Non-steroidal anti-inflammatory drugs (NSAIDs) and COX-2 inhibitors

Question 1

What is it indicated for?

Answer 1

Mild-to-moderate pain and fever

Regular treatment for pain related to inflammation such as rheumatoid arthritis, severe osteoarthritis and acute gout

Question 2

How does it work?

Answer 2

They inhibit COX-2 reducing prostaglandin synthesis, reducing inflammation and pain

Question 3

What are the side effect?

Answer 3

GI toxicity
Renal impairment
Major cardiovascular events- COX-2 inhibitors, high dose ibuprofen and diclofenac
Hypersensitivity reactions e.g. bronchospasm and angioedema and fluid retention

Question 4

What are the warnings of this drug class?

Answer 4

Contraindicated in severe renal impairment, heart failure, liver failure and known hypersensitivity

Avoid in peptic ulcer disease

Question 5

What drug interactions occur with these drugs?

Answer 5

Corticosteroids- increase risk of peptic ulcers
Anticoagulants and SSRIs- increase risk of bleeding
ACEi, ARBs ad diuretics increase risk of renal impairment
NSAIDs impair effect of antihypertensive