Cardiovascular safety of NSAIDa Essay Example | Topics and Well Written Essays - 2000 words

Cardiovascular safety of NSAIDa - Essay Example As analgesics, NSAIDs are strange in that they are non-narcotic and thus are used as a non-addictive alternative to narcotics (Sundaram, 2014) The most common members of this group of drugs such as aspirin, ibuprofen and naproxen are all available over the counter in most countries. Acetaminophen (parecetamol) is not considered an NSAID because it has only little anti-inflammatory activity. It treats pain mainly by blocking COX-2 mostly in the central nervous system, but not much in the rest of the body.NSAIDs work by inhibiting the activities of both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). They achieve their function by synthesizing prostaglandins and thromboxanes (Hughes, 2008 p. 100). It is believed that inhibiting COX-2 leads to the anti-inflammatory, analgesic and antipyretic effects. It has been discovered that, those NSAIDs that inhibit COX-1, particularly aspirin, may cause gastrointestinal bleeding and ulcers. For this reason, the use COX-2 selective inhibitors may be preferred to COX-1 inhibiting NSAIDs. This paper will, therefore, primarily focus on the cardiovascular safety or effect of such NSAI Ds. According to John Vane (1927-2004), in his Nobel-winning works â€Å"the Mechanism of action of aspirin† he elevated that, most NSAIDs act as nonselective inhibitors by targeting enzyme cyclooxygenase (COX) (Bruera & Portenoy, 2009 p. 271). They achieve their goal by inhibiting both the isoenzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Most of this inhibition caused by NSAIDs is competitively reversible (although at fluctuating degrees of reversibility), except the mechanisms of aspirin, which is irreversible inhibition. COX more specifically works as it catalyzes the formation of prostaglandins and thromboxane from arachidonic acid (a compound that is derived from the cellular phospholipid bilayer by phospholipase A2). Prostaglandins act among other things as messenger molecules in the process of

Review the literature related to the effect of surgical repair in Essay

Review the literature related to the effect of surgical repair in wound healing.Discuss the influence it may have on healing - Essay Example Reports are vague on how the prehistoric man treated wounds, but in the primitive tribes, wounds are covered with plant parts and other materials believed to have healing properties. Wounds were also filled with spider web in time past. Various crude methods of wound draining and wound closing are also reported among some tribes. An ingenious wound clamp was devised out of the jaws of insects by primitive tribes of India and South America who made the insects bite across the apposed edges of a wound.(Haeger, 1988) . Wound management has two main approaches: the surgical and non-surgical categories of intervention. In the non-surgical approach, classical methods such as administration of topical or systemic therapeutic agents, locally applied enzymes, and dressings designed to optimize the wound for later surgery, or to heal the wound by secondary intention (Knox et al., 2007). The surgical approach involves the implementation of preparatory surgical procedures which help to prepare the wound for accelerated recovery and augment the body healing process. Both of these approaches are different, yet aim at the same goal. This review is concerned with the surgical aspects and how they provide a facilitating environment for timely wound healing. For effective wound healing in modern day surgery, the aims are to ensure quick regeneration of damaged tissue, reduce infection, and maximize immune response, and central to achieving these aims are blood perfusion, oxygen supply, prevention of re-injury and good diet(Hunt and Hopf, June 1997a). Reduction of infection and quick tissue regeneration are directly related to wound blood perfusion and oxygenation. Perfusion therefore appears to be the most important factor in wound healing. Wounds in well perfused areas of the body tend to heal faster, even when they are massively infected. They also form less scar. The same goes for wounds that occur in areas of