Non steroidal anti inflammatory drugs are the most used medication around the world. They help in relieving pain, swelling, and fever. They are available as prescription NSAIDS and also as over the counter medications. These drugs can also be abused and they can have serious side effects. It is reported that every year around 20,000 tones of Aspirin is consumed in the United States alone.
Working of NSAIDS
The cyclooxgenase enzymes also known as COX enzymes are stopped from working in the body by taking prescription Non steroidal Anti-Inflammatory Medicines. These COX enzymes help in production of prostaglandins which cause the sensation of pain by irritating the nerve endings. The non steroidal anti inflammatory drugs reduce the level of prostaglandins in the body thus relieving pain.
Common prescription NSAIDS
The traditional NSAIDS include etodolac, Diclofenac, Flurbiprofen, Fenoprofen, Tolmetin, sulindac, piroxicam, Oxaprozin, naproxen, nabumetone, Meloxicam, Mefenamic acid, Meclofenamate, indomethacin and Ibuprofen. The COX-2 inhibitor is Celecoxib.
Difference between traditional NSAIDS and COX-2 inhibitors
There are two types of COX enzymes in the body namely COX -1 and COX-2 enzymes. Out of the two, only COX-1 enzymes help in protecting the lining of the stomach. The traditional NSAIDS block the COX-1 enzymes due to which pain and swelling is reduced. The protective lining of the stomach is also reduced in this process, due to which there may be effects like bleeding in stomach, bleeding in intestine, ulcers in stomach and bloating of the stomach. The COX-2 enzymes are also blocked by the traditional NSAIDS. The COX-2 inhibitors stop only the COX-2 enzymes (do not protect stomach lining) from working. The COX -2 inhibitors do not irritate the stomach lining.
Side effects of traditional NSAIDS
There may be dizziness associated with headache. Extreme weakness may be felt. Excessive gas formation with nausea is seen. There can be diarrhea or constipation. A dry mouth can also occur. Severe side effects like allergic reactions may occur, which include difficulty in breathing, swelling of face, lips and tongue and formation of hives. The stools and urine can be bloody. There can be muscle cramps with tingling and numbness. Tinnitus may occur which is ringing in the ears apart from decrease in hearing. There can be yellowing of the skin and the white part of the eyes which is a condition known as jaundice. Other side effects include stomach upset, cramps in the stomach and weight gain.
Side effects of COX -2 inhibitors
The side effects of COX -2 inhibitor includes itching, skin rash, water retention, unusual bruising with bleeding, and difficulty in sleeping.
Drug interactions
When one uses more than one drug at a time, the effectiveness of each drug may get affected and the way the body processes each drug may change. The side effect of each drug also increases. This is called a drug- drug interaction. In drug- food interaction, certain foods and drinks affect the working of the drug, and increase its side effects. Drinking alcohol after taking NSAIDS increases the risk of stomach bleeding and liver disease. Vitamins and herbal supplements consumed along with drugs can also affect the drug processing in the body. One should consult the doctor regarding the foods and drinks that need to be avoided before taking NSAIDS.
To reduce the risk of drug interactions one must be aware of the purpose of each drug and their side effects. A list of drugs one is taking should be discussed with the doctor. Before taking any new drug one must consult the doctor or pharmacist. One must select a pharmacy that has services like maintaining a drug profile for each person and checking for all possible drug interactions. If one is consulting more than one doctor, than the list of medications being taken should be discussed with both of them. One should know how to take the drug; the time the drug has to be taken and the food and drinks that need to be avoided while taking those drugs. Any side effect observed should be immediately discussed with the doctor.
Use NSAIDS the right way
If NSAIDS are taken wisely as prescribed by the doctor, following all the instructions, then they can prove very effective in alleviating pain and swelling. But if they are abused, it can lead to serious complications. Using them the right way is the key to safe and effective treatment.
