Who should benefit from non-steroidal anti-inflammatory drugs? What are NSAIDs and what is the mechanism of their action? What are the consequences of the use of NSAIDs on the gastrointestinal tract? Can we talk about the safety of non-steroidal anti-inflammatory drugs?
Non-steroidal anti-inflammatory drugs (NSAIDs) are often used by people struggling with various ailments disease, and their action allows for normal functioning in everyday life.
Among the properties of the NSAIDs, the following are pharmacological effects:
How does pain appear?
Pain is initiated by the cell membrane irritation as a result of tissue damage. In this way, the excess is released arachidonic acid which is involved in the synthesis of prostaglandins. Arachidonic acid also affects the increase in body temperature. One of the tasks of NSAIDs is the reduction of synthesis of arachidonic acid.
The mechanism of action of NSAIDs
The mechanism of action of NSAIDs is based on the inhibition of arachidonic acid cyclooxygenase (COX) – isozyme having two isoforms.
This is the first isoform of cyclooxygenase, COX-1, cyclooxygenase-1 or. This enzyme is involved in intercellular communication and maintaining body homeostasis. COX-1 activity becomes the synthesis of prostaglandins.
Prostaglandins are hormones occurring while in almost every cell. Formed with the participation of the enzyme cyclooxygenase, COX-1, which converts arachidonic acid to prostaglandins PGG 2, PGH 2.
PGH2 is then converted into PGE2, PGD2, PGF2alfa and thromboxanes. Prostaglandins are most active in the stomach, through regeneration and maintaining normal mucosal permeability.
Cyclooxygenase enzyme COX-2 is active during the inflammatory process. It has catabolic properties, which leads to the breakdown of prostaglandin synthesis.
The effect of NSAIDs on the gastrointestinal tract
By inhibiting the enzyme COX-1 is disturbed process of prostaglandins, resulting in:
- reducing the amount of mucus defense
- decreases the amount of bicarbonate in the duodenal juice
- releases the mucosal microcirculation.
Inhibition of prostaglandin synthesis leads to impaired defense mechanisms of the mucous membrane of the stomach and duodenum. As a result, the mucous membrane is more susceptible to various damaging factors. This can cause ulcers and erosions that pass in chronic conditions and deepening. In addition to ulcers also meet with perforations or bleeding of the digestive system. The most vulnerable to the occurrence of inflammation and ulceration are small and large intestines. If the degree of ulceration will be advanced, increases the risk of ulcer perforation. Consequently, blood loss occurs, thereby contributing to the development of anemia and hypoalbuminemia (excessive loss of protein concentration).
Are NSAIDs safe?
The current progress of pharmacy contributed to a safer use of non-steroidal anti-inflammatory drugs. Such specificities can be divided into two categories: selective and relatively selective.
What are the differences between selective and conventional NSAIDs?
The difference between conventional selective NSAIDs is that the new generation of drugs does not affect the inhibition of cyclooxygenase COX-1. Their task is effective inhibition of COX-2.
The disadvantage of some selective and selective NSAIDs is fairly high price.
Minimizing side effects
It is known, each drug may cause side effects. Therefore, if it is a prescription drug, the dose should be taken as prescribed by a physician or according to the package insert from the manufacturer. This will allow us to reduce the risk of side effects.