NSAIDS
NSAIDS work by inhibiting the cyclooxygenase enzymes (COX-1 and COX-2). Cyclooxygenase-1 (COX-1)
contributes to the maintenance of the gastric protective mucosal layer. Cyclooxygenase-2 (COX-2) contributes
to the inflammatory response, pain transmission, and renal blood flow. The use of NSAIDS leads to decreased
prostaglandin synthesis. Decreased prostaglandins can cause GI bleeds, decreased renal perfusion, and CV side
effects. The serious cardiovascular events with COX-2 inhibitors had lead to the withdrawl of rofecoxib and
valdecoxib by the FDA. Celecoxib is still available for use in osteoarthritis, RA, and pain. NSAIDS do not alter
the disease process and joint destruction; its primary use is for symptom control.
| N | Nursing: Do not use when breast feeding, pregnant, NSAIDS pass across placenta. |
| S | Serious bleeding (GI bleeding) |
| A | Asthma, Angioedema |
| I | Intestinal bleeding: PUD; Can interfere with efficacy of HTN drugs because it blocks prostaglandins (ACE/ARBS) |
| D | Drugs that can effect coagulation (Plavix, Lovenox, Coumadin, ASA). It will inhibit platelets and increase chance of bleeding |