Inflammatory Process
When body tissues are injured or infected, chemicals that are normally contained in white blood cells pour out into the blood and sometimes into the injured tissue in an attempt to rid the body of any real or perceived foreign substances. This release of chemicals causes increased blood flow to the affected area. That increased flow causes the warmth and redness associated with inflammation. These chemicals also cause internal fluid leakage, which results in swelling. You feel pain because this process of inflammation affects the nerve cells. Among the chemicals produced during this process are prostaglandins. Their purpose is to mediate or help connect the processes that result in inflammation.
Initially, the process of inflammation protects the body, but when the response is over and above what is required, inflammation does more damage than good. Allergies, asthma and arthritis are good examples of diseases in which this process is out of control and treatment is required to tame the inflammatory response.
NSAID Process
Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce inflammation by inhibiting the actions of cyclooxygenase (COX) enzymes that are responsible for the release of prostaglandins. There are many forms of COX enzymes, but only one form, known as COX-2, is involved in the inflammatory process. All NSAIDs inhibit COX-2 and relieve the symptoms of inflammation, but some also inhibit another enzyme known as COX-1. COX-1 plays many roles in the body, among them facilitating blood clotting and protecting the gut. When this enzyme is inhibited, side effects such as stomach irritation and internal bleeding are more common.
The original nonprescription NSAIDs, including ibuprofen (Advil, Nuprin and Motrin), naproxen sodium (Aleve and Naprosyn) and aspirin inhibit both forms of cyclooxygenase. Newer forms of NSAIDs are more selective and inhibit mostly COX-2. Because of their selectivity, fewer long-term side effects are associated with these drugs. These include celecoxib (Celebrex), piroxicam (Feldene) and sulindac (Clinoril) in addition to prescription-strength ibuprofen and naproxen sodium.
Corticosteroid Process
Another class of anti-inflammatory drugs used to treat all types of inflammation are corticosteroids or, more specifically, glucocorticoids. The most commonly known glucocorticoids are prednisone and prednisolone. Corticosteroids decrease the swelling of inflammation by preventing certain leukocytes (white blood cells) from traveling to the affected tissue. Glucocoritcoids also work like NSAIDs to inhibit both COX-1 and COX-2 enzymes and the action of prostaglandins. Because they are nonselective, like some NSAIDs, they may cause serious side effects when used long-term.
