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Tuesday, October 20, 2020

US FDA drug safety alert about Nonsteroidal Anti Inflammatory Drugs in last trimester of pregnancy excluding 81 mg Aspirin prescribed by doctors to manage certain issue in pregnancy

Nonsteroidal anti inflammatory agents (NSAIDs) are drugs which are used to reduce inflammation and pain, and fever pain due to injuries and to relive joint pain due to gout. US FDA has published a drug safety alert about use of these drugs in pregnancy and risk of reduction of amniotic fluid and risk of serious kidney problem and have recommended to provide a safety warning on product pack about use of these drugs in pregnancy and risk of kidney problems in unborn baby, and recommended that these drugs should not be used in pregnancy at 20 weeks or later.

While 81 mg of aspirin is not included in this since this dose of 81 mg of aspirin do not work as anti-inflammatory while this dose is required to maintain beneficial effect of aspirin on blood circulatory system.  

Nonsteroidal anti inflammatory Drugs include

1.Acetaminophens: Paracetamol.

2.Propionic acid Derivatives : Ibuprofen, Ketoprofen, flurbiprofen.

3.Propionic acid Derivatives : Indomethacin, Diclofenac, Acyclofenac, Bromfenac, Ketorolac 

4.Oxicam derivatives: Piroxicam,  

5.Fenamic acid derivatives : Mefenamic acid, Flufenamic acid.

6.Sulfonaanilides : Nimesulide ( Banned in Injectable form) 

7.Salycylates : Aspirin

(List is not a complete list of drugs it includes many more drugs) 

Above drugs inhibit prostaglandin synthesis the mediator responsible for pain and fever, they do this by blocking enzyme cyclooxygenase, therefore these drugs are also known as cox inhibitor drugs.

How these drugs inhibit Cyclooxygenase enzyme:

Basically these drugs consist of an propionic acid or carboxylic acid group, which compete with arachidonic acid which also consist of carboxylic acid end, these drugs fit themselves in place of arachidonic acid and bloc the synthesis of enzyme cyclooxygenase which converts arachidonic acid to prostaglandin.

The mode of action of these drugs play a vital role in side effects of the drug.

Nonsteroidal Antiinflamatory Drugs

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