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36. Non-steroidal antiinflammatory drugs. Aspirin, paracetamol: Difference between revisions

36. Non-steroidal antiinflammatory drugs. Aspirin, paracetamol (view source)

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Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most widely used drugs in the world, and they're among the most frequently implicated drugs in causing hospital admissions. They all have a similar mechanism of action; they inhibit ''cyclooxygenase'' (<abbr>COX</abbr>). This reduces the synthesis of prostaglandins and thromboxanes. This has three main effects:
== NSAIDs ==
Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most widely used drugs in the world, and they're among the most frequently implicated drugs in causing hospital admissions. They all have a similar mechanism of action; they inhibit ''cyclooxygenase'' (<abbr>COX</abbr>), which reduces the synthesis of prostaglandins and thromboxanes, hormones involved in inflammation, fever, and pain. This has three main effects:


* Antipyretic effect
* Antipyretic effect
* Anti-inflammatory effect
* Anti-inflammatory effect
* Analgesic effect
* Analgesic effect
 
The most commonly used NSAIDs are paracetamol, acetylsalicylic acid, ibuprofen, diclofenac, and naproxen. NSAIDs are available over-the-counter, but they can cause severe adverse effects, including kidney injury, cardiovascular events, gastrointestinal ulcers, and hypersensitivity reactions.
== NSAIDs in general ==


=== Indications ===
=== Indications ===
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== Paracetamol ==
== Paracetamol ==
Paracetamol (also known as acetaminophen in the US) is the weirdest of all NSAIDs. It only has weak COX-inhibiting effect, yet still causes analgesia and antipyretic effects, so many don’t even consider it an NSAID. It does not inhibit inflammation.
Paracetamol (also known as acetaminophen in the US) is the weirdest of all NSAIDs. It only has weak COX-inhibiting effect, so many don’t even consider it an NSAID, yet it still causes analgesia and antipyretic effects. It does not inhibit inflammation.


Because of its weak NSAID effects it doesn’t have the classic NSAID side effects either. As such, paracetamol is the first choice for pain or fever when no anti-inflammatory effect is necessary, due to its higher safety than other NSAIDs.. It can also be safely used during pregnancy.
Because of its weak NSAID effects it doesn’t have the classic NSAID side effects either. As such, paracetamol is the first choice for pain or fever when no anti-inflammatory effect is necessary, due to its higher safety than other NSAIDs. It can also be safely used during pregnancy.


=== Mechanism of action ===
=== Mechanism of action ===