Nonsteroidal anti-inflammatory drugs

M. D. Murray, D. C. Brater

Research output: Contribution to journalReview article

40 Scopus citations


Nonsteroidal anti-inflammatory drugs (NSAIDs) are the mainstay of treatment for those with rheumatoid disorders. Absorption of NSAIDs does not appear to differ between elderly and young persons. Most NSAIDs are weak acids that avidly bind to plasma proteins, especially albumin; elderly persons often have reductions in albumin concentrations that result in altered kinetic disposition of these drugs. Although the pharmacologic activity resides in the unbound moiety, heretofore most studies report only total NSAID concentrations. Recent knowledge indicates that the S-enantiomer of aryl-propionic acid derivatives is solely active, thereby requiring its assessment; for some, inversion of the R- to S-configuration occurs in vivo. Also it is now apparent that acylglucuronides may accumulate in patients with reduced renal function and may then revert to active drug. Our knowledge of the pharmacokinetics and pharmacodynamics of NSAIDs is still evolving. As such, clinical studies are necessary to design appropriate dosage guidelines that permit safe and effective NSAID treatment of elderly patients.

Original languageEnglish (US)
Pages (from-to)365-397
Number of pages33
JournalClinics in Geriatric Medicine
Issue number2
StatePublished - Jan 1 1990

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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