Nonsteroidal anti-inflammatory drugs: new perspectives on a familiar drug class

Nonsteroidal anti-inflammatory drugs are among the most commonly used and lethal drug classes. The anti-inflammatory, analgesic, and antipyretic effects result from the inhibition of cyclooxygenase (COX), which is the critical enzyme in the synthesis of prostaglandins. The most common adverse effects are gastrointestinal, but renal and platelet effects are also important. Recent discovery that there are two forms of cyclooxygenase (COX-1 and COX-2) has led to hypothesis that the newly marketed COX-2 selective inhibitor can provide beneficial effects without these adverse effects. Patient monitoring and education are nursing functions essential to the safe use of these agents.