Indomethacin

The classic signs of inflammation have long been recognized, the tissue becomes red, swollen, tender or painful, there is local heat and the patient may be febrile (1).
Celsus Roman writer of the first century AD, first listed the four cardinal signs of inflammation: rubor, tumor, calor, dolor (redness, swelling, heat and pain). These signs are typically more prominent in acute inflammation than in chronic inflammation (2).
Non steroidal anti-inflammatory drugs (NSAIDs) are among the most widely used of all therapeutic agents. They are frequently prescribed for ‘rheumatic’ musculoskeletal complaints and are often taken without prescription for minor aches and pains. There are now more than 50 different NSAIDs on the market and none of these
It is a potent inhibitor of prostaglandin synthesis. The analgesic action of Indomethacin is due to a decrease in the production of prostaglandins that sensitizes nociceptors to inflammatory mediators such as bradykinin and 5-hydroxytryptamine. Indomethacin is readily absorbed from the gastrointestinal tract almost completely after oral ingestion. 90% of it is bound to tissue proteins and are also the mediators of inflammatory response. Indomethacin is used in musculoskeletal disorders such as rheumatoid lesions. It is widely used in the treatment of arthritis (osteo-arthritis and acute gouty arthritis) and ankylosing spondylitis. The oral dose of Indomethacin is 25–50 mg 2-3 times a day and injectable dose is 1–2 mg/Kg/24 hours in two divided doses. The adverse effects of Indomethacin especially on the gastrointestinal tract are due to its systemic effects and not due to its local actions. Ingestion of Indomethacin has been shown, in man, to be associated with NSAID gastropathy. Its untoward effects are nausea, vomiting, anorexia, epigastric distress, diarrhoea, gastrointestinal ulcers and perforation. The traditional drugs like Indomethacin are still widely used in the remote areas because of its low cost