NSAIDs : Mnemonics

Classification

Mnemonic: Prescribed By SOFIA

1. Propionic acid derivatives: Ibuprofen, Ketoprofen, Flurbiprofen, Naproxen
2. Pyrrolo-pyrrole derivates: Ketoroloac
3. Pyrazolone derivatives: Phenylbutazone, Oxybutazone
4. Benzoxazocine derivatives: Nefopam
5. Salicyaltes: Aspirin
6. Selective COX-2 inhibitor: Celecoxib, Etoricoxib, Parecoxib
7. Oxicam derivatives: Piroxicam, Tenoxicam
8. Fenamic acid derivatives: Mefenamic acid (Anthranilic acid derivative)
9. Indol derivatives: Indomethacin, Sulindac
10. Aryl acetic acid derivatives: Diclofenac, Aceclofenac

Side effects and Contraindications

Mnemonic: BARS

1. Bleeding
   • Inhibit platelet cycloxygenase (COX), thereby blocking the formation of thromboxane A2 (TXA2) and impairing TXA2 dependent platelet aggregation
2. Asthma
   • Inhibition of COX pathway shifts the arachidonic acid metabolism to Lipoxygenase (LOX) pathway leading to increased leukotriene synthesis
3. Allergy
   • Upto 2% prevalence
4. Renal disease
   • Inhibition of PGE2/PGI2 leads to constriction of afferent arteriole and pre-renal AKI
   • Leads to sodium retention (peripheral edema, hypertension, heart failure)
5. Stomach: Mucosal damage by –
   • COX-1 inhibition: Reduced blood flow
   • Topical irritation: Epithelial damage
   • COX-2 inhibition: Leukocyte adherence

Beneficial effects

Mnemonic: Five “A”s

1. Analgesic
2. Antipyretic
3. Anti-inflammatory
4. Anti-thrombotic
5. Arteriosus closure (PDA closure)