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Antiinflamatorios No Esteroideos (AINE)

Antiinflamatorios No Esteroideos (AINE)

Los LOS Neisseria medicamentos antiinflamatorios no esteroideos (AINE) son una clase de medicamentos que consisten en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum aspirina, AINE reversibles y AINE selectivos. Los LOS Neisseria AINE se utilizan como agentes antiplaquetarios, analgésicos, antipiréticos y antiinflamatorios. Los LOS Neisseria efectos secundarios comunes incluyen irritación gastrointestinal, sangrado prolongado y lesión renal aguda.

Last updated: Dec 15, 2025

Editorial responsibility: Stanley Oiseth, Lindsay Jones, Evelin Maza

Contents

Farmacodinamia

Mecanismo de acción

Los LOS Neisseria medicamentos antiinflamatorios no esteroideos ejercen sus efectos terapéuticos al AL Amyloidosis interrumpir el metabolismo de los LOS Neisseria ácidos grasos, principalmente la acción de la ciclooxigenasa (COX) sobre el ácido araquidónico.

  • El ácido araquidónico es un fosfolípido que se encuentra en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum las membranas celulares y que es liberado por una variedad de estímulos que incluyen daño a la membrana celular.
  • La COX convierte el ácido araquidónico en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum:
    • Tromboxanos:
      • Participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la adhesión plaquetaria
      • Participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vasoconstricción
    • Prostaglandinas:
      • Median la inflamación
      • Aumentan el punto de ajuste de la temperatura hipotalámica
      • Participan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la anti-nocicepción
      • Activan contracciones uterinas durante la menstruación
    • Prostaciclina (prostaglandina I2):
      • Inhibe la agregación plaquetaria
      • Participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vasodilatación
  • Hay 2 isoenzimas COX:
    • COX-1 se expresa constitutivamente en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el cuerpo:
      • Participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum el mantenimiento del revestimiento de la mucosa gastrointestinal
      • Participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la vasoregulación renal
      • Participa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la agregación plaquetaria
    • La expresión inducida por COX-2 ocurre solo durante la respuesta inflamatoria
  • AINE no selectivos para la COX:
    • Irreversiblemente (aspirina) o reversiblemente (otros AINE) inhiben tanto la COX-1 como la COX-2
    • Disminuyen la síntesis de:
      • Tromboxano A2
      • Prostaglandinas
      • Prostaciclinas
    • Los LOS Neisseria efectos terapéuticos y adversos se atribuyen a la disminución de estos eicosanoides
  • AINE selectivos para la COX-2:
    • Inhiben selectivamente la COX-2
    • Disminuyen la síntesis de prostaglandinas
    • No afectan la COX-1 y, por tanto, la síntesis de tromboxano A2
    • Tienen diferentes perfiles de efectos secundarios de los LOS Neisseria AINE no selectivos

Farmacocinética

Los LOS Neisseria AINE son generalmente muy similares:

  • Ácidos débiles liposolubles
  • Absorción casi completa del tracto gastrointestinal
    • Hay formulaciones tópicas disponibles ( diclofenac Diclofenac A non-steroidal anti-inflammatory agent (nsaid) with antipyretic and analgesic actions. It is primarily available as the sodium salt. Nonsteroidal Antiinflammatory Drugs (NSAIDs))
    • Las formulaciones intravenosas están disponibles (ibuprofeno)
  • Mínimo metabolismo hepático de 1er paso
  • Altamente unidos a proteínas
  • Pequeño volumen de distribución
  • Metabolizados por CYP3A y CYP2C y/o glucuronidación.
  • Las vidas medias varían de ＜ 2 a ＞ 8 horas.
  • Excretados por vía renal
The arachidonic acid pathway

Vía del ácido araquidónico
HPETEs: ácidos hidroperoxieicosatetraenoicos
LOX: lipoxigenasa
LT: leucotrieno

Imagen por Lecturio.

Related videos

3:13
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Clasificación

Los LOS Neisseria AINE se pueden dividir en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum grupos según su capacidad para inhibir las isoformas de la ciclooxigenasa (COX-1 y COX-2).

  • Los LOS Neisseria AINE no selectivos inhiben tanto la COX-1 como la COX-2.
    • Incluidos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum esta categoría:
      • Aspirina
      • Diclofenac Diclofenac A non-steroidal anti-inflammatory agent (nsaid) with antipyretic and analgesic actions. It is primarily available as the sodium salt. Nonsteroidal Antiinflammatory Drugs (NSAIDs)
      • Ibuprofeno
      • Naproxeno
      • Ácido mefenámico
      • Indometacina
      • ketoprofeno
      • Piroxicam Piroxicam A cyclooxygenase inhibiting, non-steroidal anti-inflammatory agent (nsaid) that is well established in treating rheumatoid arthritis and osteoarthritis and used for musculoskeletal disorders, dysmenorrhea, and postoperative pain. Its long half-life enables it to be administered once daily. Nonsteroidal Antiinflammatory Drugs (NSAIDs)
      • Sulindac Sulindac A sulfinylindene derivative prodrug whose sulfinyl moiety is converted in vivo to an active nsaid analgesic. Specifically, the prodrug is converted by liver enzymes to a sulfide which is excreted in the bile and then reabsorbed from the intestine. This helps to maintain constant blood levels with reduced gastrointestinal side effects. Nonsteroidal Antiinflammatory Drugs (NSAIDs)
  • Los LOS Neisseria AINE selectivos inhiben solo la isoforma COX-2.
    • Incluidos en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum esta categoría:
      • Celecoxib Celecoxib A pyrazole derivative and selective cyclooxygenase 2 inhibitor that is used to treat symptoms associated with rheumatoid arthritis; osteoarthritis and juvenile arthritis, as well as the management of acute pain. Nonsteroidal Antiinflammatory Drugs (NSAIDs)
      • Meloxicam Meloxicam A benzothiazine and thiazole derivative that acts as a nsaid and cyclooxygenase-2 (cox-2) inhibitor. It is used in the treatment of rheumatoid arthritis; osteoarthritis; and ankylosing spondylitis. Nonsteroidal Antiinflammatory Drugs (NSAIDs) (a dosis < 7,5 mg/día)

Indicaciones

  • Aspirina:
    • Dosis bajas (< 325 mg/día):
      • Efecto antiplaquetario para prevenir eventos isquémicos ateroscleróticos (normalmente a dosis de 75-100 mg/día).
      • Nota: según el USPSTF, ya no se recomienda el inicio de dosis bajas diarias de aspirina para la prevención primaria de enfermedades cardiovasculares en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum personas mayores de 60 años.
    • Dosis media (325-4000 mg/día): efectos analgésicos y antipiréticos
    • Dosis altas (4000-8000 mg/día):
      • Efecto antiinflamatorio
      • La dosis máxima habitual es de 4500 mg/día debido a la preocupación por la toxicidad (e.g., hemorragia y ulceración gastrointestinal, pérdida de audición, tinnitus Tinnitus A nonspecific symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, and other noises in the ear. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. Cranial Nerve Palsies)
    • Nota: No se trata necesariamente de límites estrictos, y hay cierto solapamiento entre estas categorías.
  • AINE reversibles:
    • Analgésico
    • Antipirético
    • Antiinflamatorio
    • Cierre de conducto arterioso permeable (indometacina)
  • Celecoxib Celecoxib A pyrazole derivative and selective cyclooxygenase 2 inhibitor that is used to treat symptoms associated with rheumatoid arthritis; osteoarthritis and juvenile arthritis, as well as the management of acute pain. Nonsteroidal Antiinflammatory Drugs (NSAIDs):
    • Artritis reumatoide
    • Osteoartritis

Related videos

5:02
Aspirin (ASA)

Efectos Secundarios

Efectos del tracto gastrointestinal

  • Las prostaglandinas inhiben la secreción de ácido gástrico y promueven la producción de moco protector.
  • Los LOS Neisseria AINE bloquean las prostaglandinas:
    • → Dispepsia
    • → Erosión gastrointestinal
    • → Ulceración gastrointestinal
    • → Sangrado gastrointestinal

Efectos cardiovasculares

  • La prostaciclina es un potente vasodilatador e inhibidor de la agregación plaquetaria.
  • Los LOS Neisseria AINE bloquean la prostaciclina:
    • → Vasoconstricción
    • → Agregación plaquetaria
  • Las plaquetas contienen solo COX-1, que produce tromboxano A2.
  • El tromboxano A2 es un potente vasoconstrictor y agregador plaquetario y es trombogénico.
  • La inhibición selectiva de la COX-2 produce efectos de la COX-1 sin oposición:
    • → Vasoconstricción
    • → Agregación plaquetaria
    • → Estado protrombótico
  • El uso prolongado de inhibidores de la COX-2 se asocia con un mayor riesgo de complicaciones cardiovasculares.
  • Los LOS Neisseria AINE no selectivos (excepto la aspirina) también se asocian con un mayor riesgo (aunque menos que con los LOS Neisseria selectivos de la COX-2).
  • El perfil de riesgo cardiovascular/AINE más seguro en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum este contexto parece ser el naproxeno.

Efectos renales

  • Las prostaglandinas participan en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum la liberación de renina, regulación del tono vascular y control de la función tubular en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum los LOS Neisseria riñones.
  • Los LOS Neisseria AINE bloquean las prostaglandinas:
    • → Lesión renal aguda
    • → Nefritis intersticial
    • → Necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage papilar renal

Efectos varios

  • Riesgo de sangrado asociado a AINE significativo solo en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum combinación con otros anticoagulantes.
  • El diclofenac Diclofenac A non-steroidal anti-inflammatory agent (nsaid) with antipyretic and analgesic actions. It is primarily available as the sodium salt. Nonsteroidal Antiinflammatory Drugs (NSAIDs) y el sulindac Sulindac A sulfinylindene derivative prodrug whose sulfinyl moiety is converted in vivo to an active nsaid analgesic. Specifically, the prodrug is converted by liver enzymes to a sulfide which is excreted in the bile and then reabsorbed from the intestine. This helps to maintain constant blood levels with reduced gastrointestinal side effects. Nonsteroidal Antiinflammatory Drugs (NSAIDs) se han asociado con disfunción e insuficiencia hepática.

Toxicidad de la Aspirina

La toxicidad por salicilatos es una serie de síntomas y alteraciones metabólicas atribuibles a la ingestión excesiva de ácido salicílico (e.g., aspirina y otras preparaciones de venta libre). La exposición accidental se observa en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes pediátricos, mientras que la exposición intencionada se observa con mayor frecuencia en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum adolescentes y adultos jóvenes (i.e., intento de suicidio).

  • Síntomas iniciales:
    • Náuseas y vómitos
    • Tinnitus Tinnitus A nonspecific symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, and other noises in the ear. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. Cranial Nerve Palsies y vértigo (sobreactivación del nervio craneal VIII)
    • Diaforesis
    • Hiperventilación
    • Taquicardia
    • Hiperactividad
  • Síntomas de toxicidad progresiva:
    • Agitación
    • Delirio
    • Convulsiones
    • Letargo/estupor
    • Hipertermia
  • Trastorno metabólico (ácido–base):
    • La fase temprana de alcalosis respiratoria: debido a la sobreactivación del centro respiratorio medular
    • La fase intermedia de alcalosis respiratoria combinada y acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis metabólica
    • La fase tardía de acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis metabólica con brecha aniónica alta: debido al AL Amyloidosis metabolito de la aspirina (salicilato)
  • Tratamiento:
    • Toxicidad por aspirina tratada con bicarbonato de sodio (NaHCO3–): el bicarbonato de sodio alcaliniza la orina, facilitando la excreción de salicilato.
    • La diálisis puede ser necesaria si el tratamiento con bicarbonato de sodio no tiene éxito.

Related videos

2:46
Aspirin Toxicity

Comparación de los AINE

Tabla: Comparación de los LOS Neisseria AINE
Clase Mecanismo de acción Uso clínico Efectos secundarios
AINE reversibles (e.g., ibuprofeno, ketorolaco, indometacina)
  • Inhiben reversiblemente la COX-1 y COX-2
  • Disminución de la síntesis de prostaglandina y tromboxano A2 (TXA2)
  • Analgésico
  • Antipirético
  • Antiinflamatorio
  • Cierre de conducto arterioso permeable
  • Úlceras gástricas y sangrado gastrointestinal
  • Lesión renal aguda
  • Nefritis intersticial
  • Necrosis Necrosis The death of cells in an organ or tissue due to disease, injury or failure of the blood supply. Ischemic Cell Damage papilar renal
  • Aspirina:
    • Síndrome de Reye en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum niños con una infección viral
    • Síntomas parecidos al AL Amyloidosis asma ASMA Autoimmune Hepatitis en EN Erythema nodosum is an immune-mediated panniculitis (inflammation of the subcutaneous fat) caused by a type IV (delayed-type) hypersensitivity reaction. It commonly manifests in young women as tender, erythematous nodules on the shins. Erythema Nodosum pacientes con pólipos nasales o atopia
    • Tinnitus Tinnitus A nonspecific symptom of hearing disorder characterized by the sensation of buzzing, ringing, clicking, pulsations, and other noises in the ear. Objective tinnitus refers to noises generated from within the ear or adjacent structures that can be heard by other individuals. The term subjective tinnitus is used when the sound is audible only to the affected individual. Tinnitus may occur as a manifestation of cochlear diseases; vestibulocochlear nerve diseases; intracranial hypertension; craniocerebral trauma; and other conditions. Cranial Nerve Palsies
    • Alcalosis respiratoria– acidosis Acidosis A pathologic condition of acid accumulation or depletion of base in the body. The two main types are respiratory acidosis and metabolic acidosis, due to metabolic acid build up. Respiratory Acidosis metabólica mixta
Aspirina
  • Inhibe irreversiblemente la COX-1 y COX-2
  • Disminución de la síntesis de prostaglandinas y TXA2
  • Dosis baja (< 300 mg/día): antiagregante plaquetario
  • Dosis media (300–2400 mg/día): analgésico y antipirético
  • Dosis alta (2400–4000 mg/día): antiinflamatorio
Inhibidores de la COX-2 (e.g., celecoxib Celecoxib A pyrazole derivative and selective cyclooxygenase 2 inhibitor that is used to treat symptoms associated with rheumatoid arthritis; osteoarthritis and juvenile arthritis, as well as the management of acute pain. Nonsteroidal Antiinflammatory Drugs (NSAIDs))
  • Inhiben selectivamente la COX-2
  • Disminución de la síntesis de prostaglandinas
  • Plaquetas y síntesis de TXA2 preservadas
  • Artritis reumatoide
  • Osteoartritis
  • Mayor riesgo de trombosis:
    • Trombosis venosa profunda
    • Embolismo pulmonar
  • Infarto de miocardio (IM) agudo
  • Alergia a las sulfas

Referencias

  1. Solomon, D.H. (2025). Nonselective NSAIDs: overview of adverse effects. UpToDate. Retrieved October 15, 2025, from https://www.uptodate.com/contents/nonselective-nsaids-overview-of-adverse-effects
  2. Solomon, D. H. (2025). NSAIDs (including aspirin): Pharmacology and mechanism of action. UpToDate. Retrieved October 15, 2025, from https://www.uptodate.com/contents/nsaids-including-aspirin-pharmacology-and-mechanism-of-action
  3. Solomon, D.H. (2025). Overview of COX-2 selective NSAIDs. UpToDate. Retrieved October 15, 2025, from https://www.uptodate.com/contents/overview-of-cox-2-selective-nsaids
  4. Dawood, M.Y. (2006). Primary dysmenorrhea: advances in pathogenesis and management. Obstet Gynecol 108:428–441. https://pubmed.ncbi.nlm.nih.gov/16880317/
  5. Shekelle, P.G., et al. (2017). Management of gout: a systematic review in support of an American College of Physicians clinical practice guideline. Ann Intern Med 166:37–51. https://pubmed.ncbi.nlm.nih.gov/27802478/
  6. Oyler, D.R., et al. (2015). Nonopioid management of acute pain associated with trauma: Focus on pharmacologic options. J Trauma Acute Care Surg 79:475–483. https://pubmed.ncbi.nlm.nih.gov/26307883/
  7. Zacher, J., et al. (2008). Topical diclofenac and its role in pain and inflammation: an evidence-based review. Curr Med Res Opin 24:925–950. https://pubmed.ncbi.nlm.nih.gov/18279583/
  8. Van den Bekerom, M.P.J., et al. (2015). Non-steroidal anti-inflammatory drugs (NSAIDs) for treating acute ankle sprains in adults: benefits outweigh adverse events. Knee Surg Sports Traumatol Arthrosc 23:2390–2399. https://pubmed.ncbi.nlm.nih.gov/24474583/
  9. May, J.J., Lovell, G., Hopkins, W.G. (2007). Effectiveness of 1% diclofenac gel in the treatment of wrist extensor tenosynovitis in long distance kayakers. J Sci Med Sport 10:59–65. https://pubmed.ncbi.nlm.nih.gov/16787761/
  10. Barkin, R.L. (2015). Topical nonsteroidal anti-inflammatory drugs: the importance of drug, delivery, and therapeutic outcome. Am J Ther 22:388–407. https://pubmed.ncbi.nlm.nih.gov/22367354/
  11. Chaiamnuay, S., Allison, J.J., Curtis, J.R. (2006). Risks versus benefits of cyclooxygenase-2-selective nonsteroidal antiinflammatory drugs. Am J Health Syst Pharm 63:1837–1851. https://pubmed.ncbi.nlm.nih.gov/16990630/
  12. Day, R.O., Graham, G.G. (2013). Nonsteroidal anti-inflammatory drugs (NSAIDs). 346:f3195. https://pubmed.ncbi.nlm.nih.gov/23757736/
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