What is the mechanism of action of NSAIDs
Antiinflammatory drugs act on different pathways of the arachidonic acid cascade to produce anti-inflammatory, analgesic and antipyretic effects
They inhibit cyclooxygenase enzymes in cell membranes, which in turn limits the synthesis of prostaglandins, which plays a role in pain and sensitivity in both the peripheral and central nervous system
What is the respectively role of COX-1 and COX-2
Prostaglandins produced from COX-1 activity play a role in gastroprotection (secretion of gastric mucus, production of bicarbonate), maintenance of renal perfusion under hypotensive/hypovolemic states and vascular homeostasis
PGs produced from COX-2 are predominantly induced after tissue injury and trigger inflammation via numerous inflammatory mediators which sensitise peripheral nerves
However, COX-1 can also be associated with inflammation and COX-2 can be involved in homeostatic functions
What are the sites of action of corticosteroids and NSAIDs on the arachidonic acid cascade
Corticosteroid Inhibition is on phospholipases thus limiting the production of arachidonic acid
NSAID Inhibition is on cyclooxygenases thus limiting the production of prostaglandins
