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Antiphlogistic – Anti-Inflammatory Drugs Explained

An antiphlogistic is an anti-inflammatory drug that reduces inflammation in the body. It is used to relieve pain, swelling, and inflammatory conditions.

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Things worth knowing about "Antiphlogistic"

An antiphlogistic is an anti-inflammatory drug that reduces inflammation in the body. It is used to relieve pain, swelling, and inflammatory conditions.

What Is an Antiphlogistic?

The term antiphlogistic (plural: antiphlogistics) refers to a group of substances and medications with anti-inflammatory properties. The name derives from the Greek words anti (against) and phlogosis (inflammation). Antiphlogistics are used to reduce inflammatory responses in the body, relieve pain, and reduce swelling.

Types of Antiphlogistics

There are two main groups of antiphlogistics, which differ in their mechanism of action and areas of application:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most commonly used antiphlogistics. They act as anti-inflammatory, analgesic, and antipyretic agents without containing corticosteroids. Well-known active ingredients include:

  • Ibuprofen – commonly used for headaches, fever, and joint pain
  • Diclofenac – used for osteoarthritis, sports injuries, and rheumatic conditions
  • Naproxen – for chronic inflammatory diseases
  • Acetylsalicylic acid (aspirin) – also used in lower doses as a platelet inhibitor

Steroidal Antiphlogistics (Corticosteroids)

Corticosteroids such as cortisone, prednisolone, or dexamethasone are synthetic derivatives of the naturally occurring hormone cortisol. They have a very potent anti-inflammatory effect and are used for more severe inflammatory conditions, such as autoimmune diseases, severe asthma, or allergic reactions.

Mechanism of Action

Non-steroidal anti-inflammatory drugs inhibit the enzyme cyclooxygenase (COX), which is responsible for the synthesis of prostaglandins. Prostaglandins are messenger molecules that trigger inflammation, pain, and fever. By inhibiting COX enzymes, fewer prostaglandins are produced, thereby reducing inflammation, pain, and fever.

Corticosteroids act at the cellular level by entering the cell nucleus and suppressing the gene expression of pro-inflammatory substances (e.g., interleukins, tumor necrosis factor).

Indications

Antiphlogistics are used for a wide range of conditions and complaints:

  • Acute and chronic pain (e.g., back pain, joint pain, headaches)
  • Inflammatory joint diseases such as rheumatoid arthritis and osteoarthritis
  • Sports injuries (bruises, strains, tendinitis)
  • Autoimmune diseases (e.g., lupus erythematosus, rheumatoid arthritis)
  • Respiratory diseases (e.g., asthma, COPD – typically treated with corticosteroids)
  • Inflammatory skin conditions (e.g., eczema, psoriasis)
  • Fever and flu-like illnesses

Dosage and Administration

Depending on the active ingredient, antiphlogistics are available as tablets, capsules, suppositories, creams, gels, sprays, or injectable solutions. The dosage depends on the specific active ingredient, the age of the patient, and the severity of the condition. Many NSAIDs are available without a prescription at pharmacies, while corticosteroids require a prescription.

Important: Antiphlogistics should always be taken for as short a period as possible and at the lowest effective dose in order to minimize side effects.

Side Effects

Like all medications, antiphlogistics can cause side effects. Common adverse effects of NSAIDs include:

  • Gastric irritation, nausea, stomach pain (best taken with food)
  • Increased risk of gastric ulcers with prolonged use
  • Impaired kidney function with long-term use
  • Increased risk of heart attack and stroke with certain NSAIDs (particularly COX-2 inhibitors)

With prolonged use of corticosteroids, the following side effects may occur:

  • Weight gain and changes in fat metabolism
  • Elevated blood sugar levels (including steroid-induced diabetes)
  • Bone loss (osteoporosis)
  • Immunosuppression (increased susceptibility to infections)
  • Skin changes, increased blood pressure

Drug Interactions

Antiphlogistics, especially NSAIDs, can interact with other medications. Particularly important combinations to be aware of include:

  • Blood thinners (e.g., warfarin) – increased risk of bleeding
  • Other pain medications – risk of overdose
  • Antihypertensives – reduced blood pressure-lowering effect
  • Corticosteroids – increased gastrointestinal strain

References

  1. Aktories K., Förstermann U., Hofmann F., Starke K.: General and Special Pharmacology and Toxicology. Urban and Fischer Verlag, 12th edition, 2021.
  2. World Health Organization (WHO): The use of non-steroidal anti-inflammatory drugs (NSAIDs) in clinical practice. WHO, Geneva, 2020. Available at: https://www.who.int
  3. Mutschler E., Geisslinger G., Kroemer H. K., Ruth P., Schäfer-Korting M.: Drug Actions (Mutschler Arzneimittelwirkungen). Wissenschaftliche Verlagsgesellschaft Stuttgart, 11th edition, 2019.

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