NSAIDs: COX Blockers!

Non-steroidal anti-inflammatory drugs are some of the most effective non-opioid pain relievers that we have.  There are lots of kinds of NSAIDs, but luckily, most of them are probably familiar to you!

NSAIDs inhibit part of the arachidonic acid (AA) pathway that leads to the formation of enzymes known as cyclooxogenase (COX) 1 and 2. COX 1 and 2 are an integral part of the synthesis of prostaglandin E (PGE2), a major player in the inflammatory response.

This pathway is a wonderful example of how pictures help us with physiology.

https://i1.wp.com/www.arthritis.co.za/images/nsc.gif

image:  http://www.arthritis.co.za/images/nsc.gif

As you can see from the diagram, COX-1 and COX-2 have some very different effects!  What you see on the right is a representation of COX-2 as part of the inflammatory cascade.  It creates prostaglandin E2 and I2 when cued by cytokines.  Blocking COX-2 means blocking the inflammatory response!  On the left of the diagram is COX-1, which also produces prostaglandin E2, but is not induced by inflammatory signals.  COX-1 produces several other types of prostaglandins, and other substances like thromboxanes, to maintain homeostasis in the body.  This homeostasis is especially important in the GI and renal systems, as all of these substances balance out to protect the mucosa and prevent the blood from being too thin or thick.

Why is this so important?  Well, there are several drugs you probably already know and love (especially for tension headaches and hangovers) that are NSAIDs.  Chances are, the ones you take the most are the least selective!

 

 

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