Introduction[edit | edit source]
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a drug class used as antipyretic, anti-inflammatory, and analgesic agents. These effects make NSAIDs useful for treating muscle pain, dysmenorrhea, arthritic conditions, pyrexia, gout, and migraines. However:
- NSAIDs can cause serious side effects, some of which may be life-threatening.
- NSAIDs may interact with other medicines and cause unwanted effects.
- NSAIDs should always be used cautiously, for the shortest time possible and at the lowest effective dose.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most well recognized drugs worldwide for the treatment of pain, inflammation, and fever .
Mechanism of Action[edit | edit source]
NSAIDs work like corticosteroids, without many of the side effects of steroids. Corticosteroids are man-made drugs that are similar to cortisone, a naturally-occurring hormone. Like cortisone, NSAIDs reduce pain and inflammation that often come with joint and muscle diseases and injuries.
NSAIDs prevent our bodies from making prostaglandins. Prostaglandins are hormone-like chemicals in the body that contribute to inflammation, pain and fever by raising temperature and dilating blood vessels, which causes redness and swelling in the place they are released.
- NSAIDs block a specific enzymes called cyclooxygenase (or COX) used by the body to make thromboxanes and prostaglandins.
- Specifically: thromboxanes play a role in platelet adhesion; prostaglandins cause vasodilation, increase the temperature set-point in the hypothalamus, and play a role in anti-nociception.
Watch this 2 minute neat summary on NSAIDs.
Common NSAIDs[edit | edit source]
Prescription NSAIDs are stronger than their OTC counterparts.
It is recommended to try OTC version of a medication getting a prescription, this is called step therapy. Step therapy means trying the most conservative and cost-effective options first before taking the next step to more powerful and more expensive treatments with potentially greater side effects.
Some commonly used NSAIDs include:
- aspirin (such as Disprin)
- ibuprofen (such as Nurofen)
- naproxen (such as Naprosyn)
- diclofenac (such as Voltaren)
- celecoxib (such as Celebrex).
Uses[edit | edit source]
NSAIDs are used to treat:
- Pain of rheumatoid arthritis (RA), osteoarthritis and tendonitis. See NSAIDs in the Management of Rheumatoid Arthritis
- Muscle aches.
- Dental pain.
- Pain caused by gout.
- Menstrual cramps.
They can also be used to reduce fever or relieve minor aches caused by the common cold.
Watch this 1 minute video on NSAIDs and why they are helpful particularly for joint pains.
Adverse Effects[edit | edit source]
NSAIDs have well-known adverse effects affecting the gastric mucosa, renal system, cardiovascular system, hepatic system, and hematologic system. They include:
- Gastric adverse effects see NSAIDs Gastropathy
- Renal adverse effects that can occur include acute renal dysfunction, fluid and electrolyte disorders, renal papillary necrosis, and nephrotic syndrome/ interstitial nephritis.
- Cardiovascular adverse effects can also be increased with NSAID use; these include MI, thromboembolic events, and atrial fibrillation.
- Hematologic adverse effects are possible, particularly with nonselective NSAIDs due to their antiplatelet activity. This antiplatelet effect typically only poses a problem if the patient has a history of GI ulcers, diseases that impair platelet activity ( eg hemophilia, von Willebrand), and in some perioperative cases.
- See also The Influence of NSAIDs on Physiologic Processes and Exercise
References[edit | edit source]
- Ghlichloo I, Gerriets V. Nonsteroidal Anti-inflammatory Drugs (NSAIDs). StatPearls.2020 Available:https://www.statpearls.com/articlelibrary/viewarticle/25968/ (accessed 31.10.2021)
- Better Health Medications - non-steroidal anti-inflammatory drugs Available:https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/medications-non-steroidal-anti-inflammatory-drugs (accessed 31.10.2021)
- Sinha M, Gautam L, Shukla PK, Kaur P, Sharma S, Singh TP. Current perspectives in NSAID-induced gastropathy. Mediators of inflammation. 2013 Oct;2013. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3610380/ (accessed 31.10.2021)
- Cleveland Clinic NSAIDs Available: https://my.clevelandclinic.org/health/drugs/11086-non-steroidal-anti-inflammatory-medicines-nsaids(accessed 31.10.2-21)
- Dr Matt & Dr Mike . NSAIDs in under 2 mins!. Available from: http://www.youtube.com/watch?v=4F7UMej9StM [last accessed 14.8.2022]
- Spine Universe Prescription NSAIDs: Non-steroidal Anti-Inflammatory Drugs for Neck or Back Pain Available:https://www.spineuniverse.com/treatments/medication/prescription-nsaids-non-steroidal-anti-inflammatory-drugs-neck-or-back-pain (accessed 14.8.2022)
- Mayo Clinic. Mayo Clinic Minute: What are NSAIDs?. Available from: https://www.youtube.com/watch?v=GyNKywndRuU [last accessed 14.8.2022]