ANTI-INFLAMMATORY DRUGS

According to their chemical structure, anti-inflammatory drugs are usually subdivided into steroids and nonsteroids. Glucocorticoids are related to steroid anti- inflammatory drugs. The mechanism of their anti- inflammatory action is linked to their inhibition of phospholipase A2 which is essential for arachidonic acid synthesis. Glucocorticoids themselves do not provide a direct effect on the phospholipase; instead they promote synthesis and release of endogenous protein group – lipocortines which inhibit this enzyme. Considering that the effect of glucocorticoids occurs at the stage of arachidonic acid synthesis, their anti-inflammatory effect is attributed not only to the inhibition of prostanoid synthesis but also to the suppression of the synthesis of oxyacids, leukotrienes and PAF.

Nonsteroidal compounds possessing anti-inflammatory activity are related to the substances that cause inhibition of cyclooxygenase and, thus, reduse biosynthesis of prostanoids (prostaglandins and thromboxane). It has been proven that there exists at least two variants of cyclooxygenases – type 1 and type 2. Cyclooxygenase-1 (COX-1) is produced in the absence of any pathology; it regulates prostanoid formation in the body. COX-2 production is, to a large extent, induced by an inflammatory process. The search for selective inhibitors COX-2 arouses special interest, since they, apart from their anti-inflammatory effect, reduce the risk of the development of many adverse reactions connected with the inhibition of physiologic biosynthesis of prostanoids (which is not the result of inflammation).

Therefore, it is reasonable to classify nonsteroidal anti-inflammatory drugs in the following way. Non-selective inhibitors of cyclooxygenase-1 and -2 (COX-1+COX-2) Selective inhibitors of cyclooxygenase-2 The majority of nonsteroidal anti- inflammatory drugs provide anti-inflammatory, analgesic and antipyretic effect.

ANTIALLERGIC DRUGS In allergic reaction of the immediate type the following groups of preparations are used: A). Drugs blocking the release of histamine and other biologically active substances from sensitized mast cells and basophiles B). Drugs blocking the interaction of the free histamine with the tissue receptors sensitive to it. C). Drugs eliminating general anaphylactic (shock) manifestations. D). Drugs decreasing tissue damage. In hypersensitivity reaction of the delayed type two groups of preparations are commonly used: drugs suppressing immunogenesis and drugs diminishing tissue damage.

DRUGS AFFECTING THE IMMUNE SYSTEM DRUGS AFFECTING THE IMMUNE SYSTEM Drugs stimulating (normalizing) immune reactions are used in the complex therapy of immunodeficiency conditions, chronic infections and malignant tumors. Biogenic substances (preparations of thymus (thymalin, tactivin), interferon, interleukin- 2, BCG) and synthetic compounds (for example, levamisole) are available as immunostimulators

Aspirin trade name for acetylsalicylic acid, the most widely used drug for treating fever, pain, and inflammation. Aspirin is a synthetic chemical compound that works by interfering with the body’s production of hormonelike substances called prostaglandins. Often called a wonder drug, it is now thought to have possible preventative effects against heart disease, stroke, forms of cancer, and other diseases and conditions

Aspirin can be combined with other analgesic drugs to provide stronger pain relief than a single drug would if used alone at a higher dose, and with fewer side effects, such as drowsiness or risk of addiction. Combinations of aspirin with butalbital, codeine, and caffeine are used for treating tension headaches and migraines. The effects of aspirin depend on the dosage level. In small to moderate doses of one or more tablets, it helps reduce fevers and cold symptoms, and can relieve mild to moderate pain from common ailments such as headaches, toothaches, muscle sprains, or minor injuries. In higher doses it can help treat inflammation associated with conditions such as rheumatism and arthritis

SIDE EFFECTING Aspirin causes a small amount of bleeding in the digestive tract that could result in iron deficiency or gastric ulcers with long-term use. Complications can be avoided by using enteric-coated aspirin, which does not dissolve until reaching the intestine. So- called buffered aspirin adds compounds that reduce the acidity of aspirin in the stomach. Because of its anticlotting effects, aspirin is generally avoided in treating pain from bleeding injuries or surgery. Aspirin should not be given to children who have chicken pox or influenza because it increases the risk of contracting the rare and frequently fatal Reye's syndrome, a disease of the brain and some abdominal organs.

Diclofenac Sodium Patients who experience allergic reactions to aspirin or related medications should not take diclofenac sodium. Patients with kidney or liver problems, ulcers, heart disease, or high blood pressure should use this drug with caution. Its safety for use during pregnancy is not known, but it is known to appear in breast milk. Children under the age of 12 should not use this drug. Ulcers or internal bleeding are sometimes caused by this medication. Other possible side effects include abdominal pain, indigestion, nausea, constipation, diarrhea, headache, or dizziness. Occasionally seen are fluid retention, skin rash, ringing in the ears, blurred or double vision, hair loss, insomnia, light sensitivity, facial swelling, or vomiting. An overdose of diclofenac sodium can cause acute kidney failure, lung inflammation, drowsiness, or loss of consciousness.

SIDE EFFECTING possible side effects include abdominal pain, indigestion, nausea, constipation, diarrhea, headache, or dizziness. Occasionally seen are fluid retention, skin rash, ringing in the ears, blurred or double vision, hair loss, insomnia, light sensitivity, facial swelling, or vomiting. An overdose of diclofenac sodium can cause acute kidney failure, lung inflammation, drowsiness, or loss of consciousness. This drug may interact adversely with aspirin, blood-thinning medications, diuretics, heart medications containing digitalis, insulin and certain other diabetes drugs, cyclosporine, lithium, methotrexate, and carteolol.

Etodolac Etodolac is available only by prescription. Capsules or tablets of etodolac are taken orally every six to eight hours, usually in 200 to 400 mg doses. The total daily dosage should not exceed 1200 mg. Capsules should be taken with food and a full glass of water. (Not lying down for 20 to 30 minutes after taking the drug can help avoid stomach upset.) Effectiveness of this drug may not been seen for one to two weeks after beginning treatment.

Patients who experience allergic reactions to aspirin or related medications should not take etodolac. Patients with kidney or liver problems, peptic ulcer, heart disease, or high blood pressure should use this drug with caution. Its safety for use during pregnancy is not known, and it may appear in breast milk. Children under age 12 should not use this drug.

SIDE EFFECTING Ulcers or internal bleeding are sometimes caused by this medication. Other possible side effects include abdominal pain, indigestion, nausea, constipation, diarrhea, fever, dizziness, ringing in the ears, or muscle weakness. Occasionally seen are fluid retention, sweating, anemia, fainting, insomnia, rapid heartbeat, skin rash, or yellowing of the skin or eyes. This drug may interact adversely with aspirin, blood-thinning medications, diuretics, and digoxin. Brand Name: Lodine