Non-steroidal antiinflammatory drugs NSAIDs

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). 

The first major new drug to be approved and withdrawn from the market by the CSD was ibufenac, the first of the non-steroidal antiinflammatory drugs (NSAID) to be marketed.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. 

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... 

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). 

Within the last 10, years several new compounds were launched in the field of non-steroidal antiinflammatory drugs (NSAIDs) with a clear focus on cyclooxygenase type 2 selective compounds. In the field of opioids on the other hand no new drugs have passed phase III clinical trials. In this field innovation has been achieved through new pharmaceutical formulations of known drugs such as transdermal systems, e.g. buprenorphine patch, transmucosal systems, e.g. fentanyl lollipop, or rectal delivery systems containing e.g. morphine. These were developed in order to reduce opioid side effects, but also to overcome pharmacokinetical limitations, in particular to prolong compliance and duration of action. 

Doses of 20 mg are used in the treatment of Non-steroidal Antiinflammatory Drugs (NSAID)-associated ulceration a dose of 20 mg daily may also be used for prophylaxis in patients with a history of gastroduodenal lesions who require continued NS AID treatment [1]. 

Non-steroidal antiinflammatory drugs (NSAIDs) are the main therapeutic agents for the treatment of the symptoms of arthritis. The drugs seem to inhibit the enzyme cyclooxygenase and consequently the conversion of arachidoic acid into prostaglandins. The main drawbacks of NSAIDs are severe side effects, including gastrointestinal ulceration and... 

Agents which block the synthesis of PGs, for example non-steroidal antiinflammatory drugs (NSAIDs) such as aspirin or ibuprofen, reduce the production of the protective PGs and predispose patients to the development of ulcers. 

For therapeutic purposes, a similar frequently used group of drug compounds is the non-steroidal antiinflammatory drugs (NSAIDs). One of the best known representatives of the aryl acetic acid derivatives in diclofenac and that of aryl propionic acid derivatives ibuprofen. As both have acidic properties, they dissociate while being dissolved and may form salts with amphiphilic properties. Together with appropriate counterions, these amphiphilic organic acids may form lyotropic mesophases with water at even room or body temperature e.g., diclofenac diethylamine or ibuprofen lysinate. Furthermore, some anhy-drates of NSAID, e.g., fenoprofen calcium,exhibit thermotropic mesomorphism after thermal dehydration of the crystalline salt. 

Non-steroidal Antiinflammatory Drugs (NSAIDs). In some cases, a patient may unknowingly be taking several different products that contain the same NSAID. An arthritic patient whose condition has been managed with ibuprofen obtained via prescription (often at dosage levels at or near the recommended maximum) may purchase a non-prescription ibuprofen product for pain/discomfort not associated with the arthritis. The patient may not know that the two products contain the same drug and that there is an increased risk of adverse effects. 

Publig W, Wustinger C, Zandl C. Non-steroidal antiinflammatory drugs (NSAID) cause gastrointestinal ulcers mainly in Helicobacter pylori carriers. Wien Klin Wochenschr 1994 106(9) 276-9. 

In recent years, however, several case reports have been published, suggesting an association between the use of 5-ASA and the development of a particular type of chronic tubulo-interstitial nephritis, characterized by an important cellular infiltration of the interstitium [26, 27]. In some cases, it was shown that this cellular infiltration was not disappearing upon arrest of the drug, even after a period of more than one year [28]. Although acute renal failure under non-steroidal antiinflammatory drugs (NSAID) is well documented, the risk for developing chronic lesions remains controversial. 

A number of experimental studies have been performed looking at the gastroduodenal damaging effects of non-steroidal antiinflammatory drugs (NSAID) such as indomethacin [193]. In these studies, orally administered 5-methoxyflavone inhibited indomethacin-induced leukocyte adherence to mesenteric venules, suggesting a role of inhibition of leukocyte adherence in gastroprotective activity of this flavonic compound. 

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