NSAIDs classification

Kowalski ML, Makowska JS, Blanca M, et al. Hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) - classification, diagnosis and management review of the EAACl/ENDA and GA2LEN/ HANNA. Allergy. 2011 66 818-29. 

Table 3. Chemical classification of some of the most frequently used groups of NSAIDs...

Classification of NSAIDs According to their Chemical Structure... 

According to their chemical structure the following classification of the classical NSAIDs can be made ... 

Including the classical NSAIDs in a classification based on isoenzyme selectivity, it turns out that beside low dose aspirin there is no COX-1 selective inhibitor on the market. Instead, most of the classical NSAIDs belong to the group of nonselective COX inhibitors. 

The currently available NSAIDs exhibit a variety of molecular structures and it is usual to classify these drugs by their chemical class. Clinical trials in rheumatoid arthritis and osteoarthritis, however, rarely find substantial differences in response to average doses of NSAIDs whatever their structure, and this no doubt reflects their common mode of action. Some 60% of patients will respond to any NSAID and many of the remainder will respond to a drug from another group. A structural classification is nevertheless used here as it provides a logical framework furthermore, specific toxicity profiles tend also to relate to chemical group (see below). Summary data on NSAIDs licenced in the UK are given in Table 15.2. 

Frolich, J.C. (1997) A classification of NSAIDs according to the relative inhibition of cyclooxygenase isoenzymes. Trends Pharmacol. Sci.. 18.30-34. 

Fig. 22 Classification of the NSAID dataset based on three-dimensional autocorrelation descriptors Nonlinear map. The regions marked indicate classes of compounds. The dark gray region displays COX-2-selective drugs.

The simple NSAID example shows which decisions and parameters influence the result of similarity or diversity examinations. Most important is the choice of the descriptor set which defines the molecular properties considered. The method used for classification and any further computation has only a small effect on the result. 

Aspirin and NSAIDs inhibit the COX enzymes and prostaglandin production they do not inhibit the lipoxygenase pathways of AA metabolism and hence do not suppress LT formation (see Chapter 25). Table 26-1 provides a classification of NSAIDs and other analgesic and antipyretic agents based on their chemical structures. 

A. Classification and Prototypes Antiplatelet drugs include aspirin and other nonsteroidal anti-inflammatory dmgs (NSAIDs), dipyridamole and inhibitors of ADP receptors (ticlopidine and clopidogrel), and glycoprotein TIb/IIIa receptor inhibitors (abciximab, tirofiban, and epti-fibatide). These drugs increase bleeding time, a test used to monitor their effects. 

A. Classification and Prototypes Aspirin (acetylsaUcylic acid) is the prototype of the salicylates. The other older nonselective NSAIDs (ibuprofen, indomethacin, many others) vary primarily in their potency, analgesic and anti-inflammatory effectiveness, and duration of action. Ibu-... 

The drugs dealt with in this section include aspirin and other salicylates, NSAIDs, opioid analgesics, and the miscellaneous analgesics, such as nefopam and paracetamol. Table 6.1 , (p.l34) contains a listing, with a further classification of the NSAIDs. 

Based on an increasing body of data, Frolich proposes a simple alternative to the usual chemical classification of NSAIDs, allowing one to predict a drug s major effects according to its relative inhibition of the constitutive and inducible COX isoenzymes. 

Tables. 1 Classification of NSAIDs according to their inhibitory potencies of COX-1 and COX-2 ...

Chiral Separation of Nonsteroidal Anti-Inflammatory Drugs 13.1.2 Classification of NSAIDs... 

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