n CME : Your SA Journal of CPD - Non-steroidal antiinflammatory drugs : facts and fallacies : main topic




Inflammation is a defensive and protective response characterised by erythema, pain, heat and oedema. <br>The acute inflammatory response is initiated by tissue injury and mediated by autacoids, namely histamine, serotonin, prostaglandins and leukotrienes. <br>Normal gastrointestinal function depends on a balance between protective mechanisms and acid secretions. <br>NSAIDs upset this balance by inhibiting the COX enzyme ( I and II) which convert arachidonic acid into prostaglandins. <br>NSAIDs which selectively inhibit the COX II enzyme have emerged as effective therapy for inflammatory diseases, while leaving the COX I pathway intact. <br>As they are selective rather than specific inhibitors of COX II, some inhibition of the COX I enzyme still occurs. <br>NSAIDs, should always be used with caution, especially in patients at risk for gastrointestinal complications, fluid retention, heart failure and hypertension.


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