Masuda Ritsuko
Masui. 2016 Aug;65(7):709-717.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used groups of drugs. NSAIDs are divided into two major groups : cyclooxy- genase (COX)-2-selective inhibitors (COXIBs) and non- selective NSAIDs based on the mechanism of action. The analgesic and anti-inflammatory effects of NSAIDs are produced through the prevention of prostaglandin production by inhibition of COX activity. The pharma- cological effects and the risk profiles of the different NSAIDs are largely determined by their differential ability to inhibit the COX-1 and/or COX-2 enzymes. The NSAID-related adverse events are (1) gastroin- testinal toxicity (2) renal toxicity (3) cardiovascular risk. The hypersensitivity to NSAIDs is also major adverse event Inhibition of the constitutive isoform of COX-1, specific IgE and T cell cause NSAIDs induced anaphylaxis/asthma/urticaria. The prevention and managements of adverse effects of NSAIDs and COXIBs are reviewed.
非甾体抗炎药（NSAIDs）是最常用的药物类别之一。根据作用机制，NSAIDs分为两大类：环氧化酶（COX）-2选择性抑制剂（COXIBs）和非选择性NSAIDs。NSAIDs的镇痛和抗炎作用是通过抑制COX活性来防止前列腺素生成而产生的。不同NSAIDs的药理作用和风险特征在很大程度上取决于它们抑制COX-1和/或COX-2酶的不同能力。与NSAIDs相关的不良事件有：（1）胃肠道毒性；（2）肾毒性；（3）心血管风险。对NSAIDs的超敏反应也是主要不良事件。COX-1组成型同工型的抑制、特异性IgE和T细胞会导致NSAIDs诱发过敏反应/哮喘/荨麻疹。本文对NSAIDs和COXIBs不良反应的预防和管理进行了综述。
