Gastric Mucosal Damage by Nonsteroidal Anti-Inflammatory Drugs

Gastric mucosal damage caused by nonsteroidal anti-inflammatory drugs (NSAIDs) is a major clinical problem, and it is therefore important to understand the mechanisms involved. There are numerous complexities, including the fact that NSAIDs may have several actions besides inhibition of cyclo-oxygenase. However, even considering only the latter enzyme there will be inhibition of thromboxane synthesis as well as of the various PGs (some of which may have different actions); there may also be some diversion of substrate metabolism into leukotrienes and other fatty acid derivatives, although this is controversial.