Therapeutic Advantages and Disadvantages of Nsaid

1. Anti-Inflammatory,

 2. Antipyretic,

 3. Analgesic

Uses:

The Salicylic acid derivatives are used in the treatment of gout, rheumatic fever, osteoarthritis, and RA. Commonly treated conditions requiring analgesia include headache, arthralgia, and myalgia.

How to use

Salicylic acid is used topically to treat corns, calluses, and warts. Methyl salicylate is used externally as a cutaneous counterirritant in liniments.

CVS Applications:

Aspirin is used to inhibit platelet aggregation. Low doses are used prophylactically to

Reduce the risk to recurring transient ischemic attacks and stroke or death in those who have had single or multiple episodes of stroke

Reduce the risk of death in those having an acute myocardial infarction

a)   Reduce the risk of recurrent nonfatal myocardial infarction and or death in patients with perviousmyocardial infarction or unstable angina pectoris

b)  Reduce the risk of myocardial infarction and sudden death in patients with chronic stable angina pectoris

c)    Reduce the cardiovascular risk in patients undergoing certain revascularization procedures.

Disadvantages:

Gastrointestinal :

The most common GI effects of the salicylates are epigastric distress, nausea and vomiting. Microscopic GI bleeding is almost universal in patients treated with salicylates.

Blood:

The irreversible acetylation of platelet cyclooxygenase reduces the level of platelet TXA2 , resulting in inhibition of platelet aggregation and a prolonged bleeding time. For this reason, aspirin should not be taken for at least 1 week prior to surgery. When salicylates are administered, anticoagulants may have to be given in reduced dosage, and careful monitoring and counseling of patients are necessary.

Respiration:

In toxic doses, salicylates cause respiratory depression and a combination of uncompensated respiratory and metabolic acidosis.

Metabolic Processes:

Large doses of salicylates uncouple oxidative phosphorylation. The energy normally used for the production ofadenosine triphosphate is dissipated as heat, which explains the hyperthermia caused by salicylates when taken in toxic quantities.

Hypersensitivity:

Approximately 15% of patients taking aspirin experience hypersensitivity reactions. Symptoms of true allergy include urticaria, bronchoconstriction, or angioedema. Fatal anaphylactic shock is rare.

Raye’s Syndrome:

Aspirin and other salicylates given during viral infection has been associated with an increased incidence of Reye’s syndrome, which is an often fatal, fulminating hepatitis who therefore should be given acetaminophen instead of aspirin when such medication is required to reduce fever. Ibuprofen is also appropriate.

In Pregnancy:-

Aspirin is classified as FDA pregnancy category C risk during Trimesters 1 and 2 and category D during Trimetser3. Because salicylates are excreted in breast milk, aspirin should be avoided during pregnancy and while breast-feeding.

Drug Interactions:

          Concomitant administration of salicylates with many classes of drugs may produce undesirable side effects. Because aspirin is found in many over-the-counter agents, patients should be counseled to read labels to verify aspirin content to avoid overdose. Salicylate is 90 to 95 percent protein bound and can be displaced from its protein-binding sites, resulting in increased concentration of free salicylate’ alternatively, aspirin could displace other highly protein-bound drugs, such as warffarin, phenytoin, or valproic acid, resulting in higher free concentrations of other agents.