Question
What are the categories of non-steroidal anti-inflammatory drugs (NSAIDs)?
Answer
Categories of NSAIDs
- Cromolyn-like agents
- Antileukotriene
- Monoclonal antibodies
Cromolyn-Like Agents
Cromolyn-like agents are called mast cell stabilizers. The mast cell contains anti-inflammatory or inflammatory agents that go to the lungs to help out what it perceives as danger. However, when the mast cells go to specific areas, it causes more inflammation. The cromolyn-like agents keep the mast cell intact by stabilizing those cells in the body. The primary cromolyn-like agent is called Cromolyn Sodium. The drug agent can eliminate some inflammation in patients with Asthma, and it can be an alternative to low-dose corticosteroid therapy. Cromolyn Sodium is administered orally or by a small volume nebulizer. For respiratory therapists, giving the drug agent using a small volume nebulizer is typical instead of administering a drug agent orally. When Cromolyn Sodium is administered orally, the drug routes through the stomach lining and lipid layers to take effect. When we administer the Cromolyn Sodium by a small volume nebulizer, the drug travels directly contacting the lungs and helps alleviate the inflammation. Most of the time, we will give these drugs in combination with steroids to reduce the overall dose of steroids. Keep in mind, the benefit of this category of drugs we are discussing, and anytime we can use the drug agents to help with inflammation, we should.
Antileukotrienes
Antileukotrienes drug agents block the release of leukotriene, which is a form of inflammation in Asthma. Leukotrienes consist of fatty acids, and when those fatty acids go to the specific area of inflammation, it creates a problem. For example, during bronchoconstriction, the body senses something and sends leukotrienes to the inflamed area to help, but this action creates further inflammation in an already aggravated area. Antileukotrienes not only protect the fatty acids but is a potent bronchodilator. We will continue to hear more about antileukotrienes as we are starting to discover the causes of inflammation in current research.
Monoclonal Antibodies
You may have heard about monoclonal antibodies when talking about COVID-19 patients. The monoclonal antibodies are administered in patients with COVID-19 to treat inflammation around the heart. Immunoglobulins are classified into five categories: IgA, IgD, IgE, IgG, and IgM. Immunoglobulin IgG mainly blocks the "G" antibodies. When the body releases the IgG antibodies, it goes to the lungs and causes inflammation. Typically, the monoclonal antibodies are used to treat severe Asthma inflammation in the lungs by controlling the IgG antibodies.
This Ask the Expert is an edited excerpt from the course, Drug Agents for Respiratory Care, presented by Dr. Duane Reed, EdD, RRT, RCP.
