Basic Issues About Anti-Inflammatory


The anti-inflammatory medications are highly used by its effectiveness in treating pain and inflammation. Among the best known are anti-inflammatory drugs diclofenac, ibuprofen, indomethacin, nimesulide, ketoprofen and etodolac. As anti-inflammatory drugs act? This was discovered in 1970, when it was revealed the mechanism of action of aspirin, which all of these medications are derived. These compounds inhibit the enzyme cyclooxygenase (COX) that makes the production of substances that cause inflammation, the prostaglandins. This same mechanism is responsible for side effects of anti-inflammatory drugs, because prostaglandins are also needed for vital body functions such as protection against the acidity of the stomach and kidney blood flow.

No wonder, therefore, that the great concern as chronic use of these medications was associated with perforations, ulcers and stomach bleeding. In the early 90s, gastric complications of anti-inflammatory drugs kill more than some forms of cancer in the United States.

For this reason, we tried to discover drugs that would inhibit only the enzyme present in inflammation and not those present in the stomach. These compounds were discovered and proved that the chance of actually gastric damage was much less with them. These compounds are celecoxib, valdecoxib, etoricoxib, rofecoxib and lumiracoxib. However, it was found to inhibit only one enzyme type had, in some drugs, an unexpected effect - a higher chance of heart attack - and for this reason one of these drugs, rofecoxib (Vioxx) was withdrawn.

How is that anti-inflammatory drugs after this discovery? First, it should be borne in mind that in fibromyalgia, there is no activation of COX and release of prostaglandins, then the continued use of anti-inflammatory drugs is usually not recommended in this condition. Some patients may have a pain relief for a general analgesic effect, but they are a minority. If the continued use of these medications is necessary, you should consider two basic aspects: risk gastric and cardiovascular risk. Coxibs should be used more in patients who are at risk for ulcers, such as the elderly, those using steroids and who already have a prior history of ulcer or severe gastritis.

Whereas people who have high cardiovascular risk, such as myocardial infarction, diabetes and hypertension should avoid using coxibs and traditional anti-inflammatory drugs. If the risk of ulcer is also present, medications that reduce stomach acidity should be taken concurrently. In any case, the chronic use should be accompanied by a doctor, to monitor for complications.

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