Nonsteroidal antiinflammatory drugs - differences and similarities

Article Abstract:

The non-steroidal antiinflammatory drugs are prescribed for a large number of patients. The drugs of this group, often abbreviated NSAIDs, have analgesic properties, reduce fever, and inhibit the aggregation of platelets, a first step in blood clot formation. Aspirin and ibuprofen are two commonly used NSAIDS, but 14 different NSAIDs are available in the United States. The availability of these different but closely related drugs raises the question of whether they differ significantly in any way, and what factors should guide the choice of NSAIDs for an individual patient. The physical properties of the molecules of individual NSAIDs help determine the distribution of the drugs in the body. NSAIDs which are more highly soluble in fats will preferentially accumulate in the brain, while NSAIDs which are more acidic (and hence negatively charged at the body's pH) will accumulate in the inflamed synovial tissue of a joint with arthritis. There is no substantial evidence, however, to indicate that these differences in drug distribution are actually great enough to be important in the treatment of patients. All NSAIDs inhibit the synthesis of molecules called prostaglandins, and the NSAIDs which are more potent in this inhibition tend to have the greatest antiinflammatory effects, as well. However, the doses of NSAIDs required to achieve clinical benefits are much higher than those needed to inhibit prostaglandin synthesis, suggesting that other mechanisms may be at work as well. Furthermore, salicylate is just as effective as aspirin in controlling the inflammation seen in rheumatoid arthritis, although aspirin is a far more effective prostaglandin inhibitor. The NSAIDs have many effects within the body, and further research will be necessary to determine which of these effects contribute most strongly to the drugs' desired actions. There are many reports of individual patients who respond to one NSAID but not to another. These reports need to be confirmed in a scientific fashion, as do suggestions that some NSAIDs are superior for particular purposes. Although there are many reasons to suspect that individual NSAIDs may differ in their effectiveness as well as their side effects, it is not yet clear that these differences are great enough to be of clinical importance. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects

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Long-term use of aspirin and nonsteroidal anti-inflammatory drugs and risk of colorectal cancer

Article Abstract:

A study is conducted to examine the influence of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) in prevention of colorectal cancer. Results reveal that regular, long-term aspirin use reduces risk of colorectal cancer and non-aspirin NSAIDs appear to have a similar effect.

United States, Pharmaceutical Preparation Manufacturing, Pharmaceutical preparations, Aspirin, Aspirin Combinations, Usage, Prevention, Colorectal cancer, Drug therapy

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Rational use of analgesic and antiinflammatory drugs

Article Abstract:

Doctors should avoid prescribing acetaminophen or aspirin to patients with kidney disease. Also, a study published in 2001 showed that ibuprofen can inhibit the anticoagulant effect of aspirin.

Editorial, COX-2 inhibitors

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