Non-steroidal antiinflammatory drugs (NSAIDs) (ยาลดการอักเสบที่ไม่ใช่เสตียรอยด์)

Abstract

NSAIDs are approved for the relief of acute pain and  symptoms  of  chronic  inflammatory  conditions such as osteoarthritis and rheumatoid arthritis. The mechanism of action of NSAIDs  is  attributed to the inhibition of cyclooxygenase (COX), an enzyme that convert arachidonic acid to prostaglandins.COX exist in two isoforms,including constitutional COX-1 and inducible COX-2. Inflammatory prostaglandins are primarily derived from COX-2, while prostaglandins formed  by  COX-1 have in general a more homeostatic role.The anti-inflammatory  and  analgesic efficacies  are  thought to be mainly due to inhibition of the inducible  COX-2,  whereas  the adverse  effects  seem to be caused  by inhibition of constitutional COX-1,resulting in the  development  of COX-2  inhibitors  (selective  and  specific  COX-2  inhibitors). All  COX-2  inhibitors  have  comparable  efficacy to traditional NSAIDs but provide a slightly better gastrointestinal safety profile. However COX-2 inhibitors carry some potential cardiovascular risks, particularly when taking at high doses for prolonged periods of time.Therefore, the cardiovascular risks and  gastrointestinal benefits of COX-2 inhibitors must be carefully weighed before making  therapeutic  decisions.