Clinical Pharmacology of Non-Steroidal Anti-Inflammatory Drugs: A Review

Bacchi, Simona; Palumbo, Paola; Sponta, A.M.; Coppolino, Maria Francesca

doi:10.2174/187152312803476255

Cited by 330 publications

(270 citation statements)

References 155 publications

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“…However, side effects resulting from the use of this type of medication are a concern. For instance, indomethacin is known to cause gastritis and gastric ulcers, especially in the elderly and patients with a history of ulcerative diseases (Hernández-Díaz and Rodríguez, 2000;Bacchi et al, 2012). Therefore, the development of novel alternative drug delivery systems that reduce such side effects is required.…”

Section: Discussionmentioning

confidence: 99%

“…Decreased production of prostaglandins (PGs), especially PGE 2 , results in reduced gastric mucosal protection, leading to injuries of the gastrointestinal tract and potential cardiovascular problems, renal toxicity, high blood pressure, and fluid retention. PGE 2 derives from the activity of COX-1, and is one of the most abundant PGs in the body under physiological conditions, being involved in the immune response, blood pressure, and gastrointestinal mucosal integrity (Jones, 2001;Ricciotti and FitzGerald, 2011;Bacchi et al, 2012). PGs are the end products of arachidonic acid (AA) release from the cell membrane mediated by phospholipases in response to stimuli.…”

Section: Introductionmentioning

confidence: 99%

“…PGs are the end products of arachidonic acid (AA) release from the cell membrane mediated by phospholipases in response to stimuli. Free AA is then converted to PGs via COX and lipoxygenase (Vane et al, 1998;Smith et al, 2000;Bacchi et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

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In vitro study of the cytotoxic and genotoxic effects of indomethacin-loaded Eudragit® L 100 nanocapsules

Froder¹,

Dupeyrón²,

Carvalho³

et al. 2016

Genet. Mol. Res.

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ABSTRACT. Indomethacin is a non-steroidal anti-inflammatory agent included in one of the most commonly used drug classes worldwide. The use of this drug results in certain side effects, including gastrointestinal complications. Therefore, there exists a need to develop better methods for the delivery of such drugs into the body, such as those employing nanoparticles. The aim of the present study was to evaluate the cytotoxic and genotoxic effects of indomethacinloaded Eudragit ® L 100 nanocapsules (NI; based on methacrylic acid and methyl methacrylate) on cells unable (lymphocytes) and able to metabolize drugs (HepG2 cells), using comet and cytokinesis-block micronucleus (CBMN) assays in vitro. Cells were exposed to NI at concentrations of 5, 10, 50, 125, 250, and 500 µg/mL. The comet assay showed that NI induced no significant DNA damage in either cell type at any of the concentrations tested. The CBMN test confirmed these results; however, the highest concentration of 500 µg/mL resulted in a small but statistically significant clastogenic/aneugenic effect in HepG2 cells. These findings should encourage the development of new investigations of this nanomaterial as a delivery vehicle for antiinflammatory drugs, such as indomethacin.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In vitro study of the cytotoxic and genotoxic effects of indomethacin-loaded Eudragit® L 100 nanocapsules

Froder¹,

Dupeyrón²,

Carvalho³

et al. 2016

Genet. Mol. Res.

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“…Moreover, another considerable side-effect is hepatotoxicity. İt may occur that transaminases arise 1.2 or 1.3 times the normal rate, causing temporary renal injury (17).…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome, pain perception and activities of daily life after minimally invasive coronary artery bypass grafting

Uymaz¹,

Sezer²,

Coşkun³

et al. 2014

Anadolu Kardiyol Derg

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Objective: Minimally invasive direct coronary artery bypass (MIDCAB) for revascularization of the left anterior descending artery has become a routine operation. We present our clinical experiences with beating heart MIDCAB surgery performed through partial lower sternotomy (PLS) and retrospectively compare the results of pain perception as well as activities of daily life (ADL) with the conventional full sternotomy. Methods: From January 2009 to August 2012, 197 patients underwent MIDCAB using modified PLS at our hospital. Their mean age was 58.5±10.5 years. 54 (28%) had previous myocardial infarction, 38 (19%) had diabetes mellitus. The visual analog scale (VAS) for pain one, two and three, the ADL score for mobilization were obtained within four days after surgery. 98% of patients were followed-up with both direct visits and questionnaires to assess the major adverse cardiac events (MACE). We performed t-test for comperative data and Kaplan-Meier curves for survival analysis.Results: There was one postoperative death (0.5%) and three conversions to full sternotomy (1.5%). Postoperative angiography was performed in 34 (17.2%) patients, who had some symptoms during the follow-up period of 45 months. The graft patency rate was 96.5% (190 of 197). At follow-up (24.1±11.7 months), survival free of MACE was 91.8±3.1% at 3.5 years. Both the Visual Analog Scale (VAS 35.1±9.6 vs. 57.1±7.8) and the ADL score (80.4±11.8 vs. 36.2±8.6) were significantly higher after the operation in comparison to the matched group of beating heart revascularizations with full sternotomy (p<0.001). Conclusion: This study demonstrates that the MIDCAB using PLS can achieve an effective intermediate-term revascularization and an acceptable clinical outcome. Patients who undergo this procedure are free of major complications and enjoy good quality of life after surgery.

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“…Because of its constitutive expression, inhibition of COX-1 causes, but not exclusively, the most common NSAIDs adverse effects, mainly related to the gastrointestinal tract. The majority of the available drugs are non-selective COX inhibitors, thereby acting on both enzymes [24].…”

Section: Non-steroidal Anti-inflammatory Drugs and Modulation Of Er Smentioning

confidence: 99%

Endoplasmic reticulum stress response in the roadway for the effects of non-steroidal anti-inflammatory drugs

Mügge

Silva

2015

Endoplasmic Reticulum Stress in Diseases

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Over the past decade, a handful of evidence has been provided that nonsteroidal anti-inflammatory drugs (NSAIDs) display effects on the homeostasis of the endoplasmic reticulum (ER). Their uptake into cells will eventually lead to activation or inhibition of key molecules that mediate ER stress responses, raising not only a growing interest for a pharmacological target in ER stress responses but also important questions how the ER-stress mediated effects induced by NSAIDs could be therapeutically advantageous or not. We review here the toxicity effects and therapeutic applications of NSAIDs involving the three majors ER stress arms namely PERK, IRE1, and ATF6. First, we provide brief introduction on the well-established and characterized downstream events mediated by these ER stress players, followed by presentation of the NSAIDs compounds and mode of action, and finally their effects on ER stress response. NSAIDs present promising drug agents targeting the components of ER stress in different aspects of cancer and other diseases, but a better comprehension of the mechanisms underlying their benefits and harms will certainly pave the road for several diseases’ therapy.

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Clinical Pharmacology of Non-Steroidal Anti-Inflammatory Drugs: A Review

Cited by 330 publications

References 155 publications

In vitro study of the cytotoxic and genotoxic effects of indomethacin-loaded Eudragit® L 100 nanocapsules

In vitro study of the cytotoxic and genotoxic effects of indomethacin-loaded Eudragit® L 100 nanocapsules

Clinical outcome, pain perception and activities of daily life after minimally invasive coronary artery bypass grafting

Endoplasmic reticulum stress response in the roadway for the effects of non-steroidal anti-inflammatory drugs

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