CARDINAL SIGNS

OF INFLAMMATION
• Rubor (Redness): Inflammation causes an increased blood flow to the affected area, resulting in localized redness. This
redness is due to the dilation of blood vessels in the area.
• Calor (Heat): Inflammation leads to an increased metabolic activity in the affected area, causing heat or warmth. This is
caused by the increased blood flow and release of various inflammatory mediators.
• Tumor (Swelling): Inflammation causes fluid to accumulate in the affected tissue, leading to swelling. The increased
permeability of blood vessels allows fluid and immune cells to move from the blood vessels into the surrounding tissue.
• Dolor (Pain): Inflammation can stimulate nerve endings, leading to pain or discomfort in the affected area. The pain can
result from the release of chemicals that sensitize nerve endings or from the pressure caused by swelling.
• Functio laesa (Loss of function): Inflammation can affect the normal functioning of the affected area. For example, if
inflammation occurs in a joint, it can limit movement and cause stiffness or loss of range of motion.
 These cardinal signs of inflammation were first described by the ancient Roman physician Celsus and have since been
widely recognized as characteristic features of the inflammatory process.
1. Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of medications commonly used to reduce
inflammation, relieve pain, and lower fever. The action of NSAIDs involves inhibiting the production of
certain chemicals in the body called prostaglandins. Prostaglandins are lipid compounds that play a key
role in promoting inflammation, pain, and fever.
 NSAIDs work by inhibiting the activity of an enzyme called cyclooxygenase (COX), which is involved in the
production of prostaglandins. There are two isoforms of this enzyme: COX-1 and COX-2.

COX-1 is constitutively present in many tissues and is involved in maintaining normal physiological functions,
such as protecting the stomach lining and supporting kidney function.

COX-2, on the other hand, is induced during inflammation and is responsible for the production of
prostaglandins that promote pain and inflammation.

Examples: ibuprofen, naproxen, aspirin, and diclofenac.

2. Corticosteroids: are potent anti-inflammatory drugs that mimic the effects of natural hormones produced by the
adrenal glands. They work by suppressing the immune system and reducing inflammation. Corticosteroids can be
administered orally, topically, or via injections.

Examples: prednisone, prednisolone, and dexamethasone.

3. Disease-modifying antirheumatic drugs (DMARDs): DMARDs are a class of medications used primarily in the
treatment of autoimmune diseases such as rheumatoid arthritis. They work by suppressing the immune system and
reducing inflammation.
Examples: methotrexate, sulfasalazine, leflunomide, and hydroxychloroquine.
 ACTIVE IMMUNITY is acquired through exposure to a pathogen or vaccination, provides long-
lasting protection, takes time to develop, and offers specific defense. In contrast, PASSIVE
IMMUNITY is obtained through the transfer of pre-formed antibodies or immune cells, offers
temporary protection, is immediately effective, and provides non-specific defense.