Nonsteroidal anti-inflammatory drugs salicylates

The salicylates and nonsteroidal anti-inflammatory drug (NSAIDs) are important in the treatment of arthritic conditions. For example, the salicylates and NSAIDs are used in the treatment of rheumatoid arthritis (a chronic disease characterized by inflammatory changes within the body s connective tissue) and osteoarthritis (a noninflammatory joint disease resulting in degeneration of the articular cartilage and... 

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. 

Primary hepatocyte cultures have been used as a tool to predict the hepatotoxicity of many compounds such as nonsteroidal anti-inflammatory drugs (Castell et ah, 1988), psychotropic drugs (Boelsterli et ah, 1987), immunosuppressant drugs (Boelsterli et ah, 1988), and salicylates (Tolman et ah, 1978). Rat primary hepatocyte cultures have also been shown to be a good model for examining the mechanisms of metallothionein-induced tolerance to cadmium toxicity (Liu et ah,... 

Hypersensitivity to salicylates or nonsteroidal anti-inflammatory drugs (NSAIDs). Use extreme caution in patients with history of adverse reactions to salicylates. Cross-sensitivity may exist between aspirin and other NSAIDs that inhibit prostaglandin synthesis, and aspirin, and tartrazine. Aspirin cross-sensitivity does not appear to occur with sodium salicylate, salicylamide, or choline salicylate. Aspirin hypersensitivity is more prevalent in those with asthma, nasal polyposis, chronic urticaria. 

Rheumatoid arthritis (RA enteric-coated tablets) Treatment of patients with RA who have responded inadequately to salicylates or other nonsteroidal anti-inflammatory drugs (NSAIDs). 

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. 

Nonsteroidal anti-inflammatory drugs (SSRIs given) [NE] Reduced renal lithium excretion (except sulindac and salicylates). 

Little information is available regarding tissue distribution or metabolic products of nonsteroidal anti-inflammatory drugs in cattle. The early synthetic compounds were simple derivatives either of salicylic acid such as acetylsalicylic acid and methylsalicylic acid, or of pyrazolone such as metamizole, oxyphenbuta-zone, phenylbutazone, propylphenazone, and suxibuzone. Modern nonsteroidal anti-inflammatory drugs are derivatives either of anthranilic acid such as dido-... 

Despite the resolving power of TLC-MS-MS, few applications in drug residue analysis have been reported. One application concerns the HPTLC-MS-MS analysis of a number of nonsteroidal anti-inflammatory drugs, including salicylic acid and its glycine conjugate salicylhippuric acid, diclofenac, indomethacin, naproxen, phenacetin, and ibuprofen (67). Another application describes the detection and identification of some of these compounds or their metabolites in urine by TLC-MS-MS (67). 

Related Compounds, aspirin inhibits the synthesis of thromboxane A2 by irreversible acetylation of the enzyme cyclooxygenase. Other salicylates and nonsteroidal anti-inflammatory drugs also inhibit cyclooxygenase but have a shorter duration of inhibitory action because they cannot acetylate cyclooxygenase, ie, their action is reversible. 

Researchers at Rutgers University have developed biocompatible polymers that degrade into nonsteroidal anti-inflammatory drugs. For example, the reaction of two equivalents of benzyl salicylate and one equivalent of sebacoyl chloride forms a poly(anhydride ester) called PolyAspirin, which hydrolyzes to salicylic acid (an anti-inflammatory agent) and sebacic acid, which is excreted. This technology can perhaps be used for localized drug delivery at specific sites of injury. What is the structure of PolyAspirin ... 

Concomitant use of heparin and oral anticoagulants can increase the risk for bleeding due to the antiplatelet effect of aspirin. In addition, use with alcohol can increase the risk of Gl bleeding. / spirin displaces a number of drugs (e.g., tolbutamide, nonsteroidal anti-inflammatory drugs [NSAIDs], methotrexate, phenytoin, and probenecid) from protein binding sites in the blood. Corticosteroid use can reduce serum salicylate levels by increasing the clearance of aspirin. 

The eight groups of nonsteroidal anti-inflammatory drugs are salicylates, parachlorobenzoic acid derivatives, pyrazolone derivatives, propionic acid derivatives, fenamates, oxicams, phenylacetic acid, and selective COX-2 inhibitors. 

Nonsteroidal anti-inflammatory drugs (NSAIDs) Carboxylic acids Acetylated salicylates ... 

Nonsteroidal anti-inflammatory drugs (naproxen and ibuprofen) Penicillins Phenylbutazone Probenecid Salicylates Sulfonamides Barbitu rates Phenytoin Probenecid Retinoids Salicylates Sulfonamides Sulfonylureas Tetracycline Ethanol Retinoids Dipyridamole... 

Although mesalamine is a salicylate, its therapeutic effect does not appear to be related to cyclooxygenase inhibition indeed, traditional nonsteroidal anti-inflammatory drugs actually may exacerbate IBD. Specific mechanisms of action have not been identified, although a myriad of effects on immune function and inflammation have been shown in vitro. 

Gastric erosions are aphthous ulcers that do not penetrate the muscularis mucosa. They are most often related to H. pylori infection (Levine and Rubesin 1995). Other causative agents include alcohol, salicylates, and nonsteroidal anti-inflammatory drugs (NSAIDs). They are also seen in critically ill patients due to multiple trauma, sepsis, shock, etc. At double-contrast barium studies, gastric erosions appear as shallow small, 1-2-mm-diameter collections of barium surrounded by a radiolucent rim of oedema an appearance mirrored at endoscopy with a haemorrhagic centre and oedematous rim (Fig. 5.2a,b) (Levine and Rubesin 1995 Sohn et al. 1995 Dheer et al. 2002). H. pylori infection is also related to the presence of lymphoid follicular hyperplasia, which is commonly present in patients with peptic ulcer disease (Fig. 5.3a,b) (Torigian et al. 2001). 

Drugs that may affect nateglinide include nonsteroidal anti-inflammatory agents (NSAIDs), salicylates, monoamine oxidase inhibitors, rifamycins, MAOIs, and nonselective beta-adrenergic blocking agents, thiazides, corticosteroids, thyroid products, and sympathomimetics. 

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