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Introduction[edit | edit source]

Ibuprofen tablets.jpeg

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[1]. 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[2].

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most well recognized drugs worldwide for the treatment of pain, inflammation, and fever .[3]

Image 1: Ibuprofen, a common NSAID.

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[4].

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[2].

  • 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[1].

By reducing production of prostaglandins, NSAIDs help relieve the discomfort of fever and reduce inflammation and the associated pain[2].

Common NSAIDs[edit | edit source]

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:

They can also be used to reduce fever or relieve minor aches caused by the common cold[4].

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:

  1. Gastric adverse effects see NSAIDs Gastropathy
  2. Renal adverse effects that can occur include acute renal dysfunction, fluid and electrolyte disorders, renal papillary necrosis, and nephrotic syndrome/ interstitial nephritis.
  3. Cardiovascular adverse effects can also be increased with NSAID use; these include MI, thromboembolic events, and atrial fibrillation.
  4. 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.[1]
  5. See also The Influence of NSAIDs on Physiologic Processes and Exercise

References[edit | edit source]