Nonsteroidal anti-inflammatory drugs pharmacological effects

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. 

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-... 

Celebrex (celecoxib) is a selective cyclooxygenase (COX)-2 inhibitor nonsteroidal anti-inflammatory drug chemically designated as 4- [5-(4-methylphenyl)-3- (trifluoromethyl) -1 -H-pyrazol-1 -yl)benzenesulfon-amide. It is a diaryl-substituted pyrazole with an empirical formula of Cj Hj FjNjO S and a molecular weight of 381.38. The potent anti-inflammatory effects of an original diarylheterocyclic compound, phenylbutazone, directed scientists to pharmacologically manipulate this chemical scaffold. As a result, celecoxib was the first of the coxibs to be introduced in 1999 by Searle/Pharmacia (now part of Pfizer Inc., USA) [1]. 

Clinical pharmacology of synthetic opioid analgesics (fentanyl, sufentanil, remifentanil) is not substantially altered by renal failure. In contrast, morphine is a poor choice in patients with severe renal impairment, particularly when given repetitively. Morphine effects maybe prolonged due to very slow elimination of active metabolites. Postoperative analgesic regimens should also avoid nonsteroidal anti-inflammatory drugs. 

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