NSAID’s effect on your body
They can: 1. relieve pain (analgesic),
2. reduce fever (antipyretic) and 3. reduce the inflammatory
reaction (anti-inflammatory). It is exactly this property that provides the
potential for relief of pain associated with inflammation.
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Name a few NSAIDs They include the
prototype, aspirin, and ibuprofen, naproxen, indomethacin, diclofenac and
ketoprofen.
Most of the NSAIDs are schedule 3 drugs according to the
Medicines Control Act. Some are classified as schedule 2 drugs. The latter
include ibuprofen, diclofenac, naproxen, ketoprofen, piroxicam used
for treatment of pain, swelling and inflammation due to injuries or short term
treatment of acute gout.
Who can benefit from NSAIDs? People
with pain when the pain is associated with inflammation. NSAID’s can reduce
pain and inflammation and therefore stiffness. The anti-inflammatory action of
NSAID’s does not alter the course or progression of rheumatoid arthritis. It
will not cure or halt the disease but can relieve the symptoms of pain and
inflammation.
It is not recommended for pain where inflammation is not
a major feature, as in osteoarthritis. Then a painkiller like paracetamol, with less
toxic side-effects than NSAIDs, should rather be taken.
NSAID’s are also effective in the relief of dental
and bone pain, dysmenorrhoea and headaches.
When and how do I take my
NSAID’s? During or shortly after meals and as prescribed. Never take NSAIDs on an empty stomach.
Also, drink a glass of water or other fluid with your NSAID tablets. If you
are dehydrated while using NSAIDs, you might be at increased risk of renal damage.
Drink plenty of fluids when you exercise because the combination of exercise and NSAIDs increase your risk for renal damage. They
are usually taken orally as tablets or capsules, but many are available as a
liquid suspension or as a suppository.
What dose do I take? Your doctor will
advise you. Usually you start off with as low a dose as possible, and then your
doctor will increase it if necessary. Do not increase the dose without your
doctor’s knowledge.
How long will these drugs take to
work? Anti-inflammatory drugs usually work within a few hours,
although the maximum benefit can take one week or longer. Allow 10 –
14 days’ treatment before deciding that a specific drug is ineffective.
What are the possible
side-effects? All NSAIDs may have adverse effects, including stomach
upsets, heartburn, indigestion, rashes, headaches, and wheeziness. It can effect
the kidneys, liver, haematological, immunological and neurlogical systems. The
drugs can cause or worsen hypertension, heart failure, angina and renal
problems. Alert your doctor if you show any of the side-effects. Note
that NSAIDs can seriously damage the stomach’s inner lining causing ulceration and bleeding. Use NSAIDs with caution.
Don’t drive if you feel drowsy or dizzy.
Do some NSAIDs have fewer side-effects than
others? Yes. Newer NSAIDs are likely to cause less stomach
upsets, heartburn and indigestion, and are known as 'COX-2 specific' NSAIDs
because of their action. But they still have the potential for other
side-effects.
Who should not take NSAIDs * You should not take them
if you have a history of indigestion or stomach ulcers. If your doctor decides
that short term use of a NSAID is your best option, the concurrant use of a drug
(known as a H2-receptor antagonist or a proton pump inhibitor) can protect
your stomach lining. * You should not take non-steroidal
anti-inflammatory drugs if you have asthma, kidney problems or take the
anti-clotting drug warfarin. Consult your doctor. * The drugs can cause or
worsen hypertension, heart failure, angina and renal problems. People with heart
or renal problems shouldavoid NSAID use. *
Elderly people are more prone to develop side-effects and should rather take
short-acting NSAIDs in low dosages for short periods of time, only if absolutely necessary. * People who are hypersensitive to
aspirin and tartrazine should not take some NSAIDs. People with nasal polyps,
asthma or allergies are most at risk. * NSAIDs should not taken when joint infection is suspected. By reducing the inflammation, these drugs can mask the symptoms of
infection.
Can I take other medication while on NSAIDs?
Yes and no. Some drugs interact with NSAIDs. Let your
doctor/pharmacist know what other medicines you are taking. Some NSAIDs, such as
aspirin and ibuprofen, are available without prescription. If the NSAID is
not effective enough in reducing pain, rather: 1. increase the dose in
consultation with your doctor, or 2. change to another NSAID, or
3. add a painkiller like paracetamol, or 4. add an opoid
painkiller like codeine, or 5. add a low dose of the right
antidepressant at night.
Don’t take two different NSAIDs at one time.
What about NSAID’s and
pregnancy? Avoid these drugs during pregnancy or
while breast feeding. Discuss this with your doctor.
What
about alcohol and NSAIDs? Alcohol and NSAIDs can both upset the
stomach, and alcohol use may aggrevate irritation of the stomach lining and
consequent bleeding. NSAIDs and alcohol should never be used concurrently.
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