Nonsteroidal anti-inflammatory drugs effects

Whelton A. Nonsteroidal anti-inflammatory drugs effects on kidn function. In Primer On Kidney Diseases. Greenberg A (editor). Academic Press, San Diego 1994 p 163-167. 

Whelton A, Hamilton ON. Nonsteroidal anti-inflammatory drugs effects on kidney function. J Clin Pharmacol 1991 31 588-598. 

DiBona, G.F. (1986). Prostaglandins and nonsteroidal anti-inflammatory drugs. Effects on renal hemodynamics. Am. ]. Med., 80 (Suppl. lA), 12-21... 

Like aspirin, ibuprofen is a nonsteroidal anti-inflammatory drug. It is a cyclooxygenase inhibitor that interferes with COX-1 and COX-2 forms of that enzyme. Its effects on COX-2 give it fever-reducing (antipyretic), analgesic (pain relief), and anti-inflammatory functions. 

In addition to their beneficial effects, some medications may actually cause cellular injury and disease. An example of this phenomenon involves nonsteroidal anti-inflammatory drugs (NSAIDS). These drugs include aspirin (a derivative of salicylic acid), ibuprofen (arylpropionic acid, Advil ), and acetaminophen (para-aminophenol derivative, Tylenol ). Because of their beneficial pharmacological effects, consumption of these agents has increased significantly in recent years. NSAIDS have the ability to treat fever, pain, acute inflammation, and chronic inflammatory diseases such as arthritis. They are also used prophylactically to prevent heart disease, stroke, and colon cancer. 

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

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. 

Chutkan R, Toubia N Effect of nonsteroidal anti-inflammatory drugs on the gastrointestinal tract Diagnosis by wireless capsule endoscopy. Gastrointest Endosc Clin N Am 2004 14 67-85. 

Banerjee AK, Peters TJ Experimental nonsteroidal anti-inflammatory drug-induced enteropathy in the rat Similarities to inflammatory bowel disease and effect of thromboxane synthetase inhibitors. Gut 1990 3 i 1358— 1364. 

Like the medical treatment of uterine leiomyomas, danazol, gestrinone, mifepristone, and GnRH-a, with or without add-back therapy, have been proposed for the treatment of endometriosis as well (Olive et al. 2001 Stones et al. 2004), but unlike leiomyomas, oral contraceptive pills, in cyclic or continuous administration, and medroxyprogesterone acetate also seem to be effective (Olive et al. 2001 Stones et al. 2004). A significant benefit in terms of pelvic pain relief also is obtained with the use of nonsteroidal anti-inflammatory drugs (Olive et al. 2001 Stones et al. 2004). 

The compound 5-[5-(4-chlorophenyl)furan-2-yl]-2,3,4,5-tetrahydrofuran-2-one (F-1044, 7.85) is a nonsteroidal anti-inflammatory agent possibly acting via a ring-opened hydroxybutyric acid metabolite. To examine this hypothesis, F-1044 was submitted to extensive in vivo testing, which revealed potent activities and a unique pharmacological profile markedly different from that of acidic nonsteroidal anti-inflammatory drugs [169], These results have been interpreted to mean that part or most of the observed effects of F-... 

COX-2 Inhibitor Celecoxib (Celebrex, Pfizer) inhibits the enzyme COX-2, which is involved in pain and inflammation, but it has no effect on the COX-1 enzyme, which helps to maintain stomach lining. It is prescribed for the relief of pain and symptoms of osteoarthritis and rheumatoid arthritis. Previously, nonsteroidal anti-inflammatory drugs (NSAIDs) were used. NSAIDs inhibit both COX-1 and COX-2 enzymes and cause stomach bleeding (see Case Study 2). 

Caffeine alone may produce analgesic effects in some forms of pain, but clinically it is most often used as an adjuvant medication (Laska et al. 1983 Ghelardini et al. 1997 Kraetsch et al. 1996 Forbes et al. 1991). It enhances the analgesic effects of nonsteroidal anti-inflammatory drugs such as acetaminophen and also speeds the onset of analgesia. It is effec-... 

A recent study showed THC to be toxic to hippocampal neurons, while sparing cortical neurons in concentrations likely to be reached in normal human doses (0.5 pM) (Chan et al. 1998). Apoptotic changes were noted in the hippocampus such as shrinkage of neuronal cell bodies and nuclei as well as DNA strand breaks. THC stimulates release of arachidonic acid, and it was hypothesized that this neurotoxic effect is mediated by cyclooxygenase pathways and free radical generation. In support of this, the toxicity is inhibited by nonsteroidal anti-inflammatory drugs, such as aspirin, and antioxidants such as vitamin E. 

Karplus TM, Saag KG. (1998). Nonsteroidal anti-inflammatory drugs and cognitive function do they have a beneficial or deleterious effect Drug Safety. 19(6) 427-33. 

Woodward RM, Polenzani L, Miledi R. 1994. Effects of fena-mates and other nonsteroidal anti-inflammatory drugs on rat brain GABAA receptors expressed in Xenopus oocytes. J Pharmacol Exp Ther 268 (2) 806. 

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. 

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