NSAIDs

Nonsteroidal anti-inflammatory drugs -- are among the most common pain

relief medicines. use them to soothe headaches, sprains, arthritis
symptoms, and other daily discomforts, in addition to dulling pain nsaids
also lower fever and reduce swelling .

● ASPIRIN
Chemical formula: C9H8O4

Mechanism of Action
There are two main mechanisms of action for aspirin :-
● Pain and Inflammation:
There is a certain enzyme called cyclo-oxygenase (COX) that is responsible
for producing prostaglandins in areas of pain, which signal the message of
pain to the brain and cause the area to become inflamed It is blocks two
different types of this enzyme, COX-1 and COX-2, so that they can’t
produce as many prostaglandins as usual so it will be reduces the pain and
works as an anti-inflammatory.

● the Blood:
They are sort of “sticky” and can stick together to create a plug to stop the
flow of blood. The platelets can stick to atherosclerotic plaques in the blood
vessels, causing a clot to form inside the blood vessels and lead to a heart
attack or stroke so it helps to prevent this by reducing the “stickiness” of the
platelets..

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SAR

Aspirin it is used to relieve pain or to prevent cardiovascular events:-

● It is used to ease pain, swelling, and fever.
● It is used to treat arthritis.
● It is used to treat rheumatic fever.
● It is used to protect bypass grafts and stents in the heart.
● It is used to lower the chance of heart attack, stroke, and death in
some people.

Aspirin is quite safe, and most people can take it without experiencing
significant side effects. there are a few side effects include :-
❖ Nausea
❖ Heartburn
❖ Vomiting
❖ Headache
❖ Dizziness

There are some people who may need to avoid using Aspirin:-
⮚ Hypersensitivity to salicylic acid compounds
⮚ peptic ulcer
⮚ gastric/intestinal haemorrhage
⮚ Severe hepatic impairment , renal impairment .
⮚ Gout
⮚ during the third trimester of pregnancy

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Examples of Saudi pharmacies:-

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 ● Diclofenac
Chemical formula: C14H11Cl2NO2

Mechanism of Action
due to inhibition of both leukocyte migration and the enzyme
cyclooxygenase (COX-1 and COX-2), leading to the peripheral inhibition of
prostaglandin synthesis ,
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Diclofenac can be used to help relieve symptoms of pain and inflammation:-

● It is used to Rheumatoid arthritis
● It is used to Osteoarthritis
● It is used to Period pain
● It is used to Post-surgery pain
● It is used to Muscular injury pain
● It is used to Actinic keratosis

The side effects of Diclofenac may include :-

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 ❖ cloudy urine
❖ constipation
❖ diarrhea
❖ dizziness
❖ headache
❖ increased bleeding time
❖ itching skin or rash
❖ loss of appetite
❖ nausea
❖ pale skin
❖ severe stomach pain

There are some people who may need to avoid using Diclofenac :-
⮚ ischaemic heart disease
⮚ peripheral arterial disease
⮚ cerebrovascular disease
⮚ congestive heart failure

Examples of Saudi pharmacies:-

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 ● Ibuprofen
Chemical formula: C13H18O2

Mechanism of Action
is a non-selective inhibitor of an enzyme called cyclooxygenase (COX),
which is required for the synthesis of prostaglandins via the arachidonic acid
pathway. COX is needed to convert arachidonic acid to prostaglandin H2
(PGH2) in the body. This PGH2 is then converted to prostaglandins. The
inhibition of COX by ibuprofen lowers the level of prostaglandins .

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Ibuprofen can be used to help relieve symptoms of pain and inflammation :-

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 ● It is used to Patent Ductus Arteriosus
● It is used in the symptomatic treatment of inflammatory,
musculoskeletal and rheumatic disorders.
● It is used to Orthostatic hypotension
● It is used to manage acute and chronic orofacial pain.
● It is widely used to reduce minor aches and pains as well as to
reduce fever and manage dysmenorrhea.
● It is very commonly used for the relief of acute indications such
as fever and tension headaches.

The side effects of Ibuprofen may include :-

❖ Abdominal pain
❖ acid or sour stomach
❖ belching
❖ bloating
❖ cloudy urine
❖ decrease in amount of urine
❖ decrease in urine output or decrease in urine-concentrating ability
❖ diarrhea
❖ difficulty having a bowel movement (stool)
❖ excess air or gas in stomach or intestines
There are some people who may need to avoid using Ibuprofen:-
⮚ severe heart failure
⮚ hepatic failure
⮚ renal failure .

Examples of Saudi pharmacies :-

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 ● ketoprofen
Chemical formula: C16H14O3

Mechanism of Action
Ketoprofen works by inhibiting COX-1 and COX-2, which are needed to
produce the different prostaglandins in your body. You have many different
types of prostaglandins in your body, and there are some in almost every
tissue of your body.

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 Ketoprofen can be used to help relieve symptoms of pain and
inflammation caused by a variety of health conditions such as:

● It is used to Rheumatoid arthritis

● It is used to Osteoarthritis
● It is used to Muscular injury pain

The side effects of Ketoprofen may include:

❖ Nausea
❖ Heartburn (dyspepsia)
❖ Diarrhea
❖ Headache
❖ Dizziness
❖ Gastrointestinal ulcers
❖ Gastrointestinal bleeding

There are some people who may need to avoid using Ketoprofen:-

⮚ Proctitis
⮚ Coagulation disorders:
⮚ Cardiovascular disease:
⮚ Asthma:
⮚ Inflammatory Bowel Disease (IBD):
⮚ Renal Impairment

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 Examples of Saudi pharmacies :-

● naproxen
Chemical formula:C14H14O3

Mechanism of Action

Naproxen works by inhibiting COX-1 and COX-2, which are needed to

produce the different prostaglandins in your body. You have many different
types of prostaglandins in your body, and there are some in almost every
tissue of your body.
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Naproxen can be used to help relieve symptoms of pain and inflammation
such as:

● It is used to Rheumatoid arthritis

● It is used to Osteoarthritis
● It is used to Ankylosing spondylitis
● It is used to Period pain or heavy menstrual bleeding
● It is used to Migraine
● It is used to Muscular injury pain

There are many different side effects :-

❖ Heartburn (dyspepsia)
❖ Diarrhea
❖ Headache
❖ Dizziness
❖ Gastrointestinal ulcers
❖ Gastrointestinal bleeding
❖ Hypertension

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 There are some people who may need to avoid using Naproxen:-

⮚ Hypersensitivity to Naproxen sodium

⮚ Severe hepatic, renal and cardiac failure
⮚ During the last trimester of pregnancy
⮚ Active or previous acute peptic ulcer.
⮚ History of upper gastrointestinal bleeding or perforation, related to
previous NSAIDs therapy.
⮚ Use with concomitant NSAIDs including cyclooxygenase 2
specific inhibitors

Examples of Saudi pharmacies :-

● Etoricoxib
Chemical formula:C18H15ClN2O2S

Mechanism of Action
Etoricoxib works by inhibiting COX-2, which is needed to produce
prostaglandins in your body.

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Etoricoxib is often used to help relieve symptoms of pain and inflammation
such as:

● It is used to Osteoarthritis
● It is used to Gout
● It is used to Period pain
● It is used to Post-surgery pain
● It is used to Muscular injury pain

Etoricoxib has a more targeted effect than other NSAIDs because it only
affects COX-2, The side effects of Etoricoxib may include:

❖ Nausea
❖ Heartburn (dyspepsia)
❖ Diarrhea
❖ Headache
❖ Dizziness

There are some people who may need to avoid using Etoricoxib :-

⮚ Peptic ulcers or GI bleeding

⮚ Coagulation disorders
⮚ Cardiovascular disease
⮚ Asthma

Examples of Saudi pharmacies :-

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 ● Celecoxib
Chemical formula:C17H14F3N3O2S

Mechanism of Action :-

The inhibition of prostaglandin E2 synthesis which (a mediator of pain) results

from the inhibition of COX-2, and helps to alleviate pain symptoms

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Celecoxib used to help relieve symptoms of pain and inflammation such as:-

● rheumatoid arthritis
● ankylosing spondylitis
● menstrual pain.
● familial adenomatous polyposis.

Even though Celecoxib has a more targeted effect than other NSAIDs ,
Include :-

❖ Cough
❖ fever
❖ skin rash
❖ sneezing
❖ sore throat
❖ swelling of the face, fingers, feet, or lower legs

There are some people who may need to avoid using Celecoxib :-

⮚ systemic mastocytosis
⮚ Extreme Loss of Body Water
⮚ Anemia
⮚ increased risk of bleeding
⮚ alcoholism
⮚ high blood pressure
⮚ heart attack
⮚ chronic heart failure

Examples of Saudi pharmacies :-

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 ● mefenamic acid

Mechanism of Action :-
Mefenamic acid has a general effect on almost all the prostaglandins
because it blocks both COX-1 and COX-2 from producing prostaglandins in
your body. This means that it can reduce all of the usual effects
prostaglandins.

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Mefenamic acid used to help relieve symptoms of pain and inflammation
such as:-

● is used for the short-term treatment of mild to moderate pain from

various conditions. It is also used to decrease pain and blood loss
from menstrual periods.

The side effects of mefenamic acid may include:

❖ Nausea
❖ Heartburn (dyspepsia)
❖ Diarrhea
❖ Headache
❖ Dizziness
❖ Gastrointestinal ulcers
❖ Gastrointestinal bleeding
❖ Hypertension

There are some people who may need to avoid using mefenamic acid:-

⮚ People with an active peptic ulcer or bleeding in the gut.

⮚ People who have had recurrent peptic ulcers or bleeding in the
gut (two or more episodes).
⮚ People who have experienced bleeding or perforation in the gut
as a result of previous treatment with an NSAID.
⮚ Inflammatory bowel disease such as ulcerative colitis or Crohn's
disease.
⮚ People with severe heart failure.
⮚ People with severe liver or kidney failure.
⮚ Third trimester of pregnancy.

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Examples of Saudi pharmacies :-

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