NSAIDs: the first step of the ladder requires considerations when diving deeper

In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves discuss one of the most commonly utilized medications, non-steroidal anti-inflammatory drugs (NSAIDs).   NSAIDs are medications with anti-inflammatory, analgesic, and anti-pyretic properties.  The mechanism of action of NSAIDs is predominantly through inhibition of cylo-oxygenase, but there are multiple other pathways by which NSAIDs exert their therapeutic effect including but not limited to modulation of neutrophil function and cell membrane function.  It is important to understand that there are multiple different classes of NSAIDs, and each NSAID has its own unique properties resulting in differences in regards to safety and efficacy.     Listen as the doctors discuss important topics including: -drug-drug interactions concerning NSAIDs including NSAIDs interaction with aspirin and SSRI medications.   -research including the PRECISION trial addressing the question of whether or not Celecoxib (a selective COX-2 inhibitor) has increased cardiovascular risk relative to relatively non-selective NSAIDs. -optimal utilization of NSAIDs in the setting of acute musculoskeletal injuries. This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.   References: 1. Cardiovascular Safety of Celecoxib, Naproxen, or Ibuprofen for Arthritis. N Engl J Med;  2016. 2. Pharmacology of Nonsteroidal Antiinflammatory Drugs and Opioids. Pharmacology in Interventional Radiology; 2010. 3. New insights into the use of currently available non-steroidal anti-inflammatory drugs. Journal of Pain Research; 2014. 4. Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis;  2007. 5. Efficacy and safety of oral NSAIDs and analgesics in the management of osteoarthritis: Evidence from real-life setting trials and surveys. Seminars in Arthritis and Rheumatism; 2016. 6. COX-2 inhibition impairs mechanical stimulation of early tendon healing in rats by reducing the response to microdamage. Journal of Applied Physiology; 2015.