What are NSAIDs and how do they reduce inflammation?

Non-steroidal anti-inflammatory drugs (NSAIDs) are used to relieve the pain, stiffness and inflammation of painful conditions affecting the muscles, bones and joints. Some first aiders may be trained to admininster NSAIDs such as Iburpofen to help relieve pain.

NSAIDs are widely prescribed for the treatment of osteoarthritis, rheumatoid arthritis and other rheumatoid conditions, back pain, headaches and pain from soft tissue injuries.

They do not alter the progress of these diseases, but reduce inflammation and relieve pain and swelling of joints.

Commonly used NSAIDs include aspirin, diclofenac, felbinac, ibuprofen, ketoprofen, mefenamic acid, meloxicam, naproxen and piroxicam.

NSAIDS are rapidly absorbed from the digestive system and most start to relieve pain within an hour.

How do NSAIDs work?NSAIDs

Prostaglandins are chemicals released from the body at the site of the injury. They are responsible for producing inflammation and pain following tissue damage. NSAIDs block an enzyme (cyclo-oxygenase) which is involved in the production of prostaglandins, and as a result reduce pain and inflammation.

When these drugs are taken regularly, they build up in the blood to levels that fight pain caused by inflammation and swelling, and also provide general pain relief.

Inflammation is a nonspecific response of the immune system to damaged cells. It is characterized by redness, pain, heat and swelling of tissue.

Although there are many components to inflammation, only the prostaglandin component is substantially reduced by the action of a NSAID.

What are the side effects of NSAIDs?

With a few exceptions, most NSAIDs are free from serious side-effects although nausea, ingestion and altered bowel action are common. Aspirin has a higher potential to irritate the stomach than that of most other NSAIDs.

The main risk from NSAIDs, is that occasionally can cause bleeding in the stomach or duodenum by irritating the stomach wall. The majority of doctors will advise against the use of NSAIDs in the following situations.

  • Allergy to aspirin or any NSAID
  • During pregnancy
  • During breast feeding
  • On blood thinning agents (anticoagulants) as NSAIDs may impair blood clotting
  • Suffering from a defect of the blood clotting system (coagulation)
  • Active peptic ulcer

Care is needed if the patient has:

  • Asthma
  • Kidney impairment
  • Heart impairment
  • Liver impairment

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