NSAIDs, Non addictive analgesics

Nonopioid Analgesics

Non Steroidal Anti Inflammatory Drugs
NSAIDs

When we read NSAIDs, the first thing which comes to our minds is aspirin, but they are a huge class of analgesics, with many uses in different types of pain !!

In general, pain is first treated with the nonopioid analgesics (Non Steroidal Anti Inflamatory Drugs). These drugs are useful for treatment of pain, fever, and inflammation and for reduction of platelet aggregation. Although the NSAIDs are less effective than the opioids in providing pain relief, they do not produce tolerance and physical dependence, as do the opioids.

The mechanism of action of traditional NSAIDs involves blockade of the production of prostaglandins (The cause of inflammation and pain) by inhibition of the enzyme cyclooxygenase (COX) at the site of injury, thus decreasing the formation of mediators of pain in the peripheral nervous system.


The enzyme COX is have two types, the first one COX-1 is existing in the body, and the second one COX-2 is induced during the bruise, or abnormal enjury conditions.In addition to a role in inflammatory processes, COX-2 seems to play a role in colon cancer and Alzheimer’s disease, providing potential additional uses for COX-2-selective drugs.

We may think of prostaglandins as the (black cat), or the bad guy in the body, as it is responsible for our pain and suffer, but it has a major role in keep us alive.

It keeps the gastric mucosal lining (which is responsible of protecting our stomach from the gastric acid) and certain renal functions.Thus, inhibition of COX by the NSAIDs may be accompanied by ulceration of the stomach lining and renal damage. So we have to be careful during the use of analgesics or any drug, its not candy.

COX, non selective inhibitors:

Aspirin
Etodolac Indomethacin Sulindac
Meclofenamate Mefanamic acid
Fenoprofen Flurbiprofen Ibuprofen Ketoprofen Naproxen
Phenylbutazone Oxyphenbutazone
Piroxicam Ketorolac
Diclofenac Tolmetin
Oxaprozin Nabumetone


COX-2, selective Inhibitors:

Acetaminophen (Panadol)
Celecoxib(Celebrex) Rofecoxib (Vioxx)