Nonsteroidal anti-inflammatory agents

A drug may be classified by the chemical type of the active ingredient or by the way it is used to treat a particular condition. Each drug can be classified into one or more drug classes.

All nonsteroidal anti-inflammatory agents (NSAIDs) differ in structure but they all have similar antipyretic, anti-inflammatory and analgesic properties.

NSAIDs work by blocking the cyclo-oxygenase (COX) enzyme, so inhibit production of prostaglandins and thromboxanes, which are produced as part of the inflammatory response.

There are two types of COX enzymes, COX-1 and COX-2. COX-1 is expressed in most tissues, including platelets. COX-2 is induced in inflammatory cells when they are activated and the primary inflammatory cytokines (interleukin-1 and tumor necrosis factor alpha). COX-2 enzyme is responsible for production of mediators of inflammation. Most NSAIDs are inhibitors of both isoenzymes. The anti-inflammatory action of NSAIDs is mainly due to inhibition of COX-2, and their unwanted side effects are largely due to inhibition of COX-1.

There can be considerable variation in individual patient response and tolerance to different NSAIDs.

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