Indications - Mild to moderate pain, inflammation

Examples - Ibuprofen, Diclofenac, Naproxen, aspirin

• COX-2 specific = Celecoxib, Etoricoxib

MOA:

• Non selective COX inhibitors - block prostaglandin synthesis
• Decreased prostanoid binding to prostanoid receptors
  • Usually this binding increases activity of Na channels = more Na influx = more activation and pain sensation triggering the pain pathway
  • NSAIDs = no activation of Na channels = No increased pain sensation

Side effects:

*Generally few problems with low dosage, short term use

• GI disturbance - Heartburn, nausea, vomitting, diarrhoea, bleeding
• Hypertension
• Increased bleeding risk
• Increased risk of thrombus formation

Interactions:

• Diuretics
• ACE-i