NSAIDs systemic pattern

S.2.4 Mixed and Systemic Patterns of NSAiD-Induced Sensitivity... 

Mixed cutaneous and systemic patterns of NSAID sensitivity occur and are said to make up about 30 % of NSAID-sensitive patients. Patients show a blend of respiratory and cutaneous symptoms. 

The NSAID dexindoprofen has a similar adverse effect pattern to the parent drug, indoprofen. Gastrointestinal, nervous system, and skin reactions are the most frequent (1). 

Nabumetone is a naproxen derivative, whose efficacy is related to its active metabolite, 6-methoxy-2-naphthyla-cetic acid. Not unexpectedly, a study in 2000 patients, mostly treated for more than 6 months, ehcited an adverse events pattern similar to the other derivatives of this class of NSAIDs (SEDA-13, 81). Adverse effects were reported in 18% of patients and 10% stopped taking the drug because of adverse reactions. Diarrhea was the most common problem (13%) followed by abdominal pain (9.9%), dyspepsia (9.3%), nausea (7.8%), and flatulence (4.7%). Ten ulcers were detected. Nervous system reactions, skin rashes, edema, unspecified eye disorders, and liver function test abnormahties aU occur (1). 

There are various types of NSAID-induced rashes. The main morphological patterns are urticarial, maculo-papular, vesicular, and exfoliative. Skin reactions to NSAIDs are probably of phototoxic origin and can be associated with systemic hypersensitivity or other allergic reactions. More rarely, NSAIDs can exacerbate... 

NSAIDs are weak organic acids that are ionized in the plasma, undergo extensive binding to plasma albumin and are mainly eliminated by hepatic metabolism. The disposition of phenylbutazone, ketoprofen and flunixin shows a consistent pattern of differences between newborn (< 1-day-old) foals and adult horses (Wilcke et al, 1993,1998 Crisman et al., 1996). The volume of distribution is larger, the systemic clearance is lower and the half-life of these... 

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