Chemistry and Mechanism of Action

Ibuprofen (Advil), flurbiprofen (Ansaid), fenoprofen (Nalfon), ketoprofen (Orudis), and naproxen (Naprosyn) are all 2-substituted propionic acid derivatives. They block the production of prostaglandins via inhibition of COX and therefore are similar to the salicylates in that they produce analgesia, antipyresis, and antiinflamma-tory effects. However, they are more potent than aspirin, with a decreased incidence of side effects such as gastric irritation. Ketoprofen inhibits lipoxygenase and COX, thus decreasing the production of both leukotrienes and prostaglandins. It also decreases lysosomal release of enzymes in inflammatory diseases. The principal differences among these drugs lie in the time to onset and duration of action. Naproxen has a long half-life, whereas fenoprofen and ketoprofen have short half-lives. All of the drugs are extensively metabolized in the liver and require adequate kidney function for clearance of the metabolites. The drugs vary in plasma protein binding, but clearly all are bound to a relatively high degree and can interfere with the binding of other drugs that compete for plasma protein binding (as described for aspirin). The one exception is ketoprofen, which although highly bound to plasma proteins, does not appear to alter the binding of other drugs.

Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

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