NSAIDS
NSAIDS
NSAIDS
1. Peptic ulcer
2. Allergic patients to aspirin
3. Kidney impairment
4.Liver diseases
5.Pregnancy
6.Haemophilic patients
The concomitant administration of ibuprofen antagonizes the irrevesible platelet inhibition
of ASPIRIN (limit cardioprotective effect of aspirin).
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It is employed for acute and
long-term therapy for the
relief of symptoms of
osteoarthritis and
rheumatoid arthritis. It also
possesses uricosuric actions
and has been used in the
treatment of acute gout.
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Piroxicam synthesis
Piroxicam, 1,1-dioxid-4-hydroxy-2-methyl-N-2-pyradyl-2H-1,2-
benzothiazine-
3-carboxamide (3.2.78), is synthesized from saccharin (3.2.70). It usually
comes from toluene, which is sulfonated by chlorosulfonic acid, forming
isomeric 4- and 2-toluenesulfonyl chlorides. The isomeric products are
separated by freezing (chilling). The liquid part, 2-toluenesulfonyl chloride
(3.2.68) is separated from the crystallized 4-toluenesulfochloride and reacted
with ammonia, giving 2-toluenesulfonylamide (3.2.69). Oxidation of the
product with sodium permanganate or chromium (VI) oxide in sulfuric acid
gives saccharin—o-sulfobenzoic acid imide.]
The reaction of saccharin with sodium hydroxide results in substitution of
the imide hydrogen atom of saccharin with sodium, giving a sodium salt
(3.2.75). The resulting product is reacted with methyl chloroacetate, giving
the saccharin-substituted acetic acid methyl ester (3.2.76). Upon reaction
with sodium methoxide in dimethylsulfoxide, the product undergoes
rearrangement into 1,1-dioxide 3-methoxycarbonyl-3,4-dihydro-2-H-1,2-
benzothiazin-4- one (3.2.77). This product is methylated at the nitrogen
atom using methyl iodide, giving (3.2.78). Finally, reaction of the resulting
product with 2-aminopyridine gives piroxicam
(3.2.79)
SAR of piroxicam
The most active analogues have substituents CH3 on the nitrogen
and electron withdrawing substituents on the anilide phenyl
groups, such as Cl and CF3.
The introduction of heterocyclic ring in the amide chain
significantly increases the anti-inflammatory activity.
Example—2-thiazolyl derivative sudoxicam is more potent than
indomethacin.
The most active benzothiazine have acidities in the pKa range of
6–8.
Mechanism of actions:
A) Non-selective inhibitors to COX1 & COX2
B) Traps free radicals
C) Inhibits polymorphonuclear leukocytes migration
D) Inhibits lymphocyte function.
Well absorbed orally
Half- Life 45 hours
Given once daily
Adverse effects
Less frequent gastric upset (20%).
Dizziness.
Tinnitus.
Headache.
Allergy.
Quinoline Derivatives
Cinchophen INN, BAN, USAN,
Its antipyretic actions are very much akin to those of the
salicylates. Its major pharmacological
action was in the control and management of chronic gout
and rheumatic conditions, but by virtue of its relatively
high level of toxic effects, such as : hepatic dysfunction
ultimately leading to acute jaundice
Synthesis of Cincophin