Nonsteroidal anti-inflammatory drugs (NSAIDs) they are probably the most frequently prescribed group of drugs worldwide. And in Spain they are among the first 15 groups of drugs with the highest consumption.
Nonsteroidal anti-inflammatory drugs (NSAIDs) constitute a heterogeneous group of compounds that have analgesic, anti-inflammatory, and antipyretic (lowering body temperature) activity.
Their pharmacological effects and their toxicity are similar, which is why they are usually classified according to their chemical structure. And despite the structural chemical differences between them, they share most of their therapeutic properties.
Together with opioids, they constitute the basic pillars of current analgesic treatment.
They are used in multiple clinical situations, both acute and chronic, which is why they constitute one of the most widely used therapeutic groups in the treatment of pain.
1. Analgesic activity.
It is of moderate intensity and is included in the first analgesic step of the WHO scale.
Its usefulness is demonstrated in:
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All pain of joint origin
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muscular
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dental
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And also migraine headaches.
In summary, in all those pains in which prostaglandins participate in a prominent way, NSAIDs have a clear indication.
Analgesic efficacy depends on the NSAID and is unrelated to anti-inflammatory efficacy.
For example, paracetamol is an analgesic drug and does not have any anti-inflammatory action.
And as with the rest of the actions, the analgesic activity is limited by the maximum doses of each NSAID.
2.Anti-inflammatory action
Inhibition of prostaglandin biosynthesis blocks its dilatory and hyperalgesic actions, thus improving inflammatory signs.
However, it should be noted that the anti-inflammatory potential of NSAIDs is not equal. Some are more anti-inflammatory than others, and even some of them, such as metamizole and paracetamol, have little or no anti-inflammatory effect.
3. Antithermal action
As antipyretics, they reduce body temperature when it is increased by the action of pyrogens.
The response occurs in the form of vasodilatation and sweating, mechanisms that favor the elimination of heat.
Side effects and adverse
NSAIDs also have adverse effects, and the main ones they present would be:
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Gastrointestinal toxicity
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Impaired kidney and/or liver function
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Inhibition of platelet aggregation
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Hypersensitivity reactions.
The most frequent adverse effect associated with its use is related to irritation of the digestive tract. Most of the time it is mild and does not cause symptoms, but it can become very serious, causing pain, burning and even bleeding from the mucosa of the digestive system.
Up to 10% of people who take an NSAID may present these complications, this figure being even higher in the elderly.
Other side effects are:
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Arterial hypertension
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Fluid retention (with swelling, for example, in feet, ankles and hands)
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Renal problems
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Heart problems
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eruptions.
are contraindicated in:
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History of gastric/duodenal ulcer
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NSAID intolerance
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bleeding diathesis
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Treatment with oral anticoagulants
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Kidney failure
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People over 65 years of age, particularly if any of the above factors are associated
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Asthmatics.
Neither increase the dose nor mix them
Side effects can appear at any time while you are taking such a drug, but the longer you take it and the higher the dose, the more likely they are to appear.
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The efficacy of NSAIDs does not improve when the dose is increased, yet the risk of serious adverse effects is increased.
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As NSAIDs share a mechanism of action, taking them together (two or more at the same time) has the same effect as increasing the dose: it does not improve efficacy and the risk of side effects increases.
Topical NSAIDs: creams, ointments…
Pain of musculoskeletal origin is one of the most frequent reasons for medical consultation.
Taking into account the increase in life expectancy, the treatment of these symptoms has a significant impact on health systems.
NSAIDs are frequently used for the treatment of inflammation and musculoskeletal pain, both of rheumatic and traumatic origin or associated with arthropathies.
Recent studies show that the application of this type of preparations It is effective in the treatment of muscle and joint pain.
In order to be effective topically, anti-inflammatory active ingredients must have good anti-inflammatory and analgesic potency. And their physicochemical characteristics must make them compatible with the excipients most commonly used in this type of formulations while facilitating good penetration.
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