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Source publication
Objective:
We sought to assess the trend of non-steroidal anti-inflammatory drug (NSAID) use in primary health care institutions located in A'Seeb, a province in the capital city of Oman, Muscat. Additionally, we evaluated the relationship between a physician's years of experience and the number of prescription issued, as well as the presence of r...
Context in source publication
Context 1
... analysis of NSAIDs prescription indications showed that musculoskeletal problems were the main reason for prescribing NSAIDs in primary care (35%), followed by acute upper respiratory infections (AURI) and ear, nose and throat (ENT) problems (21%). Approximately 20% of all prescriptions had no indication given [ Figure 1]. ...
Citations
... One of the most useful medication used in primary health care are NSAID, because of their analgesic, antipyretic and anti-inflammatory activities. Inflammation in Rheumatoid arthritis and osteoarthritis is known to be reduced by the use of NSAID, also they enhance the recovery and mobility (1) . NSAID act by the same mechanism of action, through inhibiting cyclooxygenase enzymes COX that are responsible for the production of prostaglandins. ...
... Although NSAIDs can be a less costly management strategy than conservative care (e.g., ongoing physical therapy) they are not without risk of harm (4,5). Caution should be taken in prescribing NSAIDs for use in people with a high risk of diabetes mellitus, hypertension, renal impairment, and heart disease (7,8), with consideration that cyclooxygenase 2 (COX-2) selective NSAIDs are associated with fewer gastrointestinal ulcers and complications than nonselective NSAIDs (9,10). ...
Objective
Our systematic review aimed to investigate the proportion of participants with osteoarthritis who were prescribed nonsteroidal antiinflammatory drugs (NSAIDs) by their health care provider.
Methods
Electronic databases were searched for observational studies reporting NSAID prescribing to participants with diagnosed osteoarthritis of any region. Risk of bias was assessed using a tool designed for observational studies measuring prevalence. Random and fixed‐effects meta‐analysis was used. Meta‐regression investigated study‐level factors associated with prescribing. The overall evidence quality was assessed using Grading of Recommendations Assessment, Development, and Evaluation criteria.
Results
Fifty‐one studies were included, published between 1989 and 2022, with 6,494,509 participants. The mean age of participants was 64.7 years (95% confidence interval [95% CI] 62.4, 67.0; n = 34 studies). Most studies were from Europe and Central Asia (n = 23 studies), and North America (n = 12 studies). Most studies were judged to be at low risk of bias (75%). Heterogeneity was eliminated when removing studies with a high risk of bias, to give a pooled estimate of NSAIDs prescribing to participants with osteoarthritis of 43.8% (95% CI 36.8, 51.1; moderate quality of evidence). Meta‐regression determined that prescribing was associated with year (decreased prescribing over time; P = 0.05) and geographic region (P = 0.03; higher in Europe and Central Asia and in South Asia than in North America) but not with clinical setting.
Conclusion
Data from over 6.4 million participants with osteoarthritis between 1989 and 2022 indicate that NSAID prescribing has decreased over time and that prescribing differs between geographic locations. image
... Inflammation can cause many diseases, including arthritis and asthma . Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in the clinical setting to combat inflammatory diseases (Al-Shidhani et al. 2015), but they have several side effects making them unsuitable for the treatment of all inflammatory diseases (Yao et al. 2019). Therefore, it is necessary to develop new safe drugs that can be treated for inflammatory diseases. ...
... The consumption and prescription of NSAIDs are rising, while ibuprofen and paracetamol are the highly prescribed fixed-dose NSAID medication for inflammation and pain-related ailments [12][13][14]. Due to the low solubility and high permeability of NSAIDs, they are categorized as class II by the Biopharmaceutics Classification System (BCS) [15,16]. The low solubility and high permeability of NSAIDs are creating several troubles in the application and production of NSAID derivatives, particularly relating to the initial mode of action [17]. ...
The anti-inflammatory drugs are vital agents used to manage the acute and chronic inflammation-related ailments including arthritis, bowel diseases, cancer, colitis, diabetes, and heart disease. The anti-inflammatory properties of chemical agents, i.e., non-steroidal anti-inflammatory drugs, exhibited their antagonistic effect on cyclooxygenase (COX-1/2) and other immunological targets consequently decreasing the production of prostaglandin, which leads to reduce the inflammation and pain. The anti-inflammatory agents are used for the temporary relief from pain such as that of bruising, headache, and muscle strain, while sometimes they exhibited mild to moderate side effects. For the treatment of chronic inflammation-related complications, anti-inflammatory agents with high selectivity, efficacy, prolong action, and fewer or no side effects are required. To develop an anti-inflammatory drug that possess these properties, a supramolecule-based drug carrier can be the right choice, as they can boosts the efficacy of drug action via improving pharmacokinetics, bioavailability, solubility, membrane permeability, site-specific systemic transport, and discharge. In this chapter, the role of supramolecules to improve the drug-like properties and efficacy of anti-inflammatory agents have been described.
... Non-steroidal anti-inflammatory drugs (NSAIDs) are widely given to patients by physicians around the world, due to their effective inhibition effects on the cyclooxygenase enzyme (COX) [1][2][3][4][5]. Cyclooxygenase enzyme (COX) is present as two isoforms, COX-1 is present in the kidney, stomach and blood vessel, which is responsible for normal physiological activity while COX-2 have mediated the inflammation effect in the body [6][7][8]. ...
Objective
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a group of drugs widely used around the world for their analgesic, antipyretic and anti-inflammatory effect, but still have many limitations due to their side effects. So, these lead to the development of a new approach to search for a new product from natural plants that have similar therapeutic effects without common side effects like gastrointestinal ulcers.
Method
The anti-inflammatory effect of β-amyrin palmitate (1) as triterpene and 1,7-bis (4- hydroxyphenyl) hept-4-en-3-one (2) as diarylheptanoid, isolated from Pellacalyx axillaris was studied by molecular docking to find the probability of binding position and binding strength of new compounds with particular Prostaglandin G/H synthase 2 (PDB ID: 1CX2). In vivo acute anti-inflammatory activity of the isolated compounds (1 and 2) was evaluated in rats using the egg-white induced edema model of inflammation in a dose correspondent to 3 mg/Kg of Diclofenac Sodium.
Result
The tested isolated compounds showed a high activity to inhibit the swelling in paw edema and their anti-inflammatory effect began shortly after the injection of the egg white and continued to the end of the experiment in comparison to the reference and control.
Conclusion
The isolated compounds show a long period of activity with a very potent effect, this may be related to their suitable acidity and may have perfect hydrophilic –lipophilic balance. This is the first study of anti-inflammatory effect using Paw edema model and molecular docking.
... After categorizing prescriptions based on the prescriber's specialty, our results showed that 34.5% were issued by an orthopedic specialist, whereas 32.3% were issued by an internal medicine specialist. Given that analgesics and NSAIDs are prescribed for various conditions, the top three diagnoses for which analgesics were prescribed (musculoskeletal diseases, respiratory diseases, and injuries attributable to external causes, among other diseases) were selected [17,18] (Figure 2b). The mean number of analgesic prescriptions per person for musculoskeletal diseases, respiratory diseases, and injuries of external causes in patients with incident MI was 11.52, 7.01, and 2.30, respectively. ...
... Moreover, the mean number of individual analgesics per prescription for each of these primary diagnoses was 1.41%, 1.35%, and 1.29%, respectively. among other diseases) were selected [17,18] (Figure 2b). The mean number of analgesic prescriptions per person for musculoskeletal diseases, respiratory diseases, and injuries of external causes in patients with incident MI was 11.52, 7.01, and 2.30, respectively. ...
Although current guidelines for myocardial infarction (MI) recommend caution in using non-steroidal anti-inflammatory drugs (NSAIDs), real-world studies of ambulatory settings are rare. This study aimed to explore the patterns and trends of analgesic prescriptions (especially NSAIDs) among patients with a history of MI in ambulatory care settings in Korea. We analyzed real-world data from the Korea National Health Insurance Service database. Patients aged 20 years or older hospitalized with incident MI were identified between January 2007 and December 2015. Ambulatory analgesics were administered after discharge from incident hospitalization for MI, and annual trends in the prescriptions of individual analgesics were evaluated. Among the 93,597 patients with incident MI, 75,131 (80.3%) received a total of 2,081,705 ambulatory analgesic prescriptions. Prescriptions were mainly issued at primary care clinics (80.3%). Analgesics were most frequently prescribed for musculoskeletal diseases (often NSAIDs, 70.7%); aceclofenac (13.7%) and diclofenac injection (9.4%) were the frequently used NSAIDs. Additionally, significant changes were observed in the trends for some analgesics, such as loxoprofen. This study suggested that NSAIDs are commonly prescribed to patients with a history of MI. Future real-world studies are needed to elucidate the drug–disease interactions of NSAIDs prescribed after MI, especially for patients with musculoskeletal diseases.
... Intense research efforts have been dedicated to discovering effective anti-inflammatory therapies. Today, the most common treatment is with non-steroidal anti-inflammatory drugs (NSAIDs), characterized by their analgesic, antipyretic, and anti-inflammatory effects [6][7][8][9][10]. Unfortunately, significant side effects have been associated with NSAIDs, including gastric ulcers, bleeding, and perforation. ...
Compound 5-{[(2E)-3-bromo-3-carboxyprop-2-enoyl]amino}-2-hydroxybenzoic acid (C1), a new 5-aminosalicylic acid (5-ASA) derivative, has proven to be an antioxidant in vitro and an anti-inflammatory agent in mice. The in vivo inhibition of myeloperoxidase was comparable to that of indomethacin. The aim of this study was to take another step in the preclinical evaluation of C1 by examining acute toxicity with the up-and-down OECD method and pharmacokinetic profiles by administration of the compound to Wistar rats through intravenous (i.v.), oral (p.o.), and intraperitoneal (i.p.) routes. According to the Globally Harmonized System, C1 belongs to categories 4 and 5 for the i.p. and p.o. routes, respectively. An RP-HPLC method for C1 quantification in plasma was successfully validated. Regarding the pharmacokinetic profile, the elimination half-life was approximately 0.9 h with a clearance of 24 mL/min after i.v. administration of C1 (50 mg/kg). After p.o. administration (50 mg/kg), the maximum plasma concentration was reached at 33 min, the oral bioavailability was about 77%, and the compound was amply distributed to all tissues evaluated. Therefore, C1 administered p.o. in rats is suitable for reaching the colon where it can exert its effect, suggesting an important advantage over 5-ASA and indomethacin in treating ulcerative colitis and Crohn’s disease.
... In 2018, NSAID prescriptions increased by 40.7%, the most significant percentage prescribed to women on long-term treatment. Paracetamol and ibuprofen are the most frequently prescribed NSAID for chronic therapy using fixed-dose combination treatment [2][3][4]. ...
Co-crystal innovation is an opportunity in drug development for both scientists and industry. In line with the “green pharmacy” concept for obtaining safer methods and advanced pharmaceutical products, co-crystallization is one of the most promising approaches to find novel patent drugs, including non-steroidal anti-inflammatory drugs (NSAID). This kind of multi-component system improves previously poor physicochemical and mechanical properties through non-covalent interactions. Practically, there are many challenges to find commercially viable co-crystal drugs. The difficulty in selecting co-formers becomes the primary problem, followed by unexpected results, such as decreased solubility and dissolution, spring and parachute effect, microenvironment pH effects, changes in instability, and polymorphisms, which can occur during the co-crystal development. However, over time, NSAID co-crystals have been continuously updated regarding co-formers selection and methods development.
... However, the use of non-steroidal anti-inflammatory drugs (NSAIDs) accounts for approximately 25% of gastric ulcer cases with an upward trend [4]. Non-steroidal anti-inflammatory drugs (NSAIDs) are some of the most commonly prescribed drugs in the world [5]. Indomethacin is a non-steroidal anti-inflammatory agent with antipyretic, analgesic properties and is an indole derivative designated chemically as 1-(p-chlorobenzoyl)-5methoxy-2-methyl-1H-indole-3-acetic acid [6]. ...
This investigation was aimed to study the effect of Pinus halepensis aqueous bark extract and zinc to prevent indomethacin induced gastric ulcer in rats. Thirty female albino Wistar rats were divided into 6 groups of 5 animals each (n=5); Group 1: normal control, Group 2: ulcer rats received normal saline, Group 3: ulcer rats treated with P. halepensis, Group 4: ulcer rats were treated with zinc, Group 5: ulcer rats were treated with P. halepensis + zinc and Group 6 ulcer rats were treated with Ranitidine for 15 days. Stomach ulcer was induced by a single oral administration of indomethacin (30 mg/kg). Various biochimical, physiologic and histologic parameters were estimated. Obtained results show that the ulcer index, pH and total acidity level were significantly reduced (p<0.05) and Pepsin activity was significantly increased (p< 0.05) in ulcer induced rats pre-treated with extract of P. halepensis, zinc and ranitidine when compared with indomethacin treated rats. The MDA level was significantly decreased and GSH level was increased (p< 0.05) in rats treated with plant extract and zinc. Histopathology of gastric mucosa confirmed the gastro-protection by plant and zinc treatment. The study reveals anti-ulcer and antioxidant properties were observed in bark aqueous extract of P. halepensis groups with a benefic effect of zinc to reduce oxidative stress and gastric ulcer induced in the rat.
... Non-steroidal anti-inflammatory drugs, which combine a whole range of properties, displaying anti-inflammatory, analgesic, antipyretic activity are in particular demand (Bacchi et al. 2012). However, they all have ulcerogenic properties to varying degrees (Al-Shidhani et al. 2015). In order to overcome these restrictions worldwide, the search for new effective and safe anti-inflammatory drugs is continuing. ...
Synthesis of novel N ³ and C ⁵ substituted thiazolo[4,5- b ]pyridin-2-ones was carried out on the basis of [3+3]-cyclocodensation, acylation and alkylation reactions. The structures of the obtained compounds were confirmed by ¹ H NMR spectroscopy, and elemental analysis. The anti-inflammatory action of novel thiazolo[4,5- b ]pyridine-2-one derivatives was evaluated in vivo employing the carrageenan-induced rat paw edema method. When compared with Ibuprofen, some our compounds were found to be more potent.
Graphical abstract
