NSAIDs & COX Inhibitors

Introduction

• NSAIDs — a chemically diverse class of weak organic acids with analgesic, antipyretic and anti-inflammatory actions, acting by inhibiting the prostaglandin (PG) G/H synthase enzymes — the cyclooxygenases (COX-1 and COX-2).
• Non-opioid / aspirin-like — unlike morphine they do not depress the CNS, cause no dependence or abuse, and are especially effective in inflammatory pain; Vane (1971) established PG-synthesis inhibition as the core mechanism.
• Paracetamol — grouped here but a special case — good antipyretic/analgesic with only weak anti-inflammatory action.
• Symptomatic only — NSAIDs relieve pain/inflammation but do not retard joint destruction in RA, OA or rheumatic fever.