NSAIDs (Non Steroidal Anti Inflammatory Drugs) are used to decrease the symptoms of pain, swelling, and stiffness.  They act both as analgesics to relieve pain and as inhibitors of inflammation, but are not steroids (such as Prednisone). Aspirin is a classic example, but newer compounds such as ibuprofen have been formulated with the aim of producing fewer side-effects, particularly those relating to the gastro-intestinal tract.

There are three categories of NSAIDs:

1. Salicylates (acetylated, such as aspirin, and non-acetylated)
2. Traditional NSAIDs (ibuprofen)
3. COX-2 selective inhibitors (Celebrex)

SALICYLATES - frequently misused and abused

The use of the bark from the Willow, utilized over centuries, for the relief of pain and inflammation was described in 1763 by Rev Edmond Stone, and was followed in 1860, with the synthesis of salicylic acid. Aspirin was discovered in 1898 as acetyl salicylic acid. It was, together with its associated compounds, to become the mainstay of therapy for inflammation and the principal treatment for rheumatic diseases. This non steroidal anti-inflammatory drug, now constitutes the most frequently prescribed class of medications. They are frequently misused and abused.

Aspirin
Aspirin belongs to a group of drugs called salicylates. Salicylates have analgesic, antipyretic, and anti-inflammatory properties. Salicylates act to inhibit the release of certain hormone-like chemicals known as prostaglandins that may have varying actions, potentially leading to inflammatory effects, increased pain sensitivity, fever, etc.

Cautions: Prolonged aspirin use may damage the stomach or intestinal lining, causing peptic ulcers and bleeding from the digestive tract. Aspirin--even children's aspirin--should never be given to children or teenagers with flu-like symptoms or chickenpox. Aspirin can cause Reye's syndrome, a life-threatening condition that affects the nervous system and liver. As many as 30% of children and teenagers who develop Reye's syndrome die. Those who survive may have permanent brain damage.

TRADITIONAL NSAIDs

Ibuprofen - Advil®, Motrin IB®, Nuprin®
Ibuprofen is a non-steriodal anti-inflammatory drug, used to reduce inflammation.
Naproxen sodium - Aleve®
COX2 Inhibitors - Celebrex®

COX-2 selective inhibitors are the newest of the NSAIDs. COX-2 selective inhibitors are used to treat the pain and inflammation of arthritis. COX-2 inhibitors selectively inhibit COX-2, an enzyme involved in the inflammation pathway, while sparing COX-1, thereby reducing gastrointestinal toxicity.

ANALGESICS - Acetaminophen, Tylenol

Analgesic - A drug that alleviates pain without causing loss of consciousness. Unlike NSAIDs analgesics only target pain and not inflammation. A doctor may prescribe one of the analgesics in addition to one of the NSAIDs, when a patient still needs extra pain relief.

Acetaminophen
An analgesic for mild pain. An aspirin substitute. Like aspirin, acetaminophen works as a pain killer and fever reducer, but it does not have anti-inflammatory properties and does not produce the side effects associated with aspirin, such as stomach irritation. Examples of acetaminophen are Tylenol and Excedrin. Acetaminophen is available over the counter and also is often used in combination with other narcotic drugs in some of the stronger analgesics.

Tylenol
Tylenol - The trade name of acetaminophen, a drug that relieves pain and suppresses fever. Tylenol does not contain aspirin.

FDA has previously posted extensive NSAID medication information at http://www.fda.gov/cder/drug/analgesics/default.htm

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