Non-steroidal antiinflammatory drug

Synthetic ligands Thiazolidinediones and some non-steroidal antiinflammatory drugs... 

Gastric mucosal injury induced by non-steroidal antiinflammatory drugs such as aspirin and indomethacin has also been extensively studied, again with somewhat conflicting results. Several studies have shown a protective effect of SOD, catalase, hydroxyurea and desferrioxamine (Takeuchi et al., 1991a Vaananen et al., 1991 Naito et al., 1992). Del Soldato etal. (1985) also found aminopy-rine, thiourea and its derivative, MK 447, and SAZ to be protective. Allopurinol has been shown to be both protective (Takeuchi etal., 1991a) and ineffective (Vaananen etal., 1991). 

NPY Neuropeptide Y NRS Normal rabbit serum NSAID Non-steroidal antiinflammatory drug NSE Nerve-specific enolase NT Neurotensin N terminus Amino terminus of peptide... 

COX-2, cyclooxygenase-2 HF, heart failure NSAID, non-steroidal antiinflammatory drug. 

Tannenbaum H, Bomardier C, David P, et al. An evidence-based approach to prescribing non-steroidal antiinflammatory drugs Third Canadian Consensus Conference. J Rheumatol 2006 33 140-157. 

FIGURE 30-2. Pain algorithm. AED, antiepileptic drug APAP, acetaminophen NSAID, non-steroidal antiinflammatory drug SNRI, serotonin-norepinephrine reuptake inhibitor SSRI, selective serotonin reuptake inhibitor TCA, tricyclic antidepressant. 

IgE-mediated urticarial/angioedema reactions and anaphylaxis are associated with aspirin and non-steroidal antiinflammatory drugs. Urticaria is the most common form of IgE-mediated reaction. This class is second only to P-lactams in causing anaphylaxis. 

Anti-inflammatory Drugs that reduce inflammation, including the non-steroidal antiinflammatory drugs (NSAIDs) aspirin, ibuprofen and indomethacin and the glucocorticoids (e.g., dexamethasone and cortisol). 

One industrial application has been reported in detail by Giordano [26], Figure 13.23. It concerns the synthesis of Diflunisal, a non-steroidal antiinflammatory drug. Sales price is around 300 / kg and a few hundred tons are made worldwide per annum. 

Non steroidal antiinflammatory drugs were among the first classes of chiral compounds investigated in the early stages of the application of macrocyclic antibiotics as chiral selectors therefore, they were screened on vancomycin [7], teicoplanin [30], ristocetin A [33] CSPs under RPmode systems, and on avoparcin CSP under NP mode systems [37]. The enantioresolution of a variety of pro fens was later reported on commercially available vancomycin CSPs [128, 168], and recently on a ME-TAG CSP [58]. Ibuprofen enantiomers were also separated on a CDP-1-containing CSP [55]. Glycopeptide A-40,926 CSP was successfully employed in the analytical and semipreparative separation of 2-arylpropionic acids [63]. 

Oruvail is a proprietary preparation of ketoprofen and Feldene is a proprietary preparation of piroxicam, both of which are non-steroidal antiinflammatory drugs Nootropil is a proprietary preparation of piracetam, which is not a non-steroidal anti-inflammatory drug. Nootropil is indicated as adjunctival treatment in cortical myoclonus. 

Mobic is the proprietary preparation of meloxicam, a non-steroidal antiinflammatory drug, which is also a selective inhibitor of cyclo-oxygenase-2. It is therefore less likely to cause gastrointestinal side-effects than other nonsteroidal anti-inflammatory drugs. However, it is still best to administer meloxicam after food. 

Co-codamol is a combination of paracetamol (nonnapioid analgesic) and codeine (opioid analgesic). One of the side-effects of opioids is constipation. Naprosyn is a proprietary (trade name) preparation of the non-steroidal antiinflammatory drug naproxen Adalat is a proprietary preparation of the calcium-channel blocker nifedipine Amoxil is a proprietary preparation of the beta-lactam amoxicillin and Dulco-lax is the brand name of the stimulant laxative bisacodyl. 

The first major new drug to be approved and withdrawn from the market by the CSD was ibufenac, the first of the non-steroidal antiinflammatory drugs (NSAID) to be marketed. Ibufenac was a precursor of ibuprofen and its use in the United Kingdom was associated with serious and frequent hepatotoxicity. Two other drug withdrawals (also approved during their tenure by CSD) were chlormadinone and fenclozic acid. 

Jones AC, Berman P, Doherty M. Non-steroidal antiinflammatory drug usage and requirement in elderly acute hospital admissions. Br J Rheumatol 1992 31(l) 45-8. 

Phenylbutazone was recognised to potentiate the anticoagulant effect of warfarin as long ago as 1959. As subsequent in vitro studies confirmed that phenylbutazone displaced warfarin from its protein binding site, it was assumed that any non-steroidal antiinflammatory drug (NSAID) would enhance warfarin s anticoagulant effect in this way. However it is now known that the interaction is due instead to a stereoselective inhibition of the metabolism of warfarin. Warfarin is available as a racemic mixture of two enantiomers R and S), and of these the S enantiomer is five times more potent as an anticoagulant. Phenylbutazone inhibits the metabolism of the... 

Jtini P, Rutjes AWS, Dieppe PA. Are selective COX 2 inhibitors superior to traditional non steroidal antiinflammatory drugs Adequate analysis of the CLASS trial indicates that this may not be the case. BMJ 2002 324 1287-8. 

F. D. Hart, E. C. Huskinson (1984), Non-steroidal antiinflammatory drugs current status and rational therapeutic use. Drugs 27 232-255. 

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. 

Fixed dose combination of dextropropoxyphene with any other drug other than anti-spasmodics and/ or non-steroidal antiinflammatory drugs (NSAIDs). 

Ketoprofen (2-(3-benzoylphenyl)propionic acid), one of the most active non-steroidal antiinflammatory drugs, is employed in the long-term treatment of rheumatoid arthritis and also as an analgesic in the treatment of pain of varying origins [1]. Clinical use, however, requires a dose schedule of 100-200 mg 3-4 times a day, the duration of action of a single oral dose being only 6-8 h [2]. 

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