Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs are known as NSAIDs. These are funds that, due to their function, can be used on several occasions. They can, for example, have analgesic, lower fever and inflammation and have an antithrombotic effect.

NSAIDs are some of the most widely prescribed drugs worldwide. Because of their analgesic effect, doctors prescribe them for the treatment of joint pain as well as inflammation and degenerative diseases. They are also given to patients with migraines, toothaches and various forms of inflammatory conditions.

They are very common, also for self-medication. They are because they are sold over the counter without medical intervention and with a potential risk of side effects.

It is also important to note that no NSAID is better and more secure than others. Therefore , you should not take them if you are on other medicines as the drugs may interact and cause problems.

Mechanisms of non-steroidal anti-inflammatory drugs

When the body absorbs non-steroidal anti-inflammatory drugs and they pass through the liver, they bind to a plasma protein called albumin.

This is important because if the patient has a low level of albumin in the blood, the amount of funds should be adjusted. Otherwise, more of the drug will get into the bloodstream, which is not bound to proteins. As a result, the effect will be greater.

In this way, the amount of free substances will trigger the effects of non-steroidal anti-inflammatory drugs. But how?

The mechanisms of these agents are not unique. The effects can be triggered in the following ways:

• By inhibiting the enzyme cyclooxygenase (COX). This is the primary mechanism. The inhibition of this enzyme also blocks the synthesis of prostaglandins, which are substances that contribute to inflammation.
• Effects not aided by prostaglandins,  such as neutrophil inhibition in inflammation or inhibition of contributors to inflammation, such as nitric oxide induced by cytokines.
• Apoptosis. Prostaglandins inhibit apoptosis, and this may partly explain why certain NSAIDs are associated with a reduced risk of certain cancers.

Classification of NSAIDs

Non-steroidal anti-inflammatory drugs can be classified according to whether or not they inhibit COX-2. Thus, there are both non-selective and COX-2 selective NSAIDs.

Here are some of the NSAIDs that belong to the non-selective group:

• Salicylates. Acetylsalicylic acid or aspirin.
• Pyrazolones. Metamizole.
• Aminophenols. Acetaminophen or paracetamol.
• Propanoic acids. Ibuprofen.
• Acetic acids. Indomethacin.
• Enolic acids (oxicam). Piroxicam.
• Anthranilic acids (phenamates). Meclofenamic acid.

Meloxicam, nimesulide, etodolac and coxibs, such as celecoxib, are examples of COX-2 selective NSAIDs.

Pharmacokinetics and NSAIDs

The body quickly absorbs these substances. Ingestion is primarily oral. But they can also be taken topically, intravenously and rectally. Once ingested, they reach the maximum blood concentration of between two and three hours.

Doctors also recommend patients to take NSAIDs with food, as drugs can damage the lining of the gastrointestinal tract.

The agents bind strongly to the plasma protein albumin (95-99%). This is important to know as the strong binding to albumin can affect other substances with the same characteristics.

The liver also metabolizes them, and some of them have active metabolites. At the same time, almost all of them also have some degree of enterohepatic circulation. Once metabolized, they are excreted by the kidneys. Therefore, physicians should be careful with patients with renal impairment and adjust the dose.

Side effects

All drugs can cause side effects after a single intake. Therefore, it is important to understand the risks and benefits of a drug before taking it.

Non-steroidal anti-inflammatory drugs can cause gastrointestinal side effects. It can cause problems when taking these anti-inflammatory analgesics. In addition, they are also nephrotoxic. This means that they can cause kidney problems.

Other common side effects are:

• Hypertension.
• Heart problems.
• Rash.
• Edema.

It is important to see a doctor before taking NSAIDs. Knowing the side effects and taking them as prescribed is the best way to achieve the desired effect.