Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Inhibit cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), decreasing the biosynthesis of downstream eicosanoids and thereby limiting the inflammatory response.

Ibuprofen

Naproxen

Ketoprofen

Flurbuprofen

Indomethacin

Sulindac

Etodolac

Diclofenac

Ketorolac

Mefenamate

Meclofenamate

(both are more toxic than Asprin)

-Fever (antipyretic)

-Mild to moderate pain

-no anti-inflammatory properties

-used for children with viral infection in order to avoid Reye's 

Prednisone

Prednisolone

Methylprednisolone

Dexamethasone

Inhibit COX-2 action and prostaglandin biosynthesis by inducing lipocortins, activating endogenous anti-inflammatory pathways, and other mechanisms

Blocks the action of Phospholipase A2. Does not allow Phospholipids to be converted to Arachidonic acids.

Etanercept

Infliximab

Adalimumab

Anakinra

TNF-alpha, rhumatory arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, juvenile idiopathic arthritis, Crohn's disease, and ulcerative colitis (2nd one).

These increase the risk of serious infections.

Rheumatoid arthritis

also increases the risk of serious infection

Maintenance of patent ductus arteriosus, erectile dysfunction

Heart failure, cardiac arrhythmia and conduction defects, disseminated intravascular coagulation (DIC), disorders of bone development, seizure, priapism, apnea in newborn, hypotension, penile fibrosis, penile discomfort

Sickle cell anemia or trait, leukemia, myeloma, neonatal respiratory distress syndrome, anatomical deformation of the penis, penile implant, peyronie's disease

PGE1 analogue with vasodilator properties, used primarily for maintaining patent ductus arteriosus in tetralogy of Fallot, Eisenmenger pulmonary hypertension, and aortic valve atresia

Cytoprotective and antisecretory effects against gastric ulcers in long-term NSAID therapy, Abortifacient with mifepristone

Rare anemia, rare cardiac arrhythmia, gastrointestinal disturbance, diarrhea

Pregnancy

PGE1 analogue with vasodilator properties. Also used in peptic ulcer disease. Cytoprotective effects likely mediated by increasing gastric mucus and bicarbonate production, antisecretory effects mediated via inhibition of basal and nocturnal gastric acid secretion by parietal cells

Abortionn in second trimester, postpartum hemorrhage

Dystonia, pulmonary edema, gastrointestinal disturbance with prevalent diarrhea, headache, paresthesia, fever, breast tenderness

acute pelvic inflammatory disease, cardiac, pulmonary, renal, or hepatic disease

PGF2-alpha analogue that stimulates uterine contraction for abortifacient activity, luteolytic activity controls fertility

Latanoprost

Bimatoprost

Travoprost

applications, adverse effects, contraindications, therapeutic considerations

Ocular hypertension, open-angle glaucoma

Macular retinal edema, blurred vision, hyperpigmentation of eyelid, iris pigmentation

Hypersensitivity

PGF-alpha analogues with vasodilator properties, ocular hypotensive agents

Pulmonary hypertension

Supraventricular tachycardia, hemorrhage, thrombocytopenia, hypotension, rash, gastrointestinal disturbance, musculoskeletal pain, paresthesia, anxiety, influenza-like illness

Heart failure with severe left ventricular dysfunction, Chronic use in patients developing pulmonary edema

Prostacyclin (PGI) analogue that stimulates vasodilation of pulmonary and systemic arterial vasculature, also inhibits plately aggregation

Dazoxiben

Pirmagrel

Ridogrel

Dazoxiben

Pirmagrel

Ridogrel

Dazoxiben and pirmagrel inhibit thromboxane synthase, whereas ridogrel is a thromboxane A2 receptor antagonist.

Advantages of these agents over aspirin are unproven.

Little effect on platelet aggregation.

Asthma

Increased liver funtion tests, urticaria, abdominal discomfort, dizziness, insomnia

active liver disease, elevated liver enzymes

avoid concurrent use of dihydroergotamine, ergoloid mesylates, ergonovine, methylergonovine due an increased risk of ergotism (nausea, vomiting, vasospastic ischemia)

Montelukast

Zafirlukast

Chronic asthma, perennial allergic rhinitis (montelukast), seaasonal allergic rhinitis (montelukast), especially good for aspirin-induced asthma

allergic granulomatosis angiitis, hepatitis, gastrointestinal distress, hallucinations, agitation

hypersensitivity

Montelukast and zafirlukast are not indicated for acute asthma attacks and are generally not appropriate as monotherapy for asthma. Both drugs are excreted in breast milk.