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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