NSAIDs therapeutic and toxic effects
Therefore, it can be said that there is not only one mechanism responsible for the NSAIDs toxicity, but there are two important mechanisms that may condition the resultant gastric toxicity of these drugs, which are the inhibition of COX-1 with the consequent inhibition of the gastroprotective prostaglandins and the local action of NSAIDs in the lipid gel layer that protects gastricmucosa.
Additionally, the degree of water solubility and ionization, as well as liposolubility, of the NSAIDs is believed to play a role in both their absorption and gastro intestinal side effects. Therefore, the rational development of safer NSAIDs will depend upon the determination of the various effects of these drugs on membranes and vice versa, as this is a precondition to understanding how these drugs act. In this context and from the obtained results, it can be concluded that the NSAIDs are able to interact with the membranes at both pH values. However, while at pH 7.4 the ionized forms of NSAIDs prevailed and the drug location at the membrane level is shallower, at pH 5 (the pH of inflamed tissues) the neutral forms of NSAIDs have stronger interactions with the membrane, which also correlate well with their efficacy as inflammation inhibitors.
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