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Chapter: Modern Pharmacology with Clinical Applications: Antiinflammatory and Antirheumatic Drugs

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Antiinflammatory and Antirheumatic Drugs

The classical signs of inflammation are redness, swelling, heat, pain, and loss of function.

Antiinflammatory and Antirheumatic Drugs

The classical signs of inflammation are redness, swelling, heat, pain, and loss of function. The actual ex-pression of these processes depends on the site of in-flammation. For example, a skin abscess may result in the appearance of all of these features. In contrast, pneumonia, because of the inaccessibility of the lung to examination, may manifest only as loss of function (shortness of breath and hypoxia). Nevertheless, similar pathological processes occur in both sites.

Inflammation is characterized by the orderly occur-rence of several processes: initiation of the event by a foreign substance or physical injury, recruitment and chemoattraction of inflammatory cells, and activation of these cells to release inflammatory mediators capable of damaging or killing an invading microbe or tumor. In some instances, the inflammatory response is initiated by an otherwise harmless foreign material (e.g., pollen). Inflammation can also result from an autoimmune re-sponse to the host’s own tissue, as occurs in rheumatoid arthritis.

As the result of an inflammatory response, the host tissue may undergo collateral injury, since many of the inflammatory mediators are not specific for a particular tissue target. For example, many of the clinical signs (fever and labored breathing) and symptoms (shortness of breath and cough) of pneumococcal pneumonia are the result of inflammation rather than the invading microorganism. In most cases, the inflammatory re-sponse eventually subsides, but if such a self-limiting regulation does not occur, the inflammatory response will require pharmacological intervention. The need for anti-inflammatory drugs arises when the inflammatory response is inappropriate, aberrant, sustained, or causes destruction of tissue.

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