NSAIDs antiinflammatory drugs

Nonsteroidal Antiinflammatory Drugs (NSAIDs) and COX 2 Inhibitors Oh NO It s Inorganic ... 

Nonsteroidal Antiinflammatory Drugs. Nonsteroidal antiinflammatory dmgs (NSAIDs) include, among the numerous agents of this class, aspirin (acetylsaflcyhc acid), the arylacetic acids indomethacin and sulindac, and the arylpropionic acids, (5)-(147) and (R)-(148) ibuprofen, (5)-(149) and (R)- (150), flurbiprofen naproxen (41), and fenoprofen (see Analgesics, antipyretics, and antiinflammatory agents Salicylic acid and related compounds). 

Note that the product acid has one more carbon than the starling alkyl halide. An example occurs in the commercial synthesis of fenoprofen, a nonsteroidal antiinflammatory drug, or NSAID, marketed under the trade name Nalton. (See Chapter 15 Focus On.)... 

It has been proposed that the capacity of antiinflammatory drugs to scavenge and inhibit ROM production is pertinent to their therapeutic effect (Hal-hwell et al., 1988). NSAIDs, namely indomethacin, inhibit superoxide generation by stimulated guinea-pig macrophages (Oyanagui, 1976) and the scavenging effects of PMN-derived ROMs by the sulphasalazine... 

NPY Neuropeptide Y NRS Normal rabbit serum NSAID Non-steroidal antiinflammatory drug NSE Nerve-specific enolase NT Neurotensin N terminus Amino terminus of peptide... 

COX-2, cyclooxygenase-2 HF, heart failure NSAID, non-steroidal antiinflammatory drug. 

FIGURE 30-2. Pain algorithm. AED, antiepileptic drug APAP, acetaminophen NSAID, non-steroidal antiinflammatory drug SNRI, serotonin-norepinephrine reuptake inhibitor SSRI, selective serotonin reuptake inhibitor TCA, tricyclic antidepressant. 

FIGURE 54-2. Outl ine of the management of rheumatoid arthritis. (From Guidelines for the management of rheumatoid arthritis 2002 update. Arthritis Rheum 2002 46(2) 328-346, with permission.) DMARD, disease-modifying antirheumatic drug NSAID, nonsteroidal antiinflammatory drug ... 

FIGURE 55-3. Synthesis pathway for prostaglandins and leukotrienes. COX-2, cyclooxygenase enzyme 2 NSAIDs, nonsteroidal antiinflammatory drugs. (From DiPiro JT, Talbert RL, Yee GC, et al,... 

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). 

Gold salts have had a long history of use in rheumatoid arthritis.269,270 The development of orally active auranofin (also known as Ridaura (50), Figure 23) was a major improvement over the early injectable gold preparations which were polymeric (e.g., (51)—(53)). However, use has declined with the popularity of nonsteroidal antiinflammatory drugs (NSAIDS) such as indo-methacin a recent estimate of the commercial value for auranofin was 6 million. The mechanism... 

Nonsteroidal antiinflammatory drugs (NSAIDs) are the mainstay of therapy because of their excellent efficacy and minimal toxicity with shortterm use. There is little evidence to support one NSAID as more efficacious than another, and three drugs (indomethacin, naproxen, and sulindac) have FDA approval for this indication (Table 1-1). 

FIGURE 1-1. Treatment algorithm for acute gouty arthritis. (NSAID, nonsteroidal antiinflammatory drug.)... 

An individualized approach to treatment is necessary (Fig. 2-1). For mild or moderate pain, topical analgesics or acetaminophen can be used. If these measures fail or if there is inflammation, nonsteroidal antiinflammatory drugs (NSAIDs) may be useful. Appropriate nondrug therapies should be continued when drug therapy is initiated. 

FIGURE 2-1. Treatment for osteoarthritis. (COX, cyclooxygenase IA, intraarticular NSAID, nonsteroidal antiinflammatory drug OA, osteoarthritis PPI, proton pump inhibitor.)... 

Nonsteroidal antiinflammatory drugs (NSAIDs) and/or corticosteroids may be used for symptomatic relief if needed. They provide relatively rapid improvement compared with DMARDs, which may take weeks to months before benefit is seen. However, NSAIDs have no impact on disease progression, and corticosteroids have the potential for long-term complications. 

ALK-P, alkaline phosphatase ALT, alanine aminotransferase AST, aspartate aminotransferase BUN, blood urea nitrogen CBC, complete blood cell count IA, intraarticular NSAIDs, nonsteroidal antiinflammatory drugs Sa, serum creatinine UA, urinalysis. ... 

CBC, complete blood cell count EEG, electroencephalogram NSAIDs, nonsteroidal antiinflammatory drugs O2, oxygen PPF, plasma protein fraction PT, prothrombin time TIPS, transjugular intrahepatic portosystemic shunt. 

Peptic ulcer disease (PUD) refers to a group of ulcerative disorders of the upper GI tract that require acid and pepsin for their formation. Ulcers differ from gastritis and erosions in that they extend deeper into the muscularis mucosa. The three common forms of peptic ulcers include Helicobacter pylori (HP)-associated ulcers, nonsteroidal antiinflammatory drug (NSAID)-induced ulcers, and stress-related mucosal damage (also called stress ulcers). 

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