NSAIDs vs. Steroids
Mechanism of Action
Route of administration
NSAIDs and Steroids Definitions
NSAIDS vs. Steroids
NSAIDs are anti-inflammatory and reduce fever while Steroids are anti-inflammatory and immune modulators. NASIDS inhibit COX enzyme while Steroids act as hormones. NASIDS are not commonly abused, whereas Steroids are abused commonly. NASIDS does not have any effect on weight when they are used for a prolonged period, while Steroids cause obesity when they are used for a prolonged period. NASIDS does not cause adrenal necrosis of hip joint; on the other hand, Steroids cause adrenal necrosis of the hip joint. NSAIDs are contraindicated in ulcers whereas Steroids treat ulcers.
What is NSAIDS?
NSAIDs are non-steroidal anti-inflammatory drugs which reduce the pain and inflammation and are used to treat different ailments, especially gout and hyperuricemia. NSAIDS show their therapeutic effect when they inhibit the prostaglandin G/H synthase enzymes called cyclooxygenase(COX) so ultimately inhibit prostaglandins production, the main cause of pain and inflammation. Based on the type of cyclooxygenase, NSAIDs are classified as COX Non-selective NSAIDs, COX-1 selective NSAIDs, COX-2 selective NSAIDs. NSAIDS which inhibit the COX-2 are antipyretic, anti-inflammatory, and analgesic and simultaneous inhibition of COX-1 lead to different unwanted effects in the gastrointestinal tract. NSAIDs are a heterogeneous group of compounds which are different chemically, unrelated to each other in structure and possess different therapeutic effects, e.g. Aspirin inhibits COX reversibly, and Acetaminophen lacks anti-inflammatory activity, but it possesses the antipyretic and pain relieving activity. Some important classes of the NSAIDs are salicylates, para-aminophenol derivatives, acetic acid derivatives, propionic acid derivatives, cox inhibitors, NSAIDs are also used to treat the barter’s syndrome, systemic mastocytosis, cancer chemoprevention. NSAIDS are rapidly absorbed through GIT, and their peak plasma concentration is reached in 1-4 hrs. The time of absorption of NSAIDs is affected by the presence of food. NSAIDS are extensively protein bound and undergo hepatic metabolism, so they are not recommended in patients of impaired hepatic function. The main adverse effects of the NSAIDs are observed in the gastrointestinal tract, renal system, CNS, platelets, uterus, and vascular system. NSAIDS also show hypersensitivity reactions. NSAIDS show drug interactions with different classes of drugs like ACE inhibitors, corticosteroids, warfarin, sulfonylurea hypoglycemic agents, and methotrexate.
What is Steroid?
Steroid belongs to a class of organic compounds which possess a characteristics molecular structure having four rings of carbon atoms and are important for their important clinical roles as potent anti-inflammatory agents and immune modulators. The word steroids are used for a wide range of molecules. Steroids have different physiological effects. Corticosteroids, mineralocorticoid, and glucocorticoid are steroids. Corticosteroids are chemicals which are synthesized naturally as hormones, and some are synthesized in the laboratory. Mineralocorticoids regulate the level of water and sodium. Glucocorticoid regulates metabolism and inflammation. Glucocorticoids are taken by the patients of rheumatoid arthritis, systemic lupus erythematous, inflammatory bowel disease, chronic obstructive pulmonary disease, and asthma, and they take it orally. Steroids have severe side effects, and that is the limiting factor in their use. Chronic use of glucocorticoids causes bruising, muscle weakness, skin changes, sleep disturbances, weight gain, and cataracts. Glucocorticoid administration also leads to psychiatric side effects like mood disorders, panic disorder, delirium, and anxiety. Commonly recommended corticosteroids are dexamethasone, prednisolone, and prednisone; these are taken orally or parentally for the treatment of diseases where inflammation is involved like asthma, etc. Steroids are also used topically in the form of creams and ointments for the treatment of skin diseases. Anabolic and androgenic steroids are recommended to those patients who lack normal physiological hormones. Steroids abuse is too much in a young generation if it is diagnosed, proper treatment should be taken.