Side effects of non-steroidal drugs

Published:

INTRODUCTION

Non-steroidal anti-inflammatory drugs, which are more commonly abbreviated to NSAIDs, are drugs which have analgesic, antipyretic and anti-inflammatory effects. Non-steroidal anti-inflammatory drugs can act as analgesics, meaning they are used to relieve pain but are unusual in that they are non-narcotic. NSAIDs can also produce antipyretic effects, which is when an elevated body temperature is lowered, thus allowing pain to be relieved without impairing consciousness. In higher doses, non-steroidal anti-inflammatory drugs can generate an anti-inflammatory effect which fundamentally reduces inflammation. The expression 'non-steroidal' is used to differentiate between drugs and steroids, which amongst a wide range of other effects have a similar anti-inflammatory action. The most significant members in this group of drugs are found to be aspirin, ibuprofen and naproxen. This is partially because of their availability as over-the-counter medicines in community pharmacies over many areas.

Non-steroidal anti-inflammatory drugs are used to treat a range of symptoms and conditions. NSAIDs can be taken to help relieve pain and discomfort. They may help to ease the pain of a sprain or a muscle strain and backache as well as toothache. They can also be used to treat conditions such as painful periods as well as migraines. NSAIDs can help relieve symptoms of fever as well as a cold or flu and help lower a high temperature. Furthermore, NSAIDs are effective in easing inflammatory conditions of joint diseases such as osteoarthritis, which is when your joints become swollen, inflamed and painful. In some cases, a doctor may prescribe a patient with a small dose of aspirin '(75mg daily)' [1] if they are at the risk of having coronary heart disease.

Lady using a tablet
Lady using a tablet

Professional

Essay Writers

Lady Using Tablet

Get your grade
or your money back

using our Essay Writing Service!

Essay Writing Service

NSAIDs are most commonly taken orally, in the mouth, either in tablet, capsule or liquid form. They can also be given by injection or by suppository, which is inserted into your rectum. Topical NSAIDs, used for external use, can be applied directly to the affected area. Moreover, some NSAIDs are available in the form of creams or gels which can be applied to your skin and some can be found in the form of eye drops.

MECHANISMS

When non-steroidal anti-inflammatory drugs were first developed, scientists did not completely understand how they functioned, but now that more research has been carried out, the way NSAIDs work is more understood. In general, NSAIDs act as non-selective inhibitors of the enzyme cyclooxygenase, inhibiting both the cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) enzymes. Non-steroidal anti-inflammatory drugs work by interfering with specific enzymes in your body. Enzymes are a particular type of protein which helps to bring about or speed up a chemical reaction within your body. For example, digestive enzymes help break up large food particles into smaller pieces in your digestive system so that they can be absorbed by your body.

NSAIDs function by interfering with an enzyme called cyclooxygenase (COX). Different parts of your body have dissimilar types of COX enzymes, which control the production of chemicals called prostaglandins. Each prostaglandin has a different function. For example, the stomach contains the cyclooxygenase-1 enzyme (COX-1) that control the production of prostaglandins which aid in protecting the stomach from acid, which is usually found in the stomach. White blood cells contain the enzyme cyclooxygenase-2 (COX-2); this enzyme controls the prostaglandins that are associated with pain and inflammation. Prostaglandins perform many different functions inside your body, such as keeping the lining of your stomach healthy. In addition to this, prostaglandins are one of the chemicals most responsible for causing pain and inflammation.

Therefore, NSAIDs can help relieve pain and reduce inflammation by preventing cyclooxygenase enzymes from releasing the prostaglandin chemicals, which cause the pain and inflammation. On the other hand, due to prostaglandins having the ability to carry out many different functions within your body, if they are interfered with, they can cause a great range of side effects, such as stomach ulcers and indigestion.

Cyclooxygenase-2 inhibitors are a newer type of non-steroidal anti-inflammatory drug. Similar to prostaglandins, the COX-2 enzyme causes pain and inflammation within the body, whereas the COX-1 enzyme protects the stomach lining. Normally, NSAIDs interfere with both COX-1 and COX-2 enzymes, which means that although they help relieve pain and reduce inflammation, they also can have the potential to damage the stomach.

Lady using a tablet
Lady using a tablet

Comprehensive

Writing Services

Lady Using Tablet

Plagiarism-free
Always on Time

Marked to Standard

Order Now

NSAIDs were produced so that the medicine had an effect on the COX-2 enzyme, but not on the COX-1 enzyme. It was thought that the COX-2 inhibitors would treat pain and inflammation, but not affect the stomach lining. Even though COX-2 inhibitors have a lesser effect on the stomach, they may be more likely to cause side effects on the heart than normal NSAIDs. Hence, COX-2 inhibitors are more likely to be suitable for someone who is at risk of developing stomach or intestinal problems and less suitable for those at risk of heart and circulation problems.

COX-3?

SINGALLING PATHWAYS

Prostaglandins are members on any group of lipid compounds that are derived enzymatically from fatty acids and have significant functions in the body. Every prostaglandin molecule contains 20 carbon atoms, consisting of a 5-carbon ring. Prostaglandins, together with thromboxanes and prostacyclins, form the prostanoid class of fatty acid derivatives. The prostanoid class is a subclass of eicosanoids, which are re-signaling molecules made by the oxidation of 20-carbon essential fatty acids.

There are two main pathways; the lipoxygenase pathway, which leads to the formation of leukotrienes and lipoxins. The other one is the COX pathway, which leads to formation of prostaglandins and thromboxanes.

'The two known COX isoforms are similar in size, substrate specificity, and kinetics, but vary in their expression and distribution,' [3] as shown in Figure 2. COX-1 is always present in most cells throughout the body and catalyses the formation of prostaglandins. In the stomach, COX-1 catalyses the synthesis of PGE2 and PG I2.

COX-2 is found mainly in immune and inflammatory cells, such as neutrophils and macrophages. At the site of inflammation, COX-2 is responsible for the production of hyperalgesic and pro-inflammatory prostaglandins. COX-2 is strongly expressed in human colon cancer cells and NSAIDs can delay the progress of colon tumours by killing tumour cells by apoptosis. In addition, the chance of developing Alzheimer's disease may be reduced by the use of NSAIDs due to Alzheimer's involving an inflammatory constituent. COX-2 is present in the central nervous system where it is involved in fever and nerve transmission of pain. Prostaglandins catalysed by COX-2 are also involved in the birth process and ovulation.

ASPIRIN

Aspirin, which is also known as acetylsalicylic acid, is a member of chemicals called salicylates. It is often used as an analgesic to help relieve pains and aches, as an antipyretic to reduce fever and symptoms of cold and flu, and as an anti-inflammatory medication.

Aspirin also has an antiplatelet effect by inhibiting the manufacture of thromboxane, which under normal circumstances binds platelet molecules together to create a patch over damage of the walls within blood vessels. Because the platelet patch can become too large and also block blood flow, locally and downstream, aspirin is also used long-term, at low doses, to help prevent heart attacks, strokes, and blood clot formation in people at high risk for developing blood clots.[1] It has also been established that low doses of aspirin may be given immediately after a heart attack to reduce the risk of another heart attack or of the death of cardiac tissue.[2][3]

The main undesirable side effects of aspirin are gastrointestinal ulcers, stomach bleeding, and tinnitus, especially in higher doses. In children and adolescents, aspirin is no longer used to control flu-like symptoms or the symptoms of chickenpox or other viral illnesses, because of the risk of Reye's syndrome.[4]

Aspirin was the first discovered member of the class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), not all of which are salicylates, although they all have similar effects and most have inhibition of the enzyme cyclooxygenase as their mechanism of action. Today, aspirin is one of the most widely used medications in the world, with an estimated 40,000 tonnes of it being consumed each year.[5] In countries where Aspirin is a registered trademark owned by Bayer, the generic term is acetylsalicylic acid (ASA).[6][7]

Aspirin also has an antiplatelet effect by inhibiting the production of thromboxane, which under normal circumstances binds platelet molecules together to create a patch over damage of the walls within blood vessels. Because the platelet patch can become too large and also block blood flow, locally and downstream, aspirin is also used long-term, at low doses, to help prevent heart attacks, strokes, and blood clot formation in people at high risk for developing blood clots.[1] It has also been established that low doses of aspirin may be given immediately after a heart attack to reduce the risk of another heart attack or of the death of cardiac tissue.[2][3]

Lady using a tablet
Lady using a tablet

This Essay is

a Student's Work

Lady Using Tablet

This essay has been submitted by a student. This is not an example of the work written by our professional essay writers.

Examples of our work

The main undesirable side effects of aspirin are gastrointestinal ulcers, stomach bleeding, and tinnitus, especially in higher doses. In children and adolescents, aspirin is no longer used to control flu-like symptoms or the symptoms of chickenpox or other viral illnesses, because of the risk of Reye's syndrome.[4]

Aspirin was the first discovered member of the class of drugs known as non-steroidal anti-inflammatory drugs (NSAIDs), not all of which are salicylates, although they all have similar effects and most have inhibition of the enzyme cyclooxygenase as their mechanism of action. Today, aspirin is one of the most widely used medications in the world, with an estimated 40,000 tonnes of it being consumed each year.[5] In countries where Aspirin is a registered trademark owned by Bayer, the generic term is acetylsalicylic acid (ASA).[6][7]

One of the first and most influential physicians, Hippocrates, wrote about a bitter powder extracted from willow bark that could ease aches and pains and reduce fevers as long ago as the fifth century B.C. In the 1700s, the scientist Reverend Edmund Stone wrote about the success of the bark and the willow in the cure of the "agues," or fevers with aches. With a bit of chemical detective work, scientists found out that the part of willow bark that was (1) bitter and (2) good for fever and pain is a chemical known as salicin.

This chemical can be converted (changed) by the body after it is eaten to another chemical, salicylic acid. It was a pharmacist known as Leroux who showed in 1829 that salicin is this active willow ingredient, and for many years it, salicylic acid (made from salicin for the first time by Italian chemist Piria), and close relatives were used at high doses to treat pain and swelling in diseases like arthritis and to treat fever in illnesses like influenza (flu).

Aspirin Development

The problem with these chemicals was that they upset the user's stomach fairly badly. In fact, some people had bleeding in their digestive tracts from the high doses of these chemicals needed to control pain and swelling. One of these people was a German man named Hoffmann. His arthritis was pretty bad, but he just couldn't "stomach" his salicylic acid. Enter this man's son, German chemist Felix Hoffmann, who worked for a chemical company known as Friedrich Bayer & Co. Felix wanted to find a chemical that wouldn't be so hard on his dad's stomach lining; reasoning that salicylic acid may be irritating because it is an acid, he put the compound through a couple of chemical reactions that covered up one of the acidic parts with an acetyl group, converting it to acetylsalicylic acid (ASA). He found that ASA not only could reduce fever and relieve pain and swelling, but he believed it was better for the stomach and worked even better than salicylic acid.

Unfortunately, Hoffmann had to wait for fame. He finished his initial studies in 1897, and his employers didn't pay much attention to it because it was new and they were cautious -- they didn't think it had been tested enough. By 1899, though, one of Bayer's top chemists, a scientist named Dreser, had finished demonstrating the usefulness of the potent new medicine and even gave it a new name: aspirin. It is believed that the name comes from a plant relative of a rose that makes salicylic acid (several plants make this compound, not just the willow). The Bayer company could then support the tested medicine; they spread the word and marketed the new pill widely.

Over the next hundred years, this medicine would fall in and out of favor, at least two new families of medicines would be derived from it, and innumerable research articles would be published about aspirin. Thousands have been published in the past five years alone! One of the most important pieces of research about aspirin came in the early 1970s, when a British scientist named John Vane and his colleagues showed how aspirin works. His work was so important that he and his colleagues were awarded the Nobel Prize in Medicine in 1982. Dr. Vane was even made a British knight for his work!

In the next section, we'll explore exactly how aspirin relieves pain.