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Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Mechanisms, Clinical Applications, and Safety Considerations
Non-steroidal anti-inflammatory drugs (NSAIDs) are a widely used class of medications that reduce inflammation, pain, and fever by inhibiting cyclooxygenase (COX) enzymes, which mediate prostaglandin synthesis. Common NSAIDs include ibuprofen, naproxen, diclofenac, aspirin, and celecoxib, available in oral, topical, and injectable forms.
NSAIDs are indicated for musculoskeletal disorders, arthritis, postoperative pain, dysmenorrhea, cardiovascular prophylaxis (aspirin), and acute inflammatory conditions. They offer rapid symptom relief and are integral to multimodal pain management strategies.
While effective, NSAIDs carry gastrointestinal, renal, cardiovascular, and hypersensitivity risks, particularly with long-term use. COX-2 selective inhibitors reduce GI complications but may increase cardiovascular risk. Guidelines emphasize lowest effective dosing, short-term use when possible, and monitoring in high-risk patients.
Emerging trends include topical NSAID formulations, combination therapies with gastroprotective agents, and personalized dosing regimens guided by pharmacogenomics. NSAIDs remain essential tools in pain and inflammation management, balancing efficacy with careful risk assessment to optimize patient outcomes.