Non-steroidal Anti-inflammatory Drugs (NSAIDs)
NSAIDs have the following properties:
- Analgesic
- Antipyretic
- Anti-inflammatory
These result from inhibition of prostaglandin synthesis. Oral, rectal, intravenous and topical preparations are available.
Side effects
NSAIDs have a number of side-effects:
- Peptic ulceration. For those patients at risk of ulceration (and who really need the NSAID) the British National Formulary recommends you consider prescribing a proton pump inhibitor, an H2-receptor antagonist such as ranitidine given at twice the usual dose, or misoprostol
- Renal impairment (particularly when given to patients with pre-existing renal impairment or hypotension)
- Bronchospasm in a small percentage of asthmatics (typically those with chronic rhinitis and nasal polyps)
- Inhibition of platelet function with some evidence of increased blood loss following surgery5
Learning Bite
No good evidence exists suggesting any NSAID is superior. Ibuprofen is the safest, cheapest and most readily available over the counter.