by Corey, beginning of the 1970 s elucidation of the mechanism of action of nsaid (nonsteroidal anti-inflammatory drugs), 1975 thromboxane, 1976 prostacyclin, 1979 leukotrienes, 1982 Nobel Prize for Medicine awarded to Vane, Samuelsson, and Bergstrom. ... 

P. N. P. Rao, E. E. Knaus (2008) Evolution of nonsteroidal anti-inflammatory drugs (NSAlDs) Cyclooxygenase (COX) inhibition and beyond. J. Pharm. Pharmaceut. Sci., 11, 81-110. http //en.wikipedia.org/wiki/Acetylsalicylic acid (last access February 25, 2014). http //nobelprize.org/nobel prizes/medicine/laureates/1982/vane.html (last access February 25, 2014). 

Ong, C.K., Lirk, P., Tan, C.H., Seymour, R.A. 2007. An evidence-based update on nonsteroidal anti-inflammatory drugs. Clinical Medicine Research, 5 19-34. 

WE Coyne, Nonsteroidal Anti-inflammatory Agents and Antipyretics, In Burger s Medicinal Chemistry and Drug Discovery, ME WoUf (Ed.) 5th edn., John Wiley and Sons inc.. New York (1995). 

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