Available online Jul 13, 2018.
[ Review ] Volume 19, Issue 4, 2010, Pages 374-381
Background: Non steroidal anti-inflammatory drugs
(NSAIDs) are a group of heterogeneous compounds with
anti inflammatory, analgesic and often times anti pyretic
properties. They are weak organic acids and are the most
commonly used drugs in Orthopaedic/Trauma practice.
They provide mild to moderate pain relief.
NSAID share common therapeutic and side effects
irrespective of the class or group to which an individual
drug may belong. These side effects are many and varied
and constitute a major concern in their usage since most
of them are life threatening.
The NSAIDs are also one of the most commonly abused
drugs. The abuses stem mostly from poor prescription
habit by the health professionals.
The poor prescription habit by the professionals and
laissez-a-faire attitude to NSAID Usage informed the
need for this review which addresses the issues,
controversies and preventive strategies to reduce the
complications in Orthopedics/Trauma practice.
Methods: Literature on the subject was reviewed
extensively using manual library internet search.
Publications from local and international Journals
spanning a period of over thirty years were reviewed.
The internet search was done using pubmed and
ortholink search engines.
Results: NSAIDs act locally at the site of origin of pain by
inhibiting the cyclooxygenase enzymes and induce no
change in mood and dependency. The inhibition of the
Cox enzymes can be reversible or irreversible and leads
to inhibition of prostaglandin synthesis. All the
therapeutic and most of the side effects of NSAIDs result
from the inhibition of the cyclooxygenase pathway.
Thus the Cox-2 selective inhibitors have lesser side
effects than the non selective Cox inhibitors; though there
is recent evidence linking them with adverse
There is paucity of information in literature on the
guidelines of the prescription/usage of NSAIDs, and the
preventive strategies in orthopedics and traumatology.
Conclusion: NSAIDs are the most commonly
prescribed group of drugs in orthopedics and trauma
practice. They constitute a great asset to any Doctor who
deals with pains associated with inflammation which
they relief quite effectively. NSAID Usage is froth with
significant life threatening complications. A high index
of suspicion of the possibility of occurrence of these
complications, adherence to proper prescription
guidelines and preventive strategies, change of the
laissez-a-faire attitude of the professionals to NSAID
prescription and appropriate monitoring of the patients
on the drugs are paramount in improving their safety
profiles. Orthopedic and Trauma surgeons need to be
aware of the serious side effects and the role of
preventive strategies in the use of NSAIDs.
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Volume 19 | Issue 4
Page Nos. 374-381
Online since Jul 13, 2018