Current Perspectives in NSAID-Induced Gastropathy

Abstract

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most highly prescribed drugs in the world. Their analgesic, anti-inflammatory, and antipyretic actions may be beneficial; however, they are associated with severe side effects including gastrointestinal injury and peptic ulceration. Though several approaches for limiting these side effects have been adopted, like the use of COX-2 specific drugs, comedication of acid suppressants like proton pump inhibitors and prostaglandin analogs, these alternatives have limitations in terms of efficacy and side effects. In this paper, the mechanism of action of NSAIDs and their critical gastrointestinal complications have been reviewed. This paper also provides the information on different preventive measures prescribed to minimize such adverse effects and analyses the new suggested strategies for development of novel drugs to maintain the anti-inflammatory functions of NSAIDs along with effective gastrointestinal protection.

A Comprehensive Review on Food and Medicinal Prospects of Astraeus hygrometricus

“…90 The nonsteroidal anti-inflammatory drugs that are commonly administrated to reduce inflammation in the body have shown to possess significant side effects. 91,92 Present studies demonstrated that presence of bioactive compounds in whole mushrooms and their extracts may present efficacious anti-inflammatory activity. 90 Ethanolic extract of A. hygrometricus exhibited noteworthy anti-inflammatory effect as demonstrated by Biswas et al which is very much comparable to that of nonsteroidal anti-inflammatory drugs.…”

Gastroduodenal Mucosal Injury Profile in Long-Term Low-Dose Aspirin Users and Its Influencing Factors

“…28 This is because aspirin has particular characteristic compared to other NSAIDs group, including its acidic property and irreversible bond with cyclooxygenase (COX) enzyme, which both pathophysiology may worsen gastroduodenal mucosal injury. 27,29 Based on bivariate analysis, it was found that patients with age group more than 65 years old had higher risk in the occurrence of gastroduodenal mucosal injury with OR = 2.1 (95% CI: 0.91-4.7). Yeomans et al reported more significant result, which was increased risk of 3.32 fold in age group more than 70 years old.…”

A Comprehensive Evaluation of Peripheral Analgesic and Antipyretic Activities of Divalent Metal Complexes of Indomethacin

“…[2][3][4] Inhibition of COX enzymes decreases the production of prostaglandins, resulting in the decrease in inflammation. 5,6 However, some prostaglandins have their own gastro-protective role, therefore decrease of those prostaglandins can cause gastrointestinal damage. 7 Beyond inhibiting the synthesis of these prostaglandins, NSAIDs can also cause direct damage to the mucosal surface by disrupting the surface-active phospholipids present on it.…”