Inflammation & Joints
Pain, inflammation and arthritis — NSAIDs, DMARDs, immunosuppressants, and the drugs that ease aching joints.
Foundations
How inflammation and the prostaglandin (COX) pathway work, and how pain is treated in steps.
NSAIDs & Analgesics
NSAIDs and the coxibs, paracetamol, and aspirin — the everyday painkillers and their real risks.
Rheumatoid Arthritis & DMARDs
Drugs that change the disease, not just the pain — methotrexate, and the biologic and targeted DMARDs.
Autoimmune & Immunosuppression
Corticosteroids and joint injections, the immunosuppressants, and hydroxychloroquine for lupus.
Pain & Musculoskeletal
Osteoarthritis, neuropathic pain, muscle relaxants, and the treatment of migraine.
Inflammation & the Prostaglandin Pathway: The Key to Every Painkiller
Almost every anti-inflammatory painkiller — from ibuprofen to aspirin to steroids — works by acting on one chemical pathway. Learn this single diagram, the arachidonic acid pathway, and you'll understand not just how these drugs relieve pain, but exactly why they damage the stomach and kidneys. One pathway explains both the benefit and the harm.
Treating Pain: The Analgesic Ladder and the Right Drug for the Right Pain
Pain isn't one thing, and there's no single best painkiller — there's a logical way to escalate from mild to severe, and a crucial distinction between ordinary pain and 'nerve pain' that responds to completely different drugs. This simple framework, the analgesic ladder, organises pain relief for the whole of medicine.
NSAIDs: The World's Painkillers, and Their Three Big Dangers
Ibuprofen, naproxen and diclofenac are among the most-used drugs on the planet — brilliant for pain, inflammation and fever. But they carry three serious risks that all trace back to one thing you already understand: blocking the protective COX-1. Learn the three dangers — stomach, kidney, and heart — and you'll use these everyday drugs safely.
COX-2 Inhibitors: The Clever Fix That Created a New Problem
The coxibs were a brilliant idea: if blocking COX-1 causes the stomach damage, design a drug that blocks only the inflammatory COX-2 and spare the stomach. It worked — but the story took a twist that teaches one of pharmacology's most important lessons about unintended consequences.
Paracetamol: The Safest Painkiller — Until You Take Too Much
Paracetamol is the world's most-used painkiller, and it's the odd one out: it relieves pain and fever but has almost none of an NSAID's inflammation-fighting power or its stomach and kidney risks. At normal doses it's remarkably safe — yet in overdose it silently destroys the liver. Understanding this Jekyll-and-Hyde drug is genuinely important.
