Nonsteroidal anti-inflammatory drugs side effects

Ibuprofen This is a commonly used nonsteroidal anti-inflammatory drug. Side effects and overdose can result in gastrointestinal bleeding or a metabolic acidosis. 

Bjarnason I, Hayllar J, Macherson AJ, Russell AS Side effects of nonsteroidal anti-inflammatory drugs on the small and large intestine in humans. Gastroenterology 1993,104 1832-1847. 

Aabakken L Small-bowel side-effects of nonsteroidal anti-inflammatory drugs. Eur J Gastroenterol Hepatol 1999 11 383-388. 

We do not recommend the routine use of selegiline, nonsteroidal anti-inflammatory drugs like ibuprofen, or herbs such as ginkgo biloba for patients with dementia. These all have the potential for problematic side effects that may outweigh their benefit. If they are used, please be sure that a physician closely monitors your patient. 

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. 

Interestingly, nonsteroidal anti-inflammatory drugs, such as ketoprofen 25 (Scheme 17), which are used to treat a wide range of ailments, such as inflammation, pain, and fever, also undergo photodecarboxylation. Unfortunately, many of these drugs have been shown to have cutaneous side effects, which are caused by their photodecomposition. Various research groups have demonstrated that irradiation of ketoprofen 25 yields 26 under anaerobic conditions, whereas in oxygen-saturated... 

Most of the nonsteroidal anti-inflammatory drugs (NSAIDs) are carboxylic acids. Aspirin (8.69) (acetylsalicylic acid, ASA) has been used since the turn of the last century to reduce pain and fever, but the parent compound, salicylic acid, has been known and used since antiquity, owing to its common occurrence as a glycoside in willow bark. Acetylation merely decreases its irritating effect. Among the numerous other salicylates known and used, flufenisal (8.70) has a longer duration of activity and fewer side effects than aspirin. Mefenamic acid (8.71) and flufenamic acid (8.72) are derivatives of anthranilic acid, while ibuprofen (8.73) and naproxen (8.74) are derivatives of phenylacetic and naphthylacetic acids, respectively. 

Many nonsteroidal anti-inflammatory drugs of different chemical structures (Fig. 5) have been introduced for the treatment of inflammatory and painful conditions. Many years of clinical experience with these drugs have shown that there is no induction of tolerance or dependence and no respiratory depression as seen with opioids. The major side-effects of these compounds with COX-1 selectivity or balanced COX-1 and COX-2 inhibition are damage to the gastric mucosa, prolongation of bleeding time and renal failure. 

Side-effects include disturbances of the hematopoietic system such as agranulocytosis and aplastic anaemia (Faich, 1987) and limit its use to the treatment of conditions in which other nonsteroidal anti-inflammatory drugs do not show sufficient efficacy. 

Since most codeine is dispensed as part of a compound preparation, potential side effects of the other drug(s) must also be considered. For instance, someone with stomach ulcers should not take codeine that is combined with a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen. Another type of risk from a compound preparation relates to codeine abuse. For instance, a person who abuses codeine might routinely take a dose of 100-200 mg of codeine to produce noticeable euphoria. Using Tylenol 3 to obtain this dose would also mean ingesting 1,000-2,000 mg of acetaminophen. Taking that amount of acetaminophen for any extended period presents a risk for liver damage, especially in combination with alcohol. 

The primary adverse effect of intravenous cidofovir is a dose-dependent nephrotoxicity. Concurrent administration of other potentially nephrotoxic agents (eg, amphotericin B, aminoglycosides, nonsteroidal anti-inflammatory drugs, pentamidine, foscarnet) should be avoided. Prior administration of foscarnet may increase the risk of nephrotoxicity. Other potential side effects include uveitis, decreased intraocular pressure, and probenecid-related hypersensitivity reactions. Neutropenia and metabolic acidosis are rare. The drug caused mammary adenocarcinomas in rats and is embryotoxic. 

Nonsteroidal anti-inflammatory drugs (NSAlDs) nonselectively inhibit the activities of both COX-1 and COX-2. Out of concern for the gastrointestinal side effects of NSAID, scientists have discovered and developed many specific COX-2 inhibitors that facilitate a safer choice for controlling inflammatory diseases (73). Eor example, NS-398, a selective COX-2 inhibitor, has been shown to reduce tension (mechanical stress)-induced PGE2 production from periodontal ligament cell cultures (74). 

Nonsteroidal Anti-Inflammatory Drugs NSAIDs have now become the drugs of choice over colchicine because of the severe gastrointestinal side effects associated with colchicine and its lack of efficacy to resolve the gouty pain unless used within 24 hours after the occurrence of the initial attack. NSAIDs such as indomethacin, naproxen, and ibuprofen are effective because they have a short r/2, a rapid onset of action, and are better tolerated by patients. 

Research has intensified in an effort to find new nonsteroidal anti-inflammatory drugs (NSAIDs). Long-term therapy with the corticosteroids is often accompanied by various side effects. Bfforts to discover new agents have been limited, for the mo.st part, to structural analogues of active com-... 

Nonsteroidal anti-inflammatory drugs (NSAIDs) are medications that reduce swelling, pain, and stiffness without exposing the patient to the adverse side effects that occur when using corticosteroid medication. There are eight groups of NSAIDs. These are ... 

ACE inhibitors are well tolerated in most patients but are not absent of side effects. ACE inhibitors decrease aldosterone and can increase potassium serum concentrations. Usually the increase in potassium is small, but hyperkalemia is possible. It is seen primarily in patients with chronic kidney disease or diabetes mellitus and in those on concomitant ARBs, nonsteroidal anti-inflammatory drugs, potassium supplements, or potassium-sparing diuretics. Judicious monitoring of potassium and serum creatinine values within 4 weeks of starting or increasing the dose of an ACE inhibitor often can identify these abnormalities before they evolve into more serious complications. 

---