- Nimesulide is an efficacious anti-inflammatory drug but a relatively weak inhibitor of cyclo-oxygenase.
- Nimesulide exerts anti-inflammatory action by several mechanisms in addition to cyclooxygenase inhibition.
- The distinctive feature of nimesulide is that it is usually well tolerated by aspirin-intolerant asthma patients.
- Rofecoxib, a NSAID with the highest COX-2 selectivity.
- The selective COX-2 inhibitors have the advantage over the nonselective NSAIDs in that they are less likely to cause gastric ulcers and their complications.
- The highly selective COX-1 inhibitors causes gastrointestinal complications while the highly selective COX-2 inhibitors causes cardiovascular complications.
- In equianalgesic doses, paracetamol is safer than aspirin.
- Paracetamol inhibits cyclooxygenase in the brain but not at peripheral sites of inflammation.
- N-acetyl cysteine is beneficial in acute paracetamol poisoning because it replenishes hepatic glutathione which in turn binds the toxic metabolite of paracetamol.
- For a patient of peptic ulcer, the safest non-opioid analgesic is paracetamol.
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