Nonsteroidal Anti-inflammatory Drugs: A Comprehensive Clinical and Pharmacological Review

Section 1: Introduction to NSAIDs: A Cornerstone of Modern Pharmacotherapy

1.1. Defining the Drug Class and Its Historical Context

Nonsteroidal anti-inflammatory drugs (NSAIDs) represent a class of medications renowned for their analgesic (pain-relieving), anti-inflammatory, and antipyretic (fever-reducing) properties.[1] They are among the most widely prescribed and utilized therapeutic agents worldwide, forming the foundation of treatment for a vast array of acute and chronic conditions. The term "non-steroidal" itself provides a crucial historical insight into their development. Coined around 1960, it was specifically chosen to differentiate this emerging class of drugs from corticosteroids, which, despite their potent anti-inflammatory effects, had gained a negative reputation in the 1950s due to significant and often severe side effects associated with their overuse.[3] This distinction positioned NSAIDs as a new, seemingly safer alternative for managing inflammation and pain. This historical search for a therapeutic agent that could separate efficacy from toxicity is a recurring theme that has defined the evolution of NSAIDs, foreshadowing later developments such as the creation of COX-2 selective inhibitors, which were themselves an attempt to solve the toxicity problems of their predecessors.

1.2. Overview of Core Therapeutic Properties

The clinical utility of NSAIDs stems from their three primary pharmacological actions: