[Management of Adverse Effects Associated with Nonsteroidal Anti-inflammatory Drugs and COX-2 Inhibitor].

Nonsteroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly used groups of drugs. NSAIDs are divided into two major groups : cyclooxy- genase (COX)-2-selective inhibitors (COXIBs) and non- selective NSAIDs based on the mechanism of action. The analgesic and anti-inflammatory effects of NSAIDs are produced through the prevention of prostaglandin production by inhibition of COX activity. The pharma- cological effects and the risk profiles of the different NSAIDs are largely determined by their differential ability to inhibit the COX-1 and/or COX-2 enzymes. The NSAID-related adverse events are (1) gastroin- testinal toxicity (2) renal toxicity (3) cardiovascular risk. The hypersensitivity to NSAIDs is also major adverse event Inhibition of the constitutive isoform of COX-1, specific IgE and T cell cause NSAIDs induced anaphylaxis/asthma/urticaria. The prevention and managements of adverse effects of NSAIDs and COXIBs are reviewed.