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Chapter 4 - Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

from Part II - Common Categories of Pharmacologic Medications to Treat Chronic Pain

Published online by Cambridge University Press:  01 December 2023

Omar Viswanath
Affiliation:
Creighton University, Omaha
Ivan Urits
Affiliation:
Southcoast Brain & Spine Center, Wareham
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Summary

Ibuprofen and naproxen are nonsteroidal anti-inflammatory drugs (NSAIDs) that work by inhibiting cyclooxygenase (COX) 1 and 2, enzymes involved in the synthesis of prostaglandins that contribute to pain, inflammation, and fever. Therefore, cyclooxygenase modulation contributes to the anti- inflammatory and analgesic qualities of ibuprofen and naproxen. While NSAIDs have been shown to be effective in the treatment of chronic low back pain, they can also have adverse effects on the gastrointestinal, renal, and coagulation systems, including gastric pain, vomiting, bleeding, gastric ulcers, acute renal failure, interstitial nephritis, and nephritic syndrome. Long-term use of NSAIDs increases the risk of such side effects. While short-term use is considered relatively safe, the evidence for the long-term efficacy of NSAIDs for chronic low back pain is limited, and the ACP recommends them as a first-line pharmacological agent with caution. The use of NSAIDs, especially over a prolonged time, is also not without risk. Long term use predisposes patients to considerable side effects.

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Publisher: Cambridge University Press
Print publication year: 2023

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References

Ghlichloo, I, Gerriets, V. Nonsteroidal anti-inflammatory drugs (NSAIDs). Treatment of Chronic Pain Conditions: A Comprehensive Handbook. 2021;1:7779.Google Scholar
Worthington, I, Pringsheim, T, Gawel, MJ et al. Canadian headache society guideline: Acute drug therapy for migraine headache. Can J Neurol Sci. 2016;40(S3):S1S3.CrossRefGoogle Scholar
Moyer, S. Pharmacokinetics of naproxen sodium. Cephalalgia. 1986;6(Suppl. 4):7780.CrossRefGoogle ScholarPubMed
Altabakhi, IW, Zito, PM. Acetaminophen/Aspirin/Caffeine. Treasure Island, FL; 2019.Google Scholar
Schramm, SH, Moebus, S, Ozyurt Kugumcu, M et al. Use of aspirin combinations with caffeine and increasing headache frequency: A prospective population-based study. Pain. 2015;156(9):17471754.CrossRefGoogle ScholarPubMed
Järvinen, TA, Järvinen, TL, Kääriäinen, M et al. Muscle injuries: Optimising recovery. Best Pract Res Clin Rheumatol. 2007;21(2):317331.CrossRefGoogle ScholarPubMed
Casazza BA. Diagnosis and treatment of acute low back pain. Am Fam Physician. 2012;85(4):343350.Google Scholar
Dawood, MY. Primary dysmenorrhea: Advances in pathogenesis and management. Obstet. Gynecol. 2006;108(2):428441.CrossRefGoogle Scholar
Shekelle, Paul G, Newberry, Sydne J, FitzGerald, John D et al. Management of gout: A systematic review in support of an American College of Physicians Clinical Practice Guideline. Ann. Intern. Med. 2017;166(1):3751.CrossRefGoogle Scholar
Bartfai, T, Conti, B. Fever. Sci. World J. 2010;10:490503.CrossRefGoogle Scholar
Krasselt, M, Baerwald, C. Celecoxib for the treatment of musculoskeletal arthritis. Expert Opin Pharmacother. 2019;20(14):16891702.CrossRefGoogle ScholarPubMed
Gupta, A, Bah, M. NSAIDs in the treatment of postoperative pain. Curr Pain Headache Rep. 2016;20(11):62. doi: 10.1007/s11916-016-0591-7.CrossRefGoogle ScholarPubMed
Bushra, R, Aslam, N. An overview of clinical pharmacology of ibuprofen. Oman Med. J. 2010;25(3):1551661.CrossRefGoogle ScholarPubMed
Vane, JR, Botting, RM. Mechanism of action of nonsteroidal anti-inflammatory drugs. Am. J. Med. 1998;104(3):2S8S.CrossRefGoogle ScholarPubMed
Romsing, J, Moiniche, S. A systematic review of COX-2 inhibitors compared with traditional NSAIDs, or different COX-2 inhibitors for post-operative pain. Acta Anaesthesiologica Scandinavica. 2004;48(5):525546.CrossRefGoogle ScholarPubMed
Altabakhi, IW, Zito, PM. Acetaminophen/Aspirin/Caffeine. Treasure Island, FL: StatPearls Publishing; 2019.Google Scholar
Perneby, C, Wallen, NH, Rooney, C, Fitzgerald, D, Hjemdahl, P. Dose- and time-dependent antiplatelet effects of aspirin. Thrombosis and Haemostasis. 2006;95(4):652658.CrossRefGoogle ScholarPubMed
Bushra, R, Aslam, N. An overview of clinical pharmacology of ibuprofen. Oman Med J. 2010;25(3):1551661.CrossRefGoogle ScholarPubMed
McPherson, ML, Cimino, NM. Topical NSAID formulations. Pain Medicine. 2013; 14(1);S35–S39. doi: 10.1111/pme.12288. PMID: 24373109.CrossRefGoogle ScholarPubMed
Irvine, J, Afrose, A, Islam, N. Drug development and industrial pharmacy formulation and delivery strategies of ibuprofen: Challenges and opportunities. Drug development and industrial pharmacy. 2017; 44(2):173183.CrossRefGoogle ScholarPubMed
Mills, RFN, Adams, SS, Cliffe, EE, Dickinson, W, Nicholson, JS. The metabolism of ibuprofen. Xenobiotica: The Fate of Foreign Compounds in Biological Systems. 2008; 3(9):589598. doi: 10.3109/00498257309151547. PMID: 4202799.CrossRefGoogle Scholar
Sutton, LB. Naproxen sodium: Pharmacists should counsel patients to determine whether self-medication with OTC NSAIDs is contraindicated. J. Am. Pharm. Assoc. 1996;36(11):663667.Google Scholar
Wyatt, JE, Pettit, WL, Harirforoosh, S. Pharmacogenetics of nonsteroidal anti-inflammatory drugs. Pharmacogenomics J. 2012;12(6):462467.CrossRefGoogle ScholarPubMed

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