Pathophysiologic factors affecting the pharmacokinetics of nonsteroidal antiinflammatory drugs

The nonsteroidal antiinflammatory drugs are a group of compounds mainly used in the treatment of rheumatologic disorders. Although these agents differ among themselves in their pharmacokinetic properties of absorption, distribution and elimination, they do have some common characteristics, such as high plasma protein binding, small distribution volume, and low plasma clearance. Rheumatoid arthritis, renal and hepatic disease, and old age can potentially affect the disposition of these agents. Unfortunately, no generalizations can be made and, therefore, the effect of these disease states should be carefully studied for each individual agent. A better understanding of the pathophysiologic factors affecting the pharmacokinetics of these agents will improve their efficacy and safety.