The document summarizes non-steroidal anti-inflammatory drugs (NSAIDs). It discusses their mechanism of action by inhibiting cyclooxygenase enzymes and reducing prostaglandin formation, leading to analgesic, anti-inflammatory, and antipyretic effects. NSAIDs are classified based on selectivity for COX-1 and COX-2. Common NSAIDs and their uses for pain relief are described. Adverse effects include gastric irritation and bleeding. Dental considerations advise avoiding NSAIDs if allergic and not using aspirin before and after surgery due to bleeding risk.

1. NON-STEROIDAL
ANTI-INFLAMMATORY
DRUGS (NSAIDs)
PREPARED BY : VISHAL GOHIL (21)
FINAL YR BDS
GUIDED BY : DR. VEENA PATEL
DR. JIGAR JOSHI
DR. NIMESH PATEL

2. CONTENTS
• INTRODUCTION
• MECHANISM OF ACTION
• CLASSIFICATION
• THERAPEUTIC USES
• DOSES OF FEW DRUGS
• ADVERSE EFFECTS
• DENTAL CONSIDERATIONS
VISHAL GOHIL

3. NSAIDs
• Non-steroidal anti-inflammatory drugs
• Large & chemically diverse group of drugs
with the following properties :
- Analgesic
- Anti-inflammatory
- Antipyretic
VISHAL GOHIL

4. • It inhibits cyclooxygenase ( COX )
enzymes, which is responsible for the
formation of prostaglandins that
promote pain & inflammation.
NSAIDs : Mechanism of Action
VISHAL GOHIL

5. NSAIDs : Mechanism of Action
• Analgesic effect : Blocks the undesirable effects
of prostaglandin which causes pain.
• Anti-inflammatory effect : Inhibit the leukotriene
pathway or the prostaglandin pathway or both.
• Antipyretic effect : Inhibit prostaglandin E2
( dinoprostone ) within the area of the brain that
controls temperature
VISHAL GOHIL

6. CLASSIFICATION
• A. Nonselective COX inhibitors ( traditional
NSAIDs ) :
1. Salicylates : Aspirin
2. Propionic acid derivatives : Ibuprofen, Ketoprofen, Naproxen
3. Anthranilic acid derivative : Mephenamic acid
4. Aryl-acetic acid derivatives : Diclofenac, Aceclofenac
5. Oxicam derivatives : Piroxicam, Tenoxicam
6. Pyrrolo-pyrrole derivative : Ketorolac
7. Indole derivative : Indomethacin
8. Pyrazolone derivatives : Phenylbutazone, Oxyphenbutazone
VISHAL GOHIL

7. B. Preferential COX-2 inhibitors :
Nimesulide, Meloxicam
C. Selective COX-2 inhibitors :
Celecoxib, Etoricoxib
D. Analgesic - antipyretics with poor
antiinflammatory action :
1. Paraaminophenol derivative : Paracetamol
2. Pyrazolone derivatives : Metamizol
3. Benzoxazocine derivative : Nefopam
VISHAL GOHIL

8. THERAPEUTIC USES
• Relief of mild to moderate pain
• Acute gout
• Various bone, joint & muscle pain
• Osteoarthritis
• Rheumatoid arthritis
• Juvenile rheumatoid arthritis
• Dysmenorrhea
VISHAL GOHIL

9. VISHAL GOHIL

10. ADVERSE EFFECTS
Gastric irritation, erosions,
peptic ulceration, gastric
bleeding/perforation,
esophagitis
NA+ & water retention,
chronic renal failure,
interstitial nephritis,
papillary necrosis ( rare )
VISHAL GOHIL

11. Raised transaminases,
hepatic failure ( rare )
Headache, mental
confusion, behavioural
disturbances, seizure
precipitation
Bleeding, thrombocytopenia,
hemolytic anemia,
agranulocytosisVISHAL GOHIL

12. OTHERS
• Asthma exacerbation
• Nasal polyposis : Soft, painless,
noncancerous growths on the lining of nasal
passages or sinuses.
• Skin rashes
• Pruritus : Severe itching of the skin
• Angioedema : Rapid swelling of the dermis,
subcutaneous tissue, mucosa & submucosal
tissues.
VISHAL GOHIL

13. DENTAL CONSIDERATIONS
• If patient is allergic to any NSAID, you will have to
avoid them.
• Paracetamol is the safest NSAID.
• Ibuprofen is contraindicated in asthma patients as it causes
bronchoconstriction.
- It is not recommended for pregnant or nursing women.
• If the patient is taking aspirin, then no surgery or even simple
extraction should be done.
- As it can lead to profuse bleeding because of its antiplatlet-
action. Aspirin should be stopped before 7-10 days of any
surgical procedure till 2-3 days after procedure.
- Young children are highly susceptible to aspirin
poisoning (therapeutic overdose).
VISHAL GOHIL

14. REFERENCE
• ESSENTIALS OF PHARMACOLOGY FOR
DENTISREY BY K D TRIPATHI 2ND
EDITION
• BURKET’S ORAL MEDICINE 12TH
EDITION
• TEXTBOOK OF ORAL &
MAXILLOFACIAL SURGERY BY S M
BALAJI 2ND EDITION
• WIKIPEDIA
VISHAL GOHIL

15. VISHAL GOHIL