NSARNSAIDs

NSARNSAIDs is not a standard term in pharmacology. It is sometimes used informally to refer to non-selective non-steroidal anti-inflammatory drugs (NSAIDs), a class that inhibits both COX-1 and COX-2 enzymes. In current practice, the recognized term is NSAIDs, with non-selective NSAIDs (nsNSAIDs) describing drugs that block both cyclooxygenase enzymes.

Mechanism and examples: Most nsNSAIDs reversibly inhibit COX-1 and COX-2, reducing synthesis of prostaglandins involved in pain, fever, and inflammation. Common non-selective NSAIDs include ibuprofen, naproxen, diclofenac, indomethacin, and ketorolac. Aspirin is also non-selective but typically acts irreversibly on COX enzymes, contributing to its antiplatelet effects.

Indications and use: nsNSAIDs are used for relief of mild to moderate pain, fever, and inflammatory conditions such as arthritis, muscle strains, and menstrual cramps. They are generally suitable for short-term use; chronic treatment requires careful risk-benefit assessment and often the lowest effective dose.

Safety and adverse effects: The most frequent adverse effects are gastrointestinal, including dyspepsia, gastritis, ulcers, and bleeding. Risk is higher with older age, prior ulcers, concurrent anticoagulants or steroids, higher doses, or long-term use. nsNSAIDs can impair kidney function and may raise blood pressure or worsen heart failure in susceptible individuals. Observational data indicate a potential increased risk of cardiovascular events with several NSAIDs at high doses or long duration, though risks vary by drug and dose. Aspirin’s antiplatelet effect adds bleeding risk.

Contraindications and precautions: Avoid in active or high-risk GI bleeding, significant peptic ulcer disease, severe renal impairment, or certain pregnancy situations. Use caution in the elderly, those with kidney disease, cardiovascular disease, or concomitant anticoagulants.

Interactions: nsNSAIDs can interact with anticoagulants, corticosteroids, certain antihypertensives, and alcohol, potentially increasing bleeding or renal risk. Always consider individual patient factors and consult guidance for dosing and duration.