[Pharmacologic characteristics as the basis for differential therapy using non-steroidal anti-inflammatory agents]

An attempt is made to compile the pharmacological data on the leading non-steroidal anti-inflammatory drugs. They concern the pharmacodynamics, the pharmacokinetics and the unwanted effects of these compounds. From these data a few suggestions for rational use are made: Ibuprofen and diclofenac present as drugs with short and reliable elimination-halflife. The compound with the lower potency namely ibuprofen appears particularly suitable for use in patients suffering from mild inflammatory pain of probably short duration (hours, days). Diclofenac being more potent should be used in more serious painful conditions, the variable bioavailability and the sometimes delayed absorption of diclofenac should be kept in mind if success is not achieved. Ketoprofen may have similar characteristics as diclofenac. The quality of the available data is however limited. Indomethacin and piroxicam are highly potent and reliable in onset; the bioavailability amounts to 100%. Both compounds may owe their effectiveness and reliability to substantial enterohepatic recirculation which may also be responsible for the reported somewhat higher incidence of GI-tract problems in connection with their use. They should hence be used in serious conditions going along with intensive, long-lasting inflammatory pain. Naproxen being less potent than the later two may fall into the same category.