salicylates and fenamic-acid

The pharmacologic properties, clinical efficacy and tolerability of the newer non-steroidal anti-rheumatic drugs are compared. Guidelines for a prescribing policy are given in which a safety-first approach is adopted. Propionic acid derivatives or newer drugs with similar properties are proposed as initial therapy to control symptoms of rheumatoid arthritis or osteoarthrosis. Special problems such as compliance in chronic disease, treatment of ulcer patients with anti-rheumatic drugs, therapy in the elderly, treatment for juvenile rheumatoid arthritis and treatment during pregnancy are considered.

Topics: Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Carbazoles; Chronic Disease; Diclofenac; Diflunisal; Humans; Indomethacin; ortho-Aminobenzoates; Osteoarthritis; Phenylbutazone; Piroxicam; Rheumatic Diseases; Salicylates; Thiazines; Tolmetin

Side effects of non-steroidal antirheumatic drugs (NSAD) may occur in any organ system, since the prostaglandins, the synthesis of which is inhibited by NSAD, play a role in numerous adverse cellular processes throughout the body. Besides these physiologic regulations there are adverse effects of NSAD, such as bone marrow aplasia, of unexplained etiology. The interactions of NSAD are of clinical relevance in drug types such as the salicylates, pyrazolons and fenamic acids (e.g. interactions with cumarin derivatives). The clinically relevant interactions of NSAD are discussed in detail.

Topics: Anemia, Aplastic; Anti-Inflammatory Agents, Non-Steroidal; Coumarins; Drug Interactions; Gastrointestinal Diseases; Humans; Indomethacin; Naproxen; ortho-Aminobenzoates; Phenylbutazone; Prostaglandins; Rheumatic Diseases; Salicylates; Stomach Ulcer