Prescribing pattern of gastroprotective agents with non-steroidal anti-inflammatory drugs

Abstract

Non‑steroidal anti‑inflammatory drugs (NSAIDs) are most commonly used drugs for management of pain and inflammation. They represent a most widely prescribed class of medications and are used as over the counter drugs. NSAIDs work by interfering with cyclooxygenase (COX) pathway, which involves the conversion of arachidonic acid by the enzyme COX to prostaglandins. COX is available in two isoforms i.e., COX‑1 and 2. Despite wide clinical use of classical NSAIDs as analgesics, anti‑pyretic, and anti‑inflammatory agents, their gastro‑intestinal toxicity is a major clinical limitation. This adverse effect is associated with their ability to inhibit COX‑1 in the gastrointestinal tract.[1] Subsequently, the selective COX‑2 inhibitors emerged as potentially gastro‑friendly NSAIDs and it was conceptualized that sufficient therapeutic benefits are achieved by selective COX‑2 inhibition. At first glance these COX‑2 inhibitors looked like a solution to NSAIDs related GI complication. However, Post marketing experience unmarked various adverse cardiovascular effects. Recent evidences of adverse cardiovascular events with the use of COX‑2 selective inhibitors have created a sense of insecurity not only among prescribers but also among consumers

Keywords: Research Letter