# Inflammation: What's There and What's New?
## 4 Common Treatments of the Inflammatory Process
### Natural Anti-Inflammatory Agents  
Most anti-inflammatory medications are linked to an elevated risk of severe upper gastrointestinal problems. The level of risk for particular anti-inflammatory drugs has been estimated through epidemiological studies. Through the use of oral steroids or low-dose aspirin, the likelihood of upper gastrointestinal tract leakage or perforation rises by almost twice with the use of non-aspirin, non-steroidal, anti-inflammatory medicines. Overall, with more than one anti-inflammatory drug administered concurrently, the risk is dose-dependent and higher. Therefore, in order to minimize the risk of severe upper gastrointestinal complications, anti-inflammatory drugs should be prescribed as monotherapy and at the lowest effective dose possible [3].  
\begin{table}
\begin{tabular}{c c c c c} \hline
**Drug Type** & **Mechanism of Action** & **Chemical Structure** & **Side Effects** & **Reference** \\ \hline \multicolumn{5}{c}{**Non-steroidal Anti-inflammatory Drugs NSAIDs**} \\ \hline
**Ibuprofen** & Non-selective, reversible inhibition of the cyclooxygenase enzymes COX-1 and COX-2 (coded for by PTGSSI and PTGS2, respectively). & OH & Headaches, feeling dizzy, feeling sick (mouse), being sick (romiting), wind, indigestion, and swollen ankles. & [68] \\ \hline
**Naproven** & Blocks arachid binding to competitively inhibit both cyclooxygenase (COX) isoenzymes, COX-1 and COX-2, resulting in analgesic and anti-inflammatory effects. & OH & Confusion, headaches, ringing in the ears, changes in vision, friendness, drowsiness, dizziness, and rashes. & [69] \\ \hline
**Celeoxib** & Selective inhibition of cyclooxygenase-2 (COX), which is responsible for prostaglandin synthesis, an integral part of the pain and inflammation pathway. & Stomach pain, heartburn, gas, diarrhea, constipation, nausea, vomiting in the hands or feet, dizziness, and cold symptoms. & [70] \\ \hline \end{tabular}
\end{table}
Table 2: Cont.  
\begin{table}
\begin{tabular}{c c c c c} \hline
**Drug Type** & **Mechanism of Action** & **Chemical Structure** & **Side Effects** & **Reference** \\ \hline
**Diclofenac** & Inhibition of prostaglandin synthesis by inhibiting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) with relative equipelency. & HO & Headaches, dizziness, stomach pain, feeling or being sick, diarrhea, and rashes. & [71] \\ \hline
**Indomethacin** & Inhibition of prostaglandin synthesis by inhibiting cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). & Vomiting, upset stomach, heartburn, diarrhea, a feeling of bowelfulness, constipation, bloating gas, retail irritation, dizziness, drowsiness, and nervousness. & [72] \\ \hline
**Firovicam** & Inhibition of cyclooxygenase (COX-1 and COX-2). Piroxican is a potent inhibitor of prostaglandin (PG) synthesis in vitro. & Abnormal liver function tests, urination problems, upset stomach, heartburn, loss of appetite, stomach pain, nausea, vomiting, gas, diarrhea, constipation, dizziness, headaches, rashes, and ringing in the ears. & [73] \\ \hline \end{tabular}
\end{table}
Table 2: Cont.  
Owing to the substantial side-effect profiles of steroidal and NSAID drugs, there is greater interest in natural compounds, such as nutritional supplements and herbal medicines, which have been used for centuries to reduce pain and inflammation. Many of these natural compounds often act in a similar fashion to NSAIDs by inhibiting inflammatory pathways. Many natural compounds function to inhibit the inflammatory pathways of nuclear factor-kB (NF-kB) in addition to the COX pathway [4].