Diclofenac, derived from benzeneacetic acid, is a NSAID (nonsteroidal
anti-inflammatory drug) of cyclooxygenase (COX) inhibitor. It is used for the treatment of rheumatoid arthritis,
osteoarthritis, and ankylosing spondylitis, and also for a variety of
nonrheumatic inflammatory conditions.. It is a yellowish hygroscopic crystalline
powder; soluble in alcohols and insoluble in chloroform and in dilute acid.
Chemically, it is described as 2-[(2,6-dichlorophenyl)amino] benzeneacetic acid.
The sodium or potassium salts are soluble in water; administered orally.
Nonsteroidal Antiinflammatory Drugs (NSAIDs); chemically heterogeneous large
groups of drugs which suppress inflammation in a manner similar to steroids, but
less side effects of sedation, respiratory depression, or addiction than
steroids. They are widely used for the treatment of inflammatory disorders and
painful conditions such as rheumatoid arthritis, gout, bursitis, painful
menstruation, and headache. They are effective in the relief of pain and fever.
NSAIDs inhibit the cyclooxygenase (COX) activity resulting in decreased
synthesis of prostaglandin, leukotriene and thromboxane precursors such as the
ubiquitous enzyme which catalyzes the initial step in the synthesis of
prostanoids. Prostanoid is any of a group of C-20 fatty acids complex with an
internal five or six carbon rings such as prostaglandins, prostanoic acid,
prostacyclins, and thromboxane; derived from arachidonic acid (C-20
polyunsaturated fatty acid with four cis double bonds). The action or the
synthesis of prostanoids are involved in the modulation of a variety of
pathophysiologic processes including inflammation, hemostasis, thrombosis,
cytoprotection, ulceration, hemodynamics and other the progression of kidney
diseases. Thus, NSAIDs as non-selective inhibitors of the cyclooxygenases (both
the cyclooxygenase-1 and cyclooxygenase-2 isoenzymes) may have beneficial as
well as untoward effects on a variety of human diseases. Low stomach prostanoid
levels caused by COX-1 inhibitors can result in ulceration and internal bleeding
and perforation. The selective COX-2 inhibitors such as oxicam, meloxicam, and
coxibs (celecoxib, rofecoxib, valdecoxib, parecoxib and etoricoxib) do not
interfere with COX-1. The most prominent NSAID is aspirin. Nonaspirin NSAIDs can
be classified based on chemical structures.
Nonsteroidal Anti-Inflammatory Drugs (NSAID)
by chemical structure
- Carboxylic Acid
Groups
- Salicylates (Acetylsalicylate,
Choline salicylate, Diflunisal, Magnesium choline salicylate,
Magnesium salicylate, Salsalate)
- Acetic
Acids (Bendazac, Diclofenac,
Etodolac, Indomethacin, Ketorolac, Nabumetone,
Sulindac, Tolmetin)
- Propionic acids (Carprofen,
Fenoprofen, Flurbiprofen,
Ibuprofen, Ketoprofen, Loxoprofen, Naproxen, Naproxen sodium, Oxaprozin, Vedaprofen)
- Anthranilic
acids (Meclofenamic acid, Meclofenamate sodium, Tolfenamic acid)
- Phenylacetic acids
- Aminonicotinic acids (Flunixin)
- Indole
Analogs (Indomethacin, Nabumetone, Ketorolac,
Etodolac,)
- Enolic Acid Groups
(which doesn't have carboxylic group but acid due to the enolic hydroxy
substituent)
- Pyrazolones (Phenylbutazone,
Oxyphenbutazone, Dipyrone, Ramifenazone)
- Oxicams (Meloxicam,
Piroxicam, Tenoxicam)
- Coxibs
- Celecoxib, Rofecoxib, Valdecoxib, Parecoxib,
Etoricoxib
- Gold
Salts
- Auranofin,
Gold sodium thiomalate, Aurothioglucose
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