tailieunhanh - CLINICAL PHARMACOLOGY 2003 (PART 17)

A third of all general practice consultations are for musculoskeletal complaints. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used, and their gastrointestinal effects account for an estimated 1200 deaths per year in the UK. A hitherto unsuspected inflammatory component is now known to accompany conditions such as atherosclerosis. As understanding of the complex mechanisms underlying the inflammatory process increases, new ways of influencing it are developed, as witness therapies directed against specific cytokines, and COX-2 specific NSAIDs (COXIBs). . | 15 SECTION 3 Inflammation arthritis and nonsteroidal anti-inflammatory drugs SYNOPSIS A third of all general practice consultations are for musculoskeletal complaints. Nonsteroidal anti-inflammatory drugs NSAIDs are widely used and their gastrointestinal effects account for an estimated 1200 deaths per year in the UK. A hitherto unsuspected inflammatory component is now known to accompany conditions such as atherosclerosis. As understanding of the complex mechanisms underlying the inflammatory process increases new ways of influencing it are developed as witness therapies directed against specific cytokines and COX-2 specific NSAIDs COXIBs . Inflammation Arthritis Nonsteroidal anti-inflammatory drugs Disease modifying antirheumatic drugs Drug treatment of arthritis Gout COX cyclo-oxygenase COXIB COX-2 specific NSAIDs DMARD disease modifying antirheumatic drug FGF fibroblast growth factor GM-CSF granulocyte macrophage-colony stimulating factor M-CSF macrophage-colony stimulating factor HPETE hydroperoxy-eicosatetraenoic acid IL interleukin LT leukotriene PG prostaglandin TNF tumour necrosis factor TX thromboxane many different cells and cell products and only a general account of the current understanding of the inflammatory process is provided here. A normal inflammatory response is essential to fight infections and is part of the repair mechanism and removal of debris following tissue damage. Inflammation can also cause disease due to damage of healthy tissue. This may occur if the response is over-vigorous or persists longer than is necessary. Additionally we now know that some conditions have a previously unrecognised inflammatory component . atherosclerosis. Inflammation The clinical features of inflammation have been recognised since ancient times as swelling redness pain and heat. The underlying mechanisms which produce these symptoms are complex involving THE INFLAMMATORY RESPONSE The inflammatory response occurs in vascularised tissues in response to .