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