A PILOT STUDY ON SIDE EFFECTS OF SOME NONSTEROIDAL ANTI• INFLAMMATORY DRUGS

Abstract

NSAIDs are used commonly for a variety of rheumatic disorders. Although adverse events affect only a small proportion of those taking NSAIDs, their widespread use translates into a substantial number of affected persons. Furthermore, complications associated with these side effects contribute considerably to increased morbidity and mortality, and treatment of these corrunon but debilitating diseases entails significant costs.

NSAIDs can be classified on the basis of their chemical structures into acidic and non acidic agents. They can be recently classified on the basis of their half-lives into NSAIDs with a long half-life as phenylbutazone, naproxen, sulindac, diflunisal, pi.roxicam, nabumetone, oxaprozin and tenidap and NSAIDs with a short half-life as indomethacin, ibuprofen, fenoprofen, ketoprofen, tolmetin, meclofenamate sodium, diclofenac, diclofenac potassium, etodolac, flurbiprofen and ketorolac.

The mechanisms of NSAID action include inhibition of cyclooxygenase, lipoxygenase and inhibition of free radicals. None of these mechanisms completely explains the actions ofNSAIDs, however, and other hypotheses are emerging. The recent discovery and characterization of two isoenzymes of cyclooxygenase have led to intense investigations that will cause the present NSAIDs to become obsolete. Cyclooxygenase-1 (COX- I) is constitutively present in many tissues and is responsible for the physiologic production of homeostatic and cytoprotective prostanoids in the gastric mucosa. endothelium, platelets. and kidney. Its inhibition is linked to many of the familiar adverse effects ofNSAIDs.