Overview of non-steroidal anti-inflammatory drugs (nsaids) in resource limited countries

Abstract

The non-steroidal anti-inflammatory drugs (NSAIDs) is a drug class that groups together drugs that provide analgesic (pain-killing) and antipyretic (fever-reducing) effects, and, in higher doses, anti-inflammatory effects. The analgesic and anti-inflammatory properties acts by inhibiting two recognized isoenzymes of prostaglandin G/H synthase also known as cycl-oxygenase (COX), which are COX 1 and COX 2.The pharmacodynamic action of these drugs is mostly mediated by inhibition of COX2, while the adverse reactions are largely due to COX1 inhibition.. The NSAID selectively inhibiting COX2 were developed in the 90s to reduce the risk of gastrointestinal toxicity. NSAID use has been found to be associated with an increased risk of heart failure in several randomized clinical trials and observational studies. Nevertheless, there is still limited information on the risk of heart failure associated with the use of individual NSAIDs (both COX 2 inhibitors and traditional NSAIDs) in clinical practice in resource poor communities, and especially on their doseresponse associations. The most prominent members of this group of drugs, are aspirin, ibuprofen, naproxen, that are all available over the counter in most countries. Paracetamol (acetaminophen) is generally not considered an NSAID because it has only little antiinflammatory activity. It treats pain mainly by blocking COX-2 mostly in the central nervous system, but not much in the rest of the body. Most NSAIDs inhibit the activity of (COX-1) and COX2, and thereby the synthesis of prostalglandin and thromboxanes. It is thought that inhibiting COX-2 leads to the anti-inflammatory, analgesic and antipyretic effects and that those NSAIDs also inhibiting COX-1, particularly aspirin, may cause gastrointestinal bleeding and ulcers. This review attempts to give a comprehensive view of NSAIDs pharmacological activities, the drug class, mode of action and usage in a low income economy.

A novel model to simulate venous occlusion plethysmography data and to estimate arterial and venous parameters

“…Estimated vascular parameters did not show a significant difference between the placebo and post-ibuprofen groups. Ibuprofen is an anti-inflammatory medication that inhibits the synthesis of prostaglandins (De Logu et al 2019;Fokunang et al 2018). Thus, after ibuprofen administration, we expected a vasoconstrictor effect, which could be characterized by a reduction in blood flow and an associated increase of arteriolar resistance.…”

“…Two hours before each VOP signal acquisition, each volunteer ingested either a placebo or 1200 mg of ibuprofen, sorted at random order. Ibuprofen is an anti-inflammatory medication that inhibits the synthesis of prostaglandins and modifies the vasomotor function (De Logu et al 2019;Fokunang et al 2018). Hereafter, the terms ibuprofen and placebo will be used to refer to the group, respectively, treated with or without the anti-inflammatory medication.…”

Quality by Design (Qbd) as a Tool for the Optimization of Indomethacin Freeze-Dried Sublingual Tablets: In Vitro and in Vivo Evaluation

“…Non-steroidal anti-inflammatory drugs (NSAIDs) are a heterogeneous drug group broadly prescribed for analgesic, feverreducing, and anti-inflammatory effects [17,18]. A model drug for NSAIDs in our study is Indomethacin (IND), a non-selective NSAID that is considered one of the most successful anti-rheumatic drugs and prime drug nominate for the management of pain and/or swelling in many conditions such as osteoarthritis, rheumatoid arthritis [19,20], and joint pains [21], Despite, its high therapeutic efficacy, oral administration of IND causes several adverse effects, such as gastrointestinal ulceration especially upon the repetitive use of the drug with high doses and in cases of self-medication [22,23].…”

Piperazine: A Promising Scaffold with Analgesic and Anti-inflammatory Potential

“…Owing to their unavoidable adverse effects like ulcers, gastrointestinal bleeding, renal complications, etc. [12][13][14], designing new compounds with less toxicity and more potency is the need of the hour [15].…”