Side Effects of Anti-Inflammatory Drugs IV

I. Introduction.- Current status of side-effects from anti-inflammatory drugs.- II. Clinico-Epidemiological Aspects.- The placebo response: clinical efficacy and toxicity.- Side-effects of non-steroidal anti-inflammatory drugs: studies from the Tayside Medicines Monitoring Unit.- Treatment decisions, side-effect liability and cost-effectiveness in osteoarthritis.- Measuring beneficial and adverse events in osteoarthritis clinical trials.- Do NSAIDs adversely affect joint pathology in osteoarthritis?.- Safety of non-steroidal anti-inflammatory drugs during pregnancy and lactation.- Side-effects from biologics in the therapy of rheumatic diseases.- Oral tolerance from a general perspective, and the possible role of side-effects in the gut.- Summary of Debate: Management of side-effects from anti-inflammatory drugs.- III. Fundamental Aspects.- The concept of conditional pharmacology and toxicology.- Inflammation, stress and environmental factors as determinants of NSAID efficacy and toxicity.- Do you really know what your drug looks like or how it reacts?.- IV. Gastrointestinal Tract — Clinical Aspects.- Intestinal pathology from NSAIDs.- A clinician’s view of strategies for preventing NSAID-induced gastrointestinal ulcers.- Protection from NSAID-induced gastrointestinal damage.- An overview of the key role of misoprostol in the prophylaxis of NSAIDassociated ulcers and their complications.- Clinical update of the relative safety of nabumetone in long-term clinical trials.- Global analysis of gastrointestinal safety of a new NSAID, meloxicam.- V. Gastrointestinal Tract — Experimental.- Gastrointestinal adaptation, eicosanoids, and mucosal protection from NSAIDs.- New insight into NSAID-induced gastropathy.- Cyclooxygenase selectivity and NSAIDs: cyclooxygenase-2selectivity of etodolac (Lodine).- Differential inhibition of cyclooxygenase-1 (COX-1) and -2 (COX-2) by NSAIDs: Consequences on anti-inflammatory activity versus gastric and renal safety.- Polymer delivery of the mucosal protective prostaglandin misoprostol.- Nitric oxide-releasing NSAIDs, a novel class of safe and effective anti-inflammatory agents.- Mitochondrial function and modification of NSAID carboxyl moiety.- Effects of a new class of NO-releasing NSAIDs on platelets and isolated arteries.- A1 and A2 adenosine receptors mediate opposite effects on NSAID-induced gastric ulcers in the rat.- Role of vagal nerve in defence mechanisms against NSAIDs-induced gastrointestinal mucosal damage.- Analysis of the inhibiting activity of presynaptic a2-adrenoceptors against NSAID-induced gastric mucosal lesions in the rat.- VI. Dermatoxicity.- Mechanisms of adverse reactions in the skin from anti-rheumatic drugs.- Can in-vitro assays predict chemically-induced skin damage?.- VII. Novel Therapies.- The use of ketorolac tromethamine oral rinse for the treatment of periodontitis in adults.- VIII. Abstracts.- Variability in risk of major upper gastro-intestinal complications with individual NSAIDs. Importance of drug dose and half-life; results of meta analysis.- Non-steroidal associated ulcer bleeding — defining the risk factors.- Variability in exposure to NSAIDs in relation to safety.- Non-steroidal anti-inflammatory drugs and infertility.- Perioperative use of NSAID and postoperative infectious complications.- Medico-legal issues of non-steroidal anti-inflammatory drugs (NSAIDs).- The use of DMARDs and combination therapies.- Non-steroidal anti-inflammatory drugs and acute appendicitis: a case-control study.- Non-steroidal anti-inflammatory drugs and colitis: arecord-linkage case-control study.- New exposure to NSAIDs and hospitalisation for upper gastrointestinal events.- Topical NSAIDs and upper gastrointestinal bleeding and perforation.- Non-steroidal anti-inflammatory drugs, aspirin and colo-rectal cancer.- The pattern of prescribing of community dispensed ulcer-healing drugs in Tayside.- Clinical trials of the relative safety of nabumetone in long-term clinical trials: proposed rationale for safety profile.- Cyclooxygenase-2: a novel target for safety anti-inflammatory drugs.- Inhibitory action of hydrophilic polymers on gastric lesions induced by indomethacin in rats.- Copper-derivatives and gastroprotection.- The ?3-adrenoceptor agonist CL316243 prevents indomethacin-induced jejunal ulceration in the rat.- IX. Epilogue.- The dilemma of modern medicine.