Nonsteroidal anti-inflammatory agents in arthritis.
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Abstract:
Aspirin remains the agent of first choice, but ibuprofen, fenoprofen, naproxen and tolmetin are useful drugs in rheumatoid arthritis. Ibuprofen and fenoprofen are also approved for use in osteoarthritis. Each shares anti-inflammatory, analgesic and antipyretic properties with aspirin, phenylbutazone and indomethacin. The nonsteroidal anti-inflammatory agents have fewer minor side effects than aspirin and fewer major side effects than indomethacin or phenylbutazone. The patient must understand that drugs are but one part of a comprehensive management program.Keywords:
Ibuprofen
Antipyretic
Anti-inflammatory
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Aspirin remains the agent of first choice, but ibuprofen, fenoprofen, naproxen and tolmetin are useful drugs in rheumatoid arthritis. Ibuprofen and fenoprofen are also approved for use in osteoarthritis. Each shares anti-inflammatory, analgesic and antipyretic properties with aspirin, phenylbutazone and indomethacin. The nonsteroidal anti-inflammatory agents have fewer minor side effects than aspirin and fewer major side effects than indomethacin or phenylbutazone. The patient must understand that drugs are but one part of a comprehensive management program.
Ibuprofen
Antipyretic
Anti-inflammatory
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Nonsteroidal anti-inflammatory agents/analgesics (NSAIDs) are a class of drugs that provide analgesic, antipyretic(fever-reducing) and in higher doses anti-inflammatory effects. The term nonsteroidal distinguishes thesedrugs from steroids, which among a broad range of other effects, have a similar eicosanoid-depressing, antiinflammatoryaction. As analgesics, NSAIDs are unusual in that they are non narcotic. Nonsteroidal antiinflammatorydrugs (NSAIDs) are the most highly prescribed drugs in the world. Their analgesic, antiinflammatory,and antipyretic actions may be beneficial, they are associated with severe side effects includinggastrointestinal injury and peptic ulceration. The most prominent members of this group of drugs are aspirin,ibuprofen, and naproxen. All of the drugs are available over the counter in most countries. NSAIDs are usuallyindicated for the treatment of acute or chronic conditions where pain and inflammation are present. In 2001,NSAIDs accounted for 70,000,000 prescriptions and 30 billion over-the-counter doses sold annually in the UnitedStates. In this paper, the mechanism of action of NSAIDs and their critical gastrointestinal complications havebeen reviewed. This paper also provides the information on different preventive measures prescribed to minimizesuch adverse effects and analyses the new suggested strategies for development of novel drugs to maintain theanti-inflammatory functions of NSAIDs along with effective gastrointestinal protection.Keyword- Analgesic, anti-inflammatory, NSAIDs, Gastrointestinal Damage.
Ibuprofen
Antipyretic
Anti-inflammatory
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Carrageenin (2%) was used to produce edema and hyperalgesia; indomethacin, phenylbutazone, aspirin, ibuprofen, analgin, paracetamol and phenacetin were tested at different doses for anti-inflammatory and analgesic activity in the same rats as the peak for the edema reached at the end of 3rd hr and for the hyperalgesia at the end of 4th hr. Indomethacin, phenylbutazone and ibuprofen reduced edema and increased the pain threshold. Analgin and aspirin increased the pain threshold relatively at a low dose. Paracetamol and phenacetin were inactive in the doses tested. Carrageenin (2%) was observed to possess both phlogistic and allogenic properties.
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Phenacetin
Anti-inflammatory
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Using an in vitro system of cell migration from glass capillary tubes, the nonsteroidal, anti-inflammatory agents sodium salicylate, aspirin, ibuprofen, phenylbutazone, and indomethacin were shown to inhibit the migration of human peripheral leucocytes in a dose-related manner. This drug action was not confined to one species, as shown by the modification of rat peripheral leucocyte motility by sodium salicylate and aspirin. The relevance of the human findings to the clinical effectiveness of these agents is discussed.
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Ibuprofen
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Naproxen Sodium
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The analgesic and antipyretic effects of oxaprozin were investigated in comparison with those of indomethacin, ibuprofen, phenylbutazone and aspirin. On the various writhing tests in mice, the analgesic effect of oxaprozin was about 2 to 9 times more potent than those of ibuprofen, phenylbutazone and aspirin. On the other hand, the analgesic and antipyretic effects of oxaprozin in rats were roughly equivalent to those of aspirin, but less effective than those of the other drugs tested. On the urate synovitis test in dogs, only oxaprozin showed a prophylactic effect. Therefore, The effect of oxaprozin in mice and dogs was more potent than ibuprofen, phenylbutazone and aspirin. The metabolic rate of oxaprozin in rats is 3.5 and 7.2 times more rapid than in mice and dogs, respectively, and its blood level in rats is low. Moreover, the biological half-life of oxaprozin is 39 to 43 hr and 49 to 69 hr in dogs and humans, respectively. From these results, it is suggested that oxaprozin is more potent than ibuprofen, phenylbutazone and aspirin, and in clinical use, it is a long acting anti-inflammatory drug.
Ibuprofen
Antipyretic
Anti-inflammatory
Tail flick test
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Phenacetin
Antipyretic
Acetaminophen
Ibuprofen
Salicin
Anti-inflammatory
Probenecid
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Experimental carragenin paw edema in rats, crams in rats induced by acetic acid, and yeast fever in rats were used to study antiexudative, analgetic and antipyretic action of 9 present-day non-steroidal anti-inflammatory drugs (acetylsalicylic acid, amidopyrin, analgin, phenylbutazone, mephenamic acid, voltaren, ibuprofen, indomethacin, naproxen). The correlation of individual types of anti-inflammatory activity was characterized in each drug. Of the drugs studied, the most pronounced anti-inflammatory action was exhibited by voltaren; indomethacin and naproxen were found to be less active. It was shown that the methods for the appraisal of the drugs activity make it possible to study not only their anti-inflammatory activity but also the effect on the inflammation mediators.
Ibuprofen
Antipyretic
Anti-inflammatory
Acetaminophen
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Aspirin is an effective anti inflammatory and analgesic agent. Pain relief is achieved with relatively modest doses, far below those necessary for inflammation control. The patient reacts to the need for pain relief and will take fewer aspirin than prescribed because the lower dosage is better tolerated and less expensive. This often obviates the wanted effects. This pain-inflammation gap does not exist for most nonsteroidal anti inflammatory drugs (NSAIDs), in which analgesic and anti inflammatory doses approximate each other. The range of toxic effects from aspirin is larger than that for nonsteroidal drugs. Gastric erosions and bleeding are far more prevalent with aspirin. Other organ systems are involved more by aspirin than by other drugs, and, in osteoarthritis, aspirin actually may militate against recovery by interfering with glycosaminoglycan synthesis.
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