Gastrointestinal and cardiovascular adverse events associated with NSAIDs

Arnal, María-José Domper; Mallada, Gonzalo Hijos; Lanas, Ángel

doi:10.1080/14740338.2021.1965988

Cited by 54 publications

(30 citation statements)

References 96 publications

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“…Some degree of gastrointestinal toxicity has been associated with all NSAIDs. The data from a large-scale placebo-controlled trial also confirmed that gastrointestinal injury risk increased with NSAIDs, specifically COX-2 inhibitors, diclofenac, ibuprofen, and naproxen 13 . The risk ratio varies with the NSAIDs used, i.e., the risk of gastrointestinal complications is minimal with aceclofenac, celecoxib, and ibuprofen, intermediate with diclofenac, meloxicam, ketoprofen, highest when piroxicam and ketorolac are used over the counter 14 .…”

Section: Introductionmentioning

confidence: 71%

Knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and their Adverse Effects among Medical and Non-Medical Students

2022

PJMD

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Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are the common analgesics, antipyretics, and anti-inflammatory drugs. Though, their frequent consumption cause peptic ulcer disease (PUD) and other unfavorable side effects. This study aimed to compare the knowledge and attitude of Karachi medical and non-medical students about NSAIDs and their adverse effects. Methods: A comparative cross-sectional study was conducted from June 2021-2022, including 344 students from four universities in Karachi, with an equal ratio of medical (n=172) and non-medical (n=172). The study participants were requested to fill out the questionnaire based on the usage of NSAIDs, over-the-counter availability, side effects, etc. The knowledge of adverse drug reactions, reasons for self-medication, and NSAID prescriptions were compared using the Chi-square/Fisher Test. Results: The results showed that about 88.4% of students had some previous knowledge of NSAIDs, of which 98.2% were from the medical sector and 78.4% were from the non-medical sector. 68.6% of students were familiar with the NSAIDs’ adverse effects, 90.1% were medical students, and 47.1% were non-medics. Only 47.7% of the total population was aware of PUD, with 80.2% attending medical universities. While most of the self-medicating students were non-medical 84.7%. Conclusion: Medical students of Karachi possessed more knowledge about NSAID use and its adverse effects. The most known prevalent adverse was PUD, which indicates GI bleeding. It is recommended that there is a dire need for awareness concerning the usage, safety and adverse effects of NSAIDs. Keywords: NSAIDs; Peptic Ulcer Disease; Medical Students; Non-medical Students.

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Section: Introductionmentioning

confidence: 71%

Knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and their Adverse Effects among Medical and Non-Medical Students

2022

PJMD

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“… 50 In conclusion, nonselective COX inhibitors may be safer than the selective COX-2 inhibitors for the cardiovascular system, but they have significantly higher toxicity on the GI tract. 58 …”

Section: Introductionmentioning

confidence: 99%

Design, Synthesis, and Anti-Inflammatory Activity of Some Coumarin Schiff Base Derivatives: In silico and in vitro Study

Hamid¹,

Salih²

2022

DDDT

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Introduction Inflammation is a fundamental response of the immune system during tissue damage or pathogen infection to protect and maintain tissue homeostasis. However, inflammation may lead to life-threatening conditions. The most common treatment of inflammation is non-steroidal anti-inflammatory drugs (NSAIDs). Nowadays, the development of safer new NSAIDs is critical as most of the existing NSAIDs have serious adverse effects, such as gastrointestinal (GI) toxicity and cardiotoxicity. In the present study, four compounds as Schiff base derivatives of 7-hydroxy-4-formyl coumarin and 7-methoxy-4-formyl coumarin were designed and synthesized aiming to develop a lead compound that exhibits anti-inflammatory activity and circumvents the side effects of NSAIDs, especially GI toxicity. Materials and Methods Lipinski’s rule of five was applied for each designed molecule to evaluate the drug-likeness properties. Molecular docking studies were performed using the ligands and the cyclooxygenase-2 (COX-2) protein to select the best-scored molecule using AutoDock 4.2.6. The molecules were then synthesized and characterized. An in vitro anti-inflammatory assay of the compounds against the COX-2 receptor was realized through a protein denaturation assay. Results and Discussion All four synthesized ligands passed Lipinski’s rule of five and exhibited higher binding free energy compared to the positive standard control (ibuprofen), and the K i values of compounds 5, 7, and 8 were in the nanomolar range. However, only compounds 6 and 7 obtained a higher percentage of inhibition of protein denaturation relative to ibuprofen. Conclusion The present study suggested that compound 7 may be a lead molecule because this ligand not only exhibited the best computational and experimental results but also exhibited the strongest correlation between the concentration and percentage of protein denaturation (R = 0.986 and R 2 = 0.972) with the lowest P-value (0.014).

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“…Low doses of nanodrugs are more potent due to their large surface area and small size than bulk drugs. Nanoparticle-mediated drug delivery enhances the potency, solubility, and bioavailability of drugs [30,31], while free drugs are less soluble and have low bioavailability [32], and their high dose is administrated which increases the risk of side effects [33]. In this combination therapy, two drugs were loaded onto CuO NPs for the treatment of inflammation, fever, and pain.…”

Section: Introductionmentioning

confidence: 99%

Synthesis of Copper Oxide-Based Nanoformulations of Etoricoxib and Montelukast and Their Evaluation through Analgesic, Anti-Inflammatory, Anti-Pyretic, and Acute Toxicity Activities

et al. 2022

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Copper oxide nanoparticles (CuO NPs) were synthesized through the coprecipitation method and used as nanocarriers for etoricoxib (selective COX-2 inhibitor drug) and montelukast (leukotriene product inhibitor drug) in combination therapy. The CuO NPs, free drugs, and nanoformulations were investigated through UV/Vis spectroscopy, FTIR spectroscopy, XRD, SEM, and DLS. SEM imaging showed agglomerated nanorods of CuO NPs of about 87 nm size. The CE1, CE2, and CE6 nanoformulations were investigated through DLS, and their particle sizes were 271, 258, and 254 nm, respectively. The nanoformulations were evaluated through in vitro anti-inflammatory activity, in vivo anti-inflammatory activity, in vivo analgesic activity, in vivo anti-pyretic activity, and in vivo acute toxicity activity. In vivo activities were performed on albino mice. BSA denaturation was highly inhibited by CE1, CE2, and CE6 as compared to other nanoformulations in the in vitro anti-inflammatory activity. The in vivo bioactivities showed that low doses (5 mg/kg) of nanoformulations were more potent than high doses (10 and 20 mg/kg) of free drugs in the inhibition of pain, fever, and inflammation. Lastly, CE2 was more potent than that of other nanoformulations.

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Gastrointestinal and cardiovascular adverse events associated with NSAIDs

Cited by 54 publications

References 96 publications

Knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and their Adverse Effects among Medical and Non-Medical Students

Knowledge of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and their Adverse Effects among Medical and Non-Medical Students

Design, Synthesis, and Anti-Inflammatory Activity of Some Coumarin Schiff Base Derivatives: In silico and in vitro Study

Synthesis of Copper Oxide-Based Nanoformulations of Etoricoxib and Montelukast and Their Evaluation through Analgesic, Anti-Inflammatory, Anti-Pyretic, and Acute Toxicity Activities

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