NSAID are used for relieving pain, alleviating fever, and in higher doses, anti-inflammatory. They are non-narcotic, and thus can be used as a non-addictive alternative to narcotics. They are non-steroidal, but still have the anti-inflammatory action of steroids.

Non-selective COX inhibitor, and so therefore has the unwanted GI side effects due to inhibition of COX-1. This includes:

• Salicylates, including:
  • Aspirin (see page)
  • Diflunisal
  • Salicylic acid and other salicylates
  • Salsalate
• Propionic acid derivatives, including:
  • Ibuprofen, has some anti-platelet effect, although of shorter duration than aspirin (and other anti-platelets). Examples include Nurofen, Advil. Nurofen Plus has added Codeine phosphate

Source: 6482/ibuprofen.jpg">Counsel Heal

• • Dexibuprofen
  • Naproxen
  • Fenoprofen
  • Ketoprofen
  • Dexketoprofen
  • Flurbiprofen
  • Oxaprozin
  • Loxoprofen
• Acetic acid derivatives, including:
  • Indometacin (Indocid)
  • Tolmetin
  • Sulindac
  • Etodolac
  • Ketorolac
  • Diclofenac (Voltaren)
  • Aceclofenac
  • Nabumetone
• Enolic acid (Oxicam) derivatives, including:
  • Piroxicam
  • Meloxicam (Mobic)
  • Tenoxicam
  • Droxicam
  • Lornoxicam
  • Isoxicam
  • Phenylbutazone
• Anthranilic acid derivatives (Fenamates), including:
  • Mefenamic acid
  • Meclofenamic acid
  • Flufenamic acid
  • Tolfenamic acid
• Selective COX-2 inhibitors (Coxibs), including:
  • Celecoxib (Celebrex)
  • Rofecoxib
  • Valdecoxib
  • Parecoxib
  • Lumiracoxib
  • Etoricoxib
  • Firocoxib
• Sulfonanilides, including:
  • Nimesulide
• Others, including:
  • Clonixin
  • Licofelone

• GI ulcers, and bleeding; hence, COX-2 inhibitors may be preferred
• In kids, Reye's syndrome (i.e. fatal syndrome detrimenting brain, liver, hypoglycemia), so is only indicated in rheumatic fever and Kawasaki disease

• Absolute:
  • Peptic ulcer or stomach bleeding
  • Uncontrolled HTN
  • Kidney disease
  • Past TIA (excluding aspirin)
  • Past stroke (excluding aspirin)
  • Past MI (exclusin aspirin)
  • CAD (excluding aspirin)
  • Undergoing CABG
  • Taking aspirin for heart
  • In 3rd trimester of pregnancy
  • Pt's who have undergone gastric bypass
  • Pt's who have a Hx of allergic or allergic-type NSAID hypersensitivity reactions, e.g. aspirin-induced asthma
• Relative:
  • Irritable bowel syndrome
  • Pt's >50yo, who have a FH of GI problems
  • Pt's who have had past GI problems from NSAID use

• Antiplatelet
• Aspirin