Examples of non-steroidal anti-inflammatory drugs (NSAIDs) | MPO training 19
Are you aiming to become a skilled Medical Promotion Officer (MPO)? This
article gives you clear and useful examples of non-steroidal anti-inflammatory
drugs explained in simple words. If you're preparing for a pharma career, this
content will help you build a strong base.
Here, you’ll also learn about inflammation, pain, and the mechanism behind
these drugs, which is essential for any successful MPO. You'll discover which
NSAIDs are most used and why they matter in daily medical practice. This is
not just theory—it’s what you really need to know as an MPO. Start learning
with confidence today.
Table of contents: Examples of non-steroidal anti-inflammatory drugs
What you will learn from the table of contents of this article-
Examples of non-steroidal anti-inflammatory drugs
Examples of non-steroidal anti-inflammatory drugs include ibuprofen,
naproxen, diclofenac, and aspirin. These medicines reduce pain,
inflammation, and fever without using steroids. As a Medical Promotion
Officer (MPO), it’s important to understand how each of these drugs works.
They are commonly used in hospitals and pharmacies worldwide. Knowing their
effects and differences helps you explain them better to healthcare
professionals. This article makes it easy for you to remember the key NSAIDs
with confidence.
What are NSAIDs?
NSAIDs are a group of medications used to reduce pain, inflammation, and
fever. Common examples include ibuprofen, naproxen, and diclofenac.
How do NSAIDs work?
NSAIDs work by blocking the cyclooxygenase (COX) enzymes (COX-1 and
COX-2), which help produce prostaglandins - chemicals that cause pain and
swelling in the body.
As an example, I am highlighting the medicines of Acme Laboratories Limited
because I have worked for this company for a long time.
| Brand Name (ACME) | Generic Name | Major Indications |
|---|---|---|
| A-Fenac | Diclofenac Sodium | Pain and inflammation in rheumatic disease (including juvenile idiopathic arthritis), osteoarthritis, acute gout; Relief of pain in musculoskeletal and soft tissue inflammations. |
| A-Fenac plus | Diclofenac Sodium+ Lidocaine HCl | Rheumatoid arthritis, osteoarthritis, low back pain, acute pain, juvenile chronic arthritis, post operative pain, dental and other minor surgery etc. |
| A-Fenac K | Diclofenac Potassium |
Short term treatment in: Post-traumatic pain, inflammation and
swelling due to sprains. Post-operative pain, inflammation and
swellin due to dental or orthopaedic surgery. Painful and/or
inflammatory conditions, pharyngitis, otitis media.
|
| Napro-A | Naproxen | Rheumatoid arthritis, osteoarthritis, Low back pain, primary dys menorrhoea, Ankylosing Spondylitis. |
| NAPRO-A Plus | Naproxen & Esomeprazole |
1. Osteoarthritis (OA)
2. Rheumatoid arthritis (RA)
3. Low Back pain 4. Ankylosing spondylitis (AS) 5. Ocular pain
& Traumatic eye injury.
|
| Profen | Ibuprofen | Rheumatoid arthritis, osteoarthritis, dysmenorrhoea, fever, migrain & dental pain. |
| Indo-A | Indomethacin | Rheumatoid arthritis, ankylosing spondylitis, osteoarthritis, acute painful shoulder and acute gouty arthritis. |
| Winop | Ketorolac Tromethamine | Short term management of moderate and severe post operative pain, acute and chronic musculosketal pain, cancer pain, gynecological surgery, major abdominal surgery, dental pain. |
| Setorib | Etoricoxib | Pain and inflammation in- osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, other chronic musculoskeletal disorders, acute gout, dysmenorrhoea & following dental surgery. |
| Apitac | Aceclofenac | Low back pain, ankylosing spondylitis, osteoarthritis, gynaecological pain, rheumatoid arthritis etc. |
ACME’s NSAIDs: Reliable Relief from Pain & Inflammation
- NSAIDs play a vital role in managing pain and inflammation.
- ACME offers a range of effective NSAIDs including Diclofenac, Naproxen, Ibuprofen, Ketorolac, and Etoricoxib.
- Widely used in conditions like arthritis, postoperative pain, and gynecological discomfort.
- Fast relief with lasting results.
- Always use as prescribed by a physician for safe and effective outcomes.
Inflammation and Pain
A drug class that is used for decreasing inflammation, fever &
reducing pain as well.
NSAIDS shows two types of action:
- Analgesic – Pain reliever
- Antipyretic – Fever reducer
Inflammation
Inflammation is a normal response of the body to protect tissues
from infection, injury or diseases.
Can be elicited by numerous stimuli including:
- Infectious agents
- Antigen-antibody interaction
- Ischemia
- Thermal and physical injury
Classical signs of inflammation
The five classical signs of inflammation:
- Pain
- Heat
- Redness
- Swelling
- Loss of function
Types of inflammation
Inflammation can be classified into:
- Acute Inflammation: Acute inflammation typically lasts only a few days.
- Chronic Inflammation: chronic inflammation lasts weeks, months or even indefinitely and causes tissue damage.
Mediators of Inflammation
- Vasoactive amines (Histamine, Serotonin)
- Platelet activating factor (PAF)
- Complement system
- Kinin system
- Cytokines
- Nitric oxide
- Adhesion Molecules
-
Arachidonic acid metabolites:
- i. Prostaglandins (PGS)
- ii. Thromboxane A2 (TXA2)
- iii. HETE (hydroxy-eicosatetraenoic acid)
- iv. Leukotrienes (LTS)
Mediated by cyclooxygenases (COX) enzymes.
Arachidonic acid metabolites
- Derived from: Leukocytes, mast cells, endothelial cells, and platelets.
- Component of cell membrane phospholipids.
- AA is released from these phospholipids via cellular phospholipases -that have been activated by mechanical, chemical, or physical stimuli, or by inflammatory mediators such physical stimuli, or by inflammatory mediators such as C5a.
- Metabolism proceeds along either of this two major enzymatic pathways.
- Cyclooxygenase: prostaglandins and thromboxanes AUTACOIDS.
- Lipoxygenase: leukotrienes and lipoxins.
Pain
An unpleasant sensory or emotional experience associated
with actual or potential tissue damage.
It is unquestionably a sensation in a part of the body, but
it is also unpleasant, and therefore also an emotional
experience. Many people report pain in the absence of tissue
damage or any likely pathophysiological cause; usually this
happens for psychological reasons.
Types of Pain
1. Acute pain: Acute pain often starts suddenly and feels 'sharp'.
It can be caused by many different things, such as an operation, a broken
bone or an infection. Most acute pain will go away when the reason for the
pain has been treated or the tissues have healed. If acute pain is not
relieved, it may become a chronic pain.
2. Chronic pain: Chronic pain lasts for a longer period of time.
It's usually caused by the cancer itself, but it can sometimes be caused
by the longer-term effects of cancer treatments.
3. Nociceptive pain: Nociceptive pain is a medical term used to
describe the pain from physical damage or potential damage to the body.
Examples might be the pain felt from a sports injury, a dental procedure,
or arthritis.
4. Neuropathic pain: Neuropathic pain is a medical term used to
describe the pain that develops when the nervous system is damaged or not
working properly due to disease or injury.
Cyclooxygenase (COX) Pathway
* Cyclooxygenase-a fatty acid enzyme present as COX-1 and COX-2.
* Major anti-inflammatory drugs act by inhibiting activity of the
enzyme COX-NSAIDs & COX-2 inhibitors.
What is COX?
Cyclooxygenase (COX) is a fatty acid enzyme.
Exists in two forms: COX-1 and COX-2.
What is the difference between COX-1 and COX-2 inhibitors?
Traditional NSAIDs block both COX-1 and COX-2. COX-2 selective
inhibitors (like etoricoxib or celecoxib) mainly block COX-2,
offering pain relief with less stomach irritation.
Two main forms of Cyclooxygenases (COX)
| Cyclooxygenase-1 (COX-1) | Cyclooxygenase-2 (COX-2) |
|---|---|
| Produces prostaglandins that mediate homeostatic functions | Produces prostaglandins that mediate inflammation, pain, and fever. |
| Constitutively expressed | Induced mainly in sites of inflammation by cytokines |
| Plays an important role in - Gastric mucosa, Kidney, Platelets, Vascular endothelium | - |
Cyclooxygenase (COX) Pathway in details
- Cyclooxygenase (COX) is a key fatty acid enzyme that exists in two main forms: COX-1 and COX-2.
- These enzymes convert arachidonic acid into prostaglandins, which are responsible for causing pain, fever, and inflammation in the body.
- Most anti-inflammatory drugs, known as NSAIDs, work by inhibiting the activity of COX enzymes.
- While traditional NSAIDs block both COX-1 and COX-2, selective COX-2 inhibitors (like Etoricoxib) specifically target COX-2, reducing inflammation with fewer gastrointestinal side effects.
- By interfering with the COX pathway, these medications help provide relief from pain and inflammatory conditions.
Function of COX Enzymes
Converts arachidonic acid into prostaglandins.
Prostaglandins are responsible for:
- Pain
- Fever
- Inflammation
Role of Anti-inflammatory Drugs
NSAIDs (e.g., Ibuprofen, Diclofenac) inhibit both COX-1 and COX-2.
Selective COX-2 inhibitors (e.g., Etoricoxib) target only COX-2.
- Reduces inflammation effectively
- Causes fewer gastric side effects
Clinical Relevance
Inhibiting the COX pathway helps manage:
- Rheumatoid arthritis
- Osteoarthritis
- Post-operative pain
- Menstrual cramps
- Other inflammatory conditions
Note: Always use NSAIDs under a physician’s guidance to
avoid side effects and ensure proper therapeutic outcomes.
Mechanism of action of NSAIDs
How NSAIDs Work - Explained Simply
1. When tissue gets injured
- A process starts in the body where phospholipids are released from cell membranes.
2. Phospholipids are converted into arachidonic acid
- This happens with the help of an enzyme called phospholipase.
3. Arachidonic acid can take two paths:
a) COX-1 enzyme → it produces prostaglandins that help with:
- Protecting the stomach lining (GI protection)
- Blood clotting (Haemostasis)
b) Through COX-2 enzyme → it produces prostaglandins that
cause:
- Pain, swelling and fever
4. What do NSAIDs do?
- These drugs block both COX-1 and COX-2 enzymes.
- Blocking COX-2 reduces pain, fever, and inflammation.
- Blocking COX-1 may cause side effects like stomach problems or bleeding.
In short: NSAIDs reduce pain and fever by stopping
the production of prostaglandins, which are the chemicals
responsible for these symptoms.
Classification of NSAIDs
NSAIDs can be classified based on their chemical structure or
mechanism of action.
Non-selective COX inhibitors-
| Salicylates | Aspirin (acetylsalicylic acid) | Diflunisal (Dolobid) | Salicylic acid and its salts | - | - |
| Propionic acid derivatives | Ibuprofen | Dexibuprofen | Naproxen | Ketoprofen | Dexketoprofen |
| Acetic acid derivatives | Indomethacin | Etodolac | Ketorolac | Diclofenac | Aced ofenac |
| Enolic acid (oxicam) derivatives | Piroxicam | Meloxicam | Tenoxicam | Droxi | Lornoxicam |
| Anthranilic acid derivatives (fenamates) | Mefenamic acid | Meclofenamic acid | Flufenamic acid | Tolfenamic acid | - |
| Sulfonanilides | Nimesulide | - | - | - | - |
| Selective COX-2 inhibitors (coxibs) | Celecoxib | Rofecoxib | Valde coxib | Etoricoxib | - |
Medical use of NSAIDs
NSAIDs are generally used for the symptomatic relief of the
following conditions:
1. Osteoarthritis
2. Rheumatoid arthritis
3 Mild-to-moderate pain due to inflammation and tissue injury
4. Low back pain
5. Inflammatory arthropathies (e.g., ankylosing spondylitis,
psoriatic arthritis, reactive arthritis)
6. Tennis elbow
7. Headache
8. Migraine
9. Acute gout
10. Dysmenorrhea (menstrual pain)
11. Postoperative pain
12. Muscle stiffness and pain due to Parkinson's disease
13. Pyrexia (fever)
14. Renal colic
15. Traumatic Injury
* Aspirin, the only NSAID able to irreversibly inhibit COX-1,
is also indicated for anti-thrombosis through inhibition of
platelet aggregation. This is useful for the management of
arterial thrombosis and prevention of adverse cardiovascular
events like heart attacks.
*Aspirin inhibits platelet aggregation by inhibiting the
action of thromboxane A2.
Contraindications
NSAIDs may be used with caution by people with the following
conditions:
- Irritable bowel syndrome.
- Persons who are over age 50, and who have a family history of GI (gastrointestinal) problems.
- Persons who have had past Gl problems from NSAID use.
NSAIDs should usually be avoided by people with the
following conditions:
➤ Peptic ulcer or stomach bleeding.
➤ Uncontrolled hypertension.
➤ Kidney disease.
➤ People that suffer with inflammatory bowel disease.
➤ Past transient ischemic attack.
➤ Past stroke (excluding aspirin).
➤ Past myocardial infarction (excluding aspirin).
➤ Coronary artery disease (excluding aspirin).
➤ Undergoing coronary artery bypass surgery.
➤ Congestive heart failure.
➤ In third trimester of pregnancy.
8Adverse effects
NSAIDs increase risk of a range of gastrointestinal (GI)
problems, kidney disease and adverse cardiovascular events.
As commonly used for post-operative pain, there is evidence
of increased risk of kidney complications.
Combinational risk: If a COX-2 inhibitor is taken, a
traditional NSAID (prescription or over-the-counter) should
not be taken at the same time. In addition, people on daily
aspirin therapy (e.g., for reducing cardiovascular risk)
must be careful if they also use other NSAIDs, as these may
inhibit the cardioprotective effects of aspirin.
Cardiovascular risk: NSAIDs, aside from aspirin,
increase the risk of myocardial infarction and stroke. This
occurs at least within a week of use. They are not
recommended in those who have had a previous heart attack as
they increase the risk of death or recurrent MI. Evidence
indicates that naproxen may be the least harmful out of
these.
Possible erectile dysfunction risk: long term (over 3
months) use NSAIDs comes with an increased risk of erectile
dysfunction.
Gastrointestinal risk: The main adverse drug
reactions (ADRs) associated with NSAID use relate to direct
and indirect irritation of the gastrointestinal (GI) tract.
NSAIDs cause a dual assault on the Gl tract:
The acidic molecules directly irritate the gastric mucosa,
and inhibition of COX-1 and COX-2 reduces the levels of
protective prostaglandins.
Inhibition of prostaglandin synthesis in the Gl tract causes
increased gastric acid secretion, diminished bicarbonate
secretion, diminished mucus secretion and diminished trophic
effects on the epithelial mucosa.
NB: An Anti-ulcerant should be used along with NSAIDs to
prevent Gl problem.
NSAIDs drig During pregnancy
NSAIDs are not recommended during pregnancy, particularly
during the third trimester.
Use of NSAIDs During Pregnancy – Important Precautions
- NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are commonly used to relieve pain and inflammation.
- However, their use during pregnancy requires special caution.
- It is strongly advised to avoid NSAIDs, especially in the later stages of pregnancy.
- The third trimester is particularly sensitive and carries higher risks.
- NSAIDs can lead to premature closure of the fetal ductus arteriosus.
- This may result in serious cardiovascular complications in the unborn baby.
- Kidney problems and reduced amniotic fluid levels are also associated with NSAID use.
- Some NSAIDs may even increase the risk of miscarriage in early pregnancy.
- Always consult a healthcare professional before using any pain medication during pregnancy.
- Safer alternatives, like paracetamol (acetaminophen), are generally recommended instead.
FAQs
1. What conditions are NSAIDs commonly used for?
NSAIDs are commonly used to treat conditions such as
arthritis, muscle pain, back pain, menstrual cramps, fever,
dental pain, and post-operative pain.
2. Are NSAIDs safe for long-term use?
Long-term use of NSAIDs can lead to side effects like
stomach ulcers, kidney problems, and heart risks, especially
in older adults. Always follow a doctor’s advice.
3. Can NSAIDs be taken on an empty stomach?
It is best to take NSAIDs with food or milk to help reduce
the risk of stomach upset or ulcers.
4. Can NSAIDs interact with other medications?
Yes, NSAIDs can interact with blood thinners, blood pressure
medicines, and certain antidepressants. Always inform your
doctor about any medicines you are taking.
5. Are NSAIDs safe during pregnancy?
Most NSAIDs are not recommended during pregnancy, especially
in the third trimester. Always consult a healthcare provider
before using them.
6. What are the common side effects of NSAIDs?
Common side effects include stomach pain, nausea, heartburn,
and in some cases high blood pressure or kidney issues with
long-term use.
7. Are there alternatives to NSAIDs for pain relief?
Yes. Alternatives include acetaminophen (paracetamol) for
mild pain, physical therapy, ice/heat therapy, or
prescription medications in severe cases.
Conclusion
To succeed as a Medical Promotion Officer (MPO), you must
clearly understand the basic examples of non-steroidal
anti-inflammatory drugs. These are not just drug names; they
are tools in your professional journey. Learning about
ibuprofen, diclofenac, or naproxen gives you a strong
foundation to discuss effectively with doctors. This article
gives you a simple and practical way to remember them. Keep
practicing and applying what you learn. It’s the small steps
like these that grow your skills and confidence in the field.
Sarwar Hossain Himel
I am Sarwar Hossain Himel — a sports-loving person. Education: I have obtained a BBA and MBA degree in Accounting. Profession: Currently, I am working as a Medical Promotion Officer (MPO). In addition, I have over 5 years of experience in teaching. Freelance Work: I work as a Google Blogger and Article Writer in freelancing. Passion: I love doing web design and digital marketing. Especially, web design is one of my passions.