NSAIDs

NSAIDS are drugs with analgesic and antipyretic(and, in higher doses, with anti-inflammatory effects (reducing inflammation). The term "non-steroidal" is used to distinguish these drugs from steroids which have a similar eicosanoid-depressing,anti-inflammatory action. As analgesics NSAIDs are unusual in that they are non-narcotic. NSAIDs are sometimes also referred to as **non-steroidal anti-inflammatory agents/analgesics** (**NSAIAs**) or **non-steroidal anti-inflammatory medicines** (**NSAIMs**). The most prominent members of this group of drugs are **aspirin, ibuprofen and naproxen** partly because they are available over-the-counter in many areas. NSAIDs (nonsteroidal anti-inflammatory drugs) are a large class of drugs used to treat arthritis. One of the NSAIDs is usually included in the medication regimen of an arthritis patient. NSAIDs help combat arthritis pain by interfering with the inflammatory processes. NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever. Specific uses include the treatment of headaches, arthritis sports injuries, and menstrual cramps. Aspirin (also an NSAID) is used to inhibit the clotting of blood and prevent stokes and heart attack in individuals at high risk. NSAIDs also are included in many cold and allergy preparations. > Anti-inflammatory drugs make up about half of analgesics remedying pain by reducing inflammation as opposed to opioids which affect the brain.
 * NSAIDs(Non-steroidal Anti-Inflammatory Drugs)**
 * INDICATIONS:**
 * **Anti-inflammatory-**refers to the property of a substance or treatment that reduces inflammation.
 * **Pyrexia-** is a frequent medical sign that describes an increase in internal body temperature to levels above normal. Fever is most accurately characterized as a temporary elevation in the body's thermoregulatory set-point, usually by about 1 – 2 °C ( 1.8 - 3.6 °F ).
 * **Headache & Migraine**-is a neurological syndrome characterized by altered bodily perceptions, severe headaches and nausea Physiologically, the **migraine headache** is a neurological condition more common to women than to men.
 * **Dysmenorrhoea-**is a medical condition characterized by severe uterine, pain during menstraution. While most women experience minor pain during menstruation, dysmenorrhea is diagnosed when the pain is so severe as to limit normal activities, or require medication. acute gout-is a disease hallmarked by elevated levels of uric acid in the bloodstream. In this condition, crystals of monosodium urate (MSU) or uric acid are deposited on the articular cartilage of joints, tendons, and surrounding tissues
 * **Arthritis-** is a group of conditions involving damage to the joints of the body.The most common form of arthtritis, **osteoarthritis**(degenerative joint disease) is a result of trauma to the joint, infection of the joint, or age. Other arthritis forms are **Rheumatoid** arthritis and **Psoriatic arthritis**,autoimmune in which the body attacks itself. **Septic** arthritis is caused by joint infection. **Gouty** arthritis is caused by deposition of uric acid crystals in the joint, causing inflammation. There is also an uncommon form of gout caused by the formation of rhomboid crystals of calcium pyrophosphate. This gout is known as **pseudogout.**


 * DRUGS:**


 * 1. CELECOXIB

BN: ** Celebrex®, Celcoxx, Euroflam

**AVAILABLE DOSAGE FORM:**
 * Tablet
 * Capsule

**Common side effects:** **Contraindication:** maximally recommended dose were harmful to the fetus. It should not be used in late pregnancy because there is a risk of heart defects in the newborn. Celecoxib should only be used in pregnant women when the benefits outweigh the potential risk to the fetus.
 * Headache
 * Abdominal Pain
 * Dyspepsia
 * Diarrhea Nausea
 * Flatulenca
 * Insomia
 * Hypersensitivity
 * Cross-sensitivity may exist with other NSAIDs, including aspirin
 * History of allergic-type reactions to sulfonamides History of asthma, urticaria, or allergic-type reactions to aspirin or other NSAIDs, including the aspirin triad (asthma, nasal polyps, and severe hypersensitivity reactions to aspirin)
 * Advanced renal disease
 * Peri-operative pain from coronary artery bypass graft (CABG) surgery
 * **OB:** Should not be used in late pregnancy (may cause premature closure of the ductus arteriosus).**Lactation:** Potential for serious neonatal adverse effects. Discontinue drug or bottle feed
 * Preganancy category:**
 * Category C- ** Celecoxib has not been studied in pregnant women. In animal studies, doses that were twice the


 * 2. IBUPROFEN:

B.N: **Motrin®,Advil**®**, Alaxan FR

**COMMON SIDE EFFECTS** AVAILABLE DOSAGE FORM: ** Ibuprofen should not be used regularly in individuals with inflammatory bowel disease due to its ability to cause gastric bleeding and form ulceration in the gastric lining. Pregnancy Category **: Category C  3. NAPROXEN
 * Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
 * Blistering, peeling, red skin rash.
 * Bloody or black, tarry stools.
 * Change in how much or how often you urinate, blood in your urine.
 * Chest pain, shortness of breath, or coughing up blood.
 * Fever, neck pain, stiff neck.
 * Numbness or weakness in your arm or leg, or on one side of your body.
 * Pain in your lower leg (calf).
 * Problems with vision, speech, or walking.
 * Redness or swelling of the body area where you have pain.
 * Tablet
 * Liquid
 * Chewable Tablet
 * Capsule
 * Liquid Filled Capsule
 * CONTRAINDICATIONS:**

B.N: ** Naprosyn, Sanomed®, Skelan You should not use this medicine if you have had an allergic reaction (including asthma) to naproxen, aspirin, or other NSAID medicines, such as diclofenac, ibuprofen, Advil®, Celebrex®, Ecotrin®, Motrin®, or Voltaren®. Do not use this medicine right before or right after having coronary artery bypass graft (CABG), a type of heart surgery.
 * COMMON SIDE EFFECTS:**
 * indigestion or heartburn
 * chest pain,
 * drowsiness
 * nausea.
 * Available dosage Form: **
 * Tablet
 * Liquid
 * CONTRAINDICATIONS:**

**PREGNANCY CATEGORY:**
 * Category C- ** not tested on pregnant humans but that show side effects to the fetus in animal studies

4. DICOFLENAC

B.N:** Cataflam, Voltaren, Voltaren-XR


 * COMMON SIDE EFFECTS:**


 * chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
 * black, bloody, or tarry stools;
 * coughing up blood or vomit that looks like coffee grounds;
 * swelling or rapid weight gain;
 * urinating less than usual or not at all;
 * nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
 * fever, sore throat, and headache with a severe blistering, peeling, and red skin rash;
 * bruising, severe tingling, numbness, pain, muscle weakness; or
 * fever, headache, neck stiffness, chills, increased sensitivity to light, purple spots on the skin, and/or seizure (convulsions).

** AVAILABLE DOSAGE FORMS: **


 * Tablet
 * Tablet, Enteric Coated


 * CONTRAINDICATIONS: **


 * History of allergic reactions (bronchospasm, shock, rhinitis, urticaria) following the use of Aspirin or another NSAID
 * Third-trimester pregnancy
 * Active stomach and/or duodenal ulceration or gastrointestinal bleeding
 * Inflammative intestinal disorders such as Crohn's disease or ulcerative colitis
 * Severe insufficiency of the heart (NYHA III/IV)
 * Recently, a warning has been issued by FDA not to use to treat patients recovering from heart surgery
 * Severe liver insufficiency (Child-Pugh Class C)
 * Severe renal insufficiency (creatinine clearance <30 ml/min)
 * Caution in patients with preexisting hepatic porphyria, as diclofenac may trigger attacks
 * Caution in patients with severe, active bleeding such as cerebral hemorrhage

**PREGNANCY CATEGORY:** Category C- Dicoflenac have not been studied in pregnant humans but do appear to cause harm to the fetus in animal studies. 5. ASPIRIN

B.N: ** Bayer,Ecotrin, Excedrin


 * COMMON SIDE EFFECTS:**
 * Severe stomach pain
 * Bloody vomit or vomit that looks like coffee grounds
 * Blood in stools or urine
 * Skin rash or hives with intense itching
 * Swelling of the face or eyelids
 * Wheezing or trouble breathing
 * Severe dizziness or drowsiness
 * Ringing in the ears

**AVAILABLE DOSAGE FORM:**
 * Gum
 * Chewable Tablet
 * Coated Tablet
 * Fizzy Tablet
 * Delayed Release Tablet
 * Delayed Release Capsule

**CONTRAINDICATION:** ASPIRIN should not be given to children or teenagers with fever, chickenpox, or symptoms of the flu or viral infection, because aspirin can cause a serious disease called Reye's syndrome. You should not use this medicine if you have an active stomach ulcer or any kind of bleeding problem.

Category C
 * PREGNANCY CATEGORY :**


 * 6. MEFENAMIC ACID

B.N: ** Algifort ,Ponstan, Zerrmic COMMON SIDE EFFECT: **
 * chest pain, weakness, shortness of breath, slurred speech, problems with vision or balance;
 * black, bloody, or tarry stools, coughing up blood or vomit that looks like coffee grounds;
 * urinating less than usual or not at all;
 * pain, burning, or bleeding when you urinate;
 * nausea, stomach pain, low fever, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes);
 * fever, sore throat, and headache with a severe blistering, peeling, and red skin rash; or
 * bruising, severe tingling, numbness, pain, muscle weakness.

**AVAILABLE DOSAGE FORM:** MEFENAMIC ACID should not be given to patients who have experienced asthma, urticaria, or allergic-type reactions after taking aspirin or other NSAIDs. MEFENAMIC ACID is contraindicated for the treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery (see WARNINGS ). MEFENAMIC ACID is contraindicated in patients with acute active ulceration or chronic inflammation of either the upper or lower gastrointestinal tract. MEFENAMIC ACID should not be used in patients with preexisting renal disease.
 * Capsule
 * Tablet
 * CONTRAINDICATIONS: **

Pregnancy Category C-There are no adequate and well-controlled studies in pregnant women. Because animal reproduction studies are not always predictive of human response, this drug should be used only if clearly needed.The use of mefenamic acid in late pregnancy is not recommended because of the effects on the fetal cardiovascular system of drugs of this class.
 * PREGNANCY CATEGORY: **

**7. NAPROXEN SODIUM**


 * B.N: ** Flanax Forte, Aleve, Alpron

You should not use this medicine if you have had an allergic reaction to ketorolac, aspirin, or any pain or arthritis medicines such as Aleve®, Celebrex®, Indocin®, Motrin®, or Naprosyn®. You should not use this medicine if you have a stomach ulcer, a bleeding disorder, or if you are pregnant or breast feeding. Do not take this medicine if you have advanced kidney disease. Do not use this medicine right before or right after having coronary artery bypass graft (CABG), a type of heart surgery. You should not take this medicine if you are using probenecid (Probalan®).
 * COMMON SIDE EFFECTS :**
 * Abdominal pain,
 * constipation
 * difficult or labored breathing
 * dizziness
 * drowsiness
 * headache
 * heartburn
 * nausea,
 * red or purple pinpoint spots on the skin
 * rash-like symptoms
 * ringing in the ears
 * water retention
 * CONTRAINDICATION:**

CATEGORY C
 * PREGNANCY CATEGORY:

8. KETOROLAC TROMETHAMINE

B.N: ** Eurelac, Keto COMMON SIDE EFFECT: **
 * Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing.
 * Blistering, peeling, red skin rash.
 * Bloody or black, tarry stools.
 * Change in how much or how often you urinate.
 * Chest pain, shortness of breath, or coughing up blood.
 * Dark-colored urine or pale stools.
 * Flu-like symptoms.
 * Numbness or weakness in your arm or leg, or on one side of your body.
 * Skin rash or blisters with fever.
 * Sudden and severe stomach pain, nausea, vomiting, fever, and lightheadedness.
 * Sudden or severe headache.
 * Swelling in your hands, ankles, or feet.
 * AVAILABLE DOSAGE FORM**:
 * Tablet

You should not use this medicine if you have had an allergic reaction to ketorolac, aspirin, or any pain or arthritis medicines such as Aleve®, Celebrex®, Indocin®, Motrin®, or Naprosyn®. You should not use this medicine if you have a stomach ulcer, a bleeding disorder, or if you are pregnant or breast feeding. Do not take this medicine if you have advanced kidney disease. Do not use this medicine right before or right after having coronary artery bypass graft (CABG), a type of heart surgery. You should not take this medicine if you are using probenecid (Probalan®).
 * CONTRAINDICATION: **

**PREGNANCY CATEGORY** **:** Category C


 * Bullan, Christine Joy
 * Cabanes, Audrey
 * Dizon, Charmaine

**95/100 = VERY GOOD! =)**