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Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs are used to relieve pain and inflammation, particularly in muscles, ligaments, and joints.

Common drugs

Nonsteroidal anti-inflammatory drugs
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  • Aspirin
  • Diclofenac
  • Diflunisal
  • Etodolac
  • Fenoprofen
  • Flurbiprofen
  • Ibuprofen
  • Indometacin
  • Ketoprofen
  • Ketorolac
  • Mefenamic acid
  • Nabumetone
  • Naproxen
  • Piroxicam
  • Sulindac

Nonsteroidal anti-inflammatory drugs (NSAIDs) are non-opioid painkillers that are used to relieve the discomfort and inflammation caused by a variety of musculoskeletal disorders. These drugs are also commonly used to treat other types of pain and inflammation, such as headache.

Although it is technically an NSAID, aspirin is not usually classed with other types of NSAID because it has only a limited anti-inflammatory effect at normal doses. For this reason, NSAIDs with a more powerful anti-inflammatory action are normally prescribed to treat inflammatory conditions.

NSAIDs may be used for conditions that develop suddenly, such as ligament damage and muscle strains and tears. They usually reduce symptoms within a few hours. NSAIDs are also used to relieve pain and inflammation caused by long-term musculoskeletal disorders, such as osteoarthritis and rheumatoid arthritis. When used to treat these conditions, NSAIDs can rapidly relieve pain, but they may take about 2 weeks to reduce inflammation. Although NSAIDs are effective in alleviating symptoms, they do not cure the underlying condition.

NSAIDs work by limiting the release of prostaglandins, chemicals occurring naturally in the body that cause pain and trigger the inflammatory response (see How NSAIDs work). However, prostaglandins also have a protective action in the stomach lining, and blocking their production with NSAIDs may lead to stomach irritation.

How are nonsteroidal anti-inflammatory drugs used?

NSAIDs are most commonly taken orally, although occasionally they may be applied as a gel or given by injection. Certain NSAIDs are available in a slow-release form, which may be effective for up to 24 hours. This reduces the need to take pills frequently when long-term conditions are being treated. Slow-release NSAIDs also provide a more constant level of pain relief. For many conditions, these drugs are used in combination with other treatments, such as physiotherapy. Some NSAIDs, such as ibuprofen, can be bought over the counter.

What are the side effects of nonsteroidal anti-inflammatory drugs?

NSAIDs have varying potential to irritate the stomach lining. If you are given certain NSAIDs, such as ibuprofen, for long-term use, you may also be given an antiulcer drug (see Ulcer-healing drugs) to protect the lining. One group of NSAIDs, cyclo-oxygenase 2 inhibitors (COX-2 inhibitors), are thought to have a less damaging effect on the stomach lining than some other types of NSAID.

NSAIDs may cause allergic reactions (see Drug allergy), including rashes and a condition known as angiooedema, in which temporary, painless swellings develop in the skin and mucous membranes. Some people may develop photosensitivity, in which the skin becomes abnormally sensitive to sunlight. People who have asthma or a kidney disorder are advised not to take NSAIDs because the drugs can make these conditions worse.

Posted 09.09.2010

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