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The "inflammation" in ankylosing spondylitis (AS) is part of the body's innate immune system (the first line of defense against disease and injury), but if the inflammatory response persists for too long, it can lead to a condition called Diseases of chronic inflammation (in which the body attacks itself, causing damage to organs and systems), typically with redness, swelling, heat, pain, and dysfunction
Ankylosing spondylitis The "inflammation" in ankylosing spondylitis (AS) is part of the body's innate immune system (the first line of defense against disease and injury), but if the inflammatory response persists for too long, it can lead to a A condition called chronic inflammation (in which the body attacks itself, causing damage to organs and systems), is typically characterized by redness, swelling, heat, pain, and dysfunction
What are NSAIDs?
Steroids generally refer to steroids (hormones as we understand them), while nonsteroidal anti-inflammatory drugs (NSAIDs) refer to non-hormonal anti-inflammatory drugs
Steroids generally refer to steroids (hormones as we understand them), while nonsteroidal anti-inflammatory drugs (NSAIDs) refer to non-hormonal anti-inflammatory drugs
Aspirin, indomethacin, naproxen, ibuprofen, diclofenac, loxoprofen, meloxicam, celecoxib, etoricoxib, and parecoxib are all non-steroidal body anti-inflammatory drugs
What is the role of NSAIDs in ankylosing spondylitis?
The common inflammatory mediators in patients with ankylosing spondylitis include prostaglandins, interleukins, and tumor necrosis factor , etc.
The common inflammatory mediators in patients with ankylosing spondylitis include prostaglandins, interleukins, and tumor necrosis factor , etc.
It should be noted, however , that ankylosing spondylitis also has a distinctive feature - new bone formation
But it is important to note that there is also a significant feature of ankylosing spondylitis - new bone formation
Because of the limited effect of non-steroidal anti-inflammatory drugs on the control of deep inflammation in the joint cavity, it is "powerless" to local soft tissue adhesion, so it is difficult to prevent the formation of osteophytes.
Because of the limited effect of non-steroidal anti-inflammatory drugs on the control of deep inflammation in the joint cavity, it is "powerless" to local soft tissue adhesion, so it is difficult to prevent the formation of osteophytes.
Like any other drug, non-steroidal anti-inflammatory drugs can produce some adverse reactions when used for a long time
01 Gastrointestinal 01 Gastrointestinal
Abdominal discomfort, dull pain , nausea, vomiting, fullness, belching, loss of appetite and other indigestion symptoms may occur
Abdominal discomfort, dull pain , nausea, vomiting, fullness, belching, loss of appetite and other indigestion symptoms may occur
02 Liver02 Liver
At therapeutic doses, 10% of patients developed biochemical abnormalities with mild liver damage, but significantly elevated alanine aminotransferase levels occurred in less than 2%
At therapeutic doses, 10% of patients developed biochemical abnormalities with mild liver damage, but significantly elevated alanine aminotransferase levels occurred in less than 2%
03 Nervous System03 Nervous System
Headache, dizziness, tinnitus, deafness, amblyopia, drowsiness, insomnia, paresthesia, numbness, etc.
may occur
.
Some symptoms are uncommon, such as hyperactivity, excitement, hallucinations, tremors, etc.
, the incidence is generally less than 5%
.
may occur
.
Some symptoms are uncommon, such as hyperactivity, excitement, hallucinations, tremors, etc.
, the incidence is generally less than 5%
.
04Urinary system
04Urinary System04Urinary SystemIt can cause proteinuria, cast urine, red and white blood cells, etc.
in the urine.
In severe cases, it can cause interstitial nephritis
.
In a multicenter clinical study, patients taking long-term oral NSAIDs had a 2.
1 -fold higher risk of developing kidney disease than the general population
.
in the urine.
In severe cases, it can cause interstitial nephritis
.
In a multicenter clinical study, patients taking long-term oral NSAIDs had a 2.
1 -fold higher risk of developing kidney disease than the general population
.
2.
1
05Blood system
05Blood system05Blood systemSome NSAIDs can cause neutropenia, aplastic anemia, and coagulation disorders
.
.
06 Allergies
06Allergies06Allergies _Idiopathic people may have allergic reactions such as rash, angioedema , and asthma
.
.
Blood vessel
07 Cardiovascular System
07Cardiovascular System07Cardiovascular SystemStudies have found that NSAIDs can significantly interfere with blood pressure and increase mean arterial pressure
.
It has also been reported that after taking rofecoxib for 18 months, the relative risk of cardiovascular events (such as heart attack and stroke) increased in patients
.
.
It has also been reported that after taking rofecoxib for 18 months, the relative risk of cardiovascular events (such as heart attack and stroke) increased in patients
.
cardiovascular events
08 Pregnancy
08 Pregnancy 08 PregnancyNon-steroidal anti-inflammatory drugs are considered to be a potential factor in the induction of acute fatty liver of pregnancy ; aspirin in pregnant women can cause bleeding during prenatal, postpartum, and delivery; indomethacin may cause some fetal brachymorphs , penile hypoplasia .
Induced acute fatty liver of pregnancy in pregnant women aspirin indomethacin may cause some fetal short limb deformities How to reduce the incidence of side effects?
① In clinical application, the combined use of two or more NSAIDs should be avoided
.
.
Avoid combining two or more NSAIDs
② For patients with gastrointestinal discomfort or peptic ulcer , COX-2 inhibitors are preferred over traditional non-steroidal anti-inflammatory drugs, and gastric drugs should be added if necessary
.
.
For patients with gastrointestinal discomfort or peptic ulcer, COX-2 inhibitors are preferred , and gastric drugs should be added if necessary
③ For patients with only high cardiovascular risk and no other risk factors, consider the priority use of naproxen
.
.
Cardiovascular high-risk naproxen only
.
④ While using non-steroidal anti-inflammatory drugs, if the situation allows, avoid the use of diuretics , ACEI/ARB antihypertensive drugs and other drugs that may affect renal perfusion at the same time
.
.
avoid diuretics
⑤ NSAIDs have a capping effect, and overdose should be avoided
.
Overdose, the efficacy does not increase, but the side effects will increase significantly
.
.
Overdose, the efficacy does not increase, but the side effects will increase significantly
.
Overdose should be avoided
⑥ Necessary blood and renal function monitoring should be carried out regularly under the guidance of a doctor
.
.
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