It is a group of drugs with analgesic, antipyretic and anti-inflammatory (inflammation-reducing) effects.
It is used in the treatment of moderate pain (headache, toothache, menstrual pain, joint pain, etc.), fever, rheumatic fever, rheumatoid arthritis, osteoarthritis, chronic pain, cancer pain.
They are not opioids, they are not addictive, but their pain-relieving properties are less than opioids. They do not cause drowsiness, confusion, respiratory depression.
Its anti-inflammatory properties are less than corticosteroids.
Mechanism of action:
They act by suppressing the cyclooxygenase enzyme (COX1 and COX2), which is involved in the production of prostaglandins, which plays a role in the inflammation process. They show different pain relief properties in different organs according to the duration and severity of suppression of COX1 and COX2 receptors.
On the other hand, it also blocks the thromboxane A2 enzyme and dilutes the blood. This effect is the reason why aspirin is used in some of the heart diseases.
Types of NSAIDs:
NSAIDs are a very broad group. It is evaluated in various groups in terms of its chemical properties and modes of action.
- Salicylates
- Aspirin
- Methyl salicylate
- Salsalate
- Magnesium salicylate
- Diflunisal
- Amoxiprine
- Arylalkanoic acids
- Diclofenac
- Etodolac
- Indomethacin
- Nabumethane
- Sulindak
- Ketorolac
- Profens
- Ibuprifen
- Fenoprofen
- Ketoprofen
- Loxoprofen
- Naproxen
- Suprofen
- phenamic acids
- Mefenamic acid
- Meclofenamic acid
- Prazolidine derivatives
- Phenibutazone
- Metamizole
- Oxyphenbutazone
- Oxicams
- Piroxicam
- Meloxicam
- Tenoxicam
- Sulfonanilides
- Nimesulide
Usage Principles :
- While using these drugs, it should be investigated whether the patient has an additional disease such as gastritis and ulcer. Otherwise, sometimes life-threatening complications such as bleeding and gastric perforation may occur.
- It is risky to use in patients with bleeding disorders due to its blood-thinning effect.
- Other drugs used by the patient, such as blood thinners, should be questioned well.
- It is not recommended for use during pregnancy and childbirth.
- Before use, the patient’s allergy history should be questioned.
- If the patient does not respond adequately to one NSAID group, another NSAID group can be tried, the answers may vary from person to person.
- Toxic effects can be seen in long-term or high-dose use.
- NSAID drugs are not recommended during pregnancy, there is a risk of heart failure, pulmonary hypertension in the fetus.
Side effects:
- Gastrointestinal side effects: Nausea, vomiting, indigestion, diarrhea, constipation, abdominal pain, exacerbation and bleeding can be seen in cases of gastritis or ulcer. H2 receptor blockers can be used in the presence of risk.
- Kidney-related side effects: Acute or chronic renal failure, fluid-electrolyte imbalances, edema, etc. may occur.
- Cardiac side effects: Hypertension, heart failure, exacerbation of angina, etc.
- Liver-related side effects: Liver damage, hepatitis, etc. may occur.
- Allergic reactions: Urticaria, itching, skin rash, increase in asthma attacks, etc. may occur.