Non-Steroidal Anti-Inflammatory Medicines

Nearly 30 million people in the world take NSAIM drugs daily for different painful conditions and fever. NSAIMs are extensively prescribed worldwide. In India, around 15–40% of prescriptions have at least one NSAIMs written in it. NSAIMs have an advantage of being available as OTCs and low abuse potential with good efficacy. All the NSAIMs inhibit the production of prostaglandins and produce analgesic effects with variable anti-inflammatory effects. Based on the selectivity towards COX inhibition, NSAIMs are grouped into non-selective, preferentially COX-2 selective and selective COX-2 inhibitors. Though COX-2 selective inhibitors were developed with the intention of producing less GI toxicity, they caused increased cardiac deaths. Some NSAIMs have additional features like antiplatelet activity (low dose aspirin), antineutrophil migration (indomethacin), and collagenase inhibition (piroxicam). The choice of NSAIMs depends upon the co-morbidity of the patients and clinical situation. This chapter will review the NSAIMs types, mechanism of action, comparison between NSAIMs and clinical use of NSAIMs in the various clinical conditions.