MECHANISMS OF ACTION OF ANTIINFLAMMATORY MEDICATIONS USED FOR THE TREATMENT OF OSTEOARTHRITIS

Nonsteroidal anti-inflammatory (NSAID) drugs have been used to treat o steoarthritis ever since 1899, when the effects of aspirin were first recognized. Widespread use of these compounds continues despite their recognized potential toxicity, mostly because they are generally effec tive for palliation of the pain associated with osteoarthritis. The di scovery of cyclooxygenase (COX)-1 and COX-2 has sparked interest in de velopment of NSAID that specifically target COX-2, with the hope that such compounds would be associated with a lower incidence of adverse g astrointestinal effects. Other potential methods of avoiding adverse g astrointestinal effects associated with NSAID use include concurrent a dministration of prostaglandins and use of pure analgesics, such as ac etaminophen. The role of nitric oxide in inflammation is an exciting a rea of research, and addition of nitric oxide-producing moieties to NS AID may prove to be another mechanism of avoiding gastrointestinal tox icity. There is likely to be considerable reward for the development o f an NSAID that relieves pain associated with a wide variety of condit ions, does not cause gastrointestinal toxicoses, and spares normal car tilage. Whether such a drug exists remains speculative.