Non-steroidal Anti-inflammatory Drugs: Actions and Effects - Essay Example

Non-steroidal Anti-inflammatory Drugs: Actions and Effects What are NSAIDs all about What can be their effects and side effects What could possibly human beings gain from this classification of drugs What could possibly be the explanation of those effects in human beings A non-steroidal anti inflammatory drug is a drug classification that is with specific effects. These drugs, as their classification is named, works as anti inflammatory meaning it reduces inflammation. Non-steroidal anti inflammatory drugs or NSAIDs are said to be the most prescribed medications for treating arthritis. These aren't merely pain relievers alone but they also have the characteristics of anti-inflammatory which help reduce the inflammation and they also have anti-pyretic characteristics which help reduce fever. NSAIDs also reduce clotting action specifically aspirin, an NSAID. These are commonly used to treat mild to moderate pain such as headaches and menstrual cramps and it is also given to patients with fever and minor inflammation. Not just that, it is also a mild pain reliever, and with this they not only attack pain but the source of pain as well as it is said to be anti inflammatory. As these are the main benefits of NSAIDS, they also offer other health benefits. The use of NSAIDs in minimal doses may also help prevent heart attack and stroke. With the Aspirin having that effect on clotting, they may be helpful in those patients with heart ailments such as ischemia. When we say that NSAIDs are anti inflammatory, they act on the inflammation process in the body. When there is a trauma to the body, say for example a cut, prostaglandins are produced by the cells and they will be directed to the site of the trauma. They promote inflammation, pain, and fever if there is infection. These prostaglandins are produced within the body cells by the enzyme cyclooxygenase (Cox). There are two Cox enzymes, Cox-1 and Cox-2, both enzymes produce prostaglandins that promote inflammation, pain and fever. NSAIDs block the Cox enzymes and reduce prostaglandins in the body. As an effect ongoing inflammation, pain, and fever are reduced. As NSAIDs have an effect on the inflammation process it also has effects on pain management but only limited from mild to moderate pain. So how is this so Inflammation on the first place occurs when there is acute soft tissue injury which then causes these damage cells to release chemicals that causes vasodilation and extravasation which are responsible for inflammation and pain. And since NSAIDs act on these actions, they would help in reducing pain by first reducing what caused that pain. For example, pain is caused by the inflammation, NSAIDs would act first on the inflammation process before it would reduces pain. However the study cited warns that NSAIDs should only be used on the early stages of inflammation and should be stopped as soon as possible since NSAIDs may only act on the early stages of inflammation (Dunitz, M. 2001). What now could be the effect of NSAIDs in fever In one research, in the pathogenesis of systemic inflammation and fever, signals can be transmitted through humoral and neural routes. Neural routes can be through chemo sensitive afferent fibers of the abdominal vagus and that the study concluded that capsaicin-sensitive fibers traveling within the hepatic vagal branch constitute a necessary component of the afferent mechanism of the febrile response to low, but not high, doses of circulating pyrogens. We speculate that this mechanism is triggered by blood-borne prostaglandins of the E series (Romanovsky, A. et.al, 2000). And as it is worked about by prostaglandins, and since prostaglandins are the main target of NSAIDs, it then helps the body to recuperate from fever. But as the effect of prostaglandin in the body is affected by NSAIDs, they also have effects which are not beneficial to the body. These effects are then what we call the side effects. The most common side effects of NSAIDs are the following, nausea, vomiting, diarrhea, constipation, decreased appetite, rash, dizziness, headache, and drowsiness. NSAIDs may also cause fluid retention, leading to edema (Ogbru, 2005). These side effects of NSAIDs are related to their effects on the stomach and bowels (gastrointestinal system). Approximately 15% of patients on long-term NSAID treatment develop ulceration of the stomach and duodenum. Even though many of these patients with ulcers do not have symptoms and are unaware of their ulcers, they are at risk of developing serious ulcer complications such as bleeding or perforation of the stomach. Prostaglandins are natural chemicals that serve as messengers to promoteinflammation. By inhibiting the body's production of prostaglandins, NSAIDs decrease inflammation. However, certain prostaglandins also are important in protecting the stomach lining from the corrosive effects of stomach acid as well as playing a role in maintaining the natural, healthy condition of the stomach lining. These protective prostaglandins are produced by an enzyme called Cox-1. By blocking the Cox-1 enzyme and disrupting the production of prostaglandins in the stomach, NSAIDs can cause ulcers and bleeding. Other side effects of NSAIDs include kidney failure, liver failure, ulcers and prolonged bleeding after an injury or surgery. Some individuals are allergic to NSAIDs and may develop shortness of breath when an NSAID is administered. People with asthma are at a higher risk for experiencing serious allergic reaction to NSAIDs. Individuals with a serious allergy to one NSAID are likely to experience a similar reaction to a different NSAID. Use of aspirin in children and teenagers with chicken pox or influenza has been associated with the development of Reye's syndrome, which are not really very common but are possible to occur. As we have mentioned awhile ago, NSAIDs may also be a possible treatment for ischemia. Ischemia is a restriction in blood supply, generally due to factors in the blood vessels, with resultant damage or dysfunction of tissue. NSAIDs especially aspirin helps prevent blood clots in forming. A blood clot may form in an artery (blood vessel) if a lot of platelets stick onto some atheroma. A clot in an artery may stop blood flowing to the tissues 'downstream'. If a blood clot forms in an artery in the heart or brain, it may cause a heart attack or stroke. Atheroma patches are like fatty lumps that develop in the inside lining of some arteries. This mainly occurs in older people and is sometimes called 'hardening of the arteries'. Platelets are tiny particles in the blood that help the blood to clot when a blood vessel is cut. Platelets sometimes stick onto atheroma inside an artery. So how does aspirin play a part on preventing heart attack and stroke As blood clots are formed, as what we have mentioned awhile ago, by platelets grouping together, aspirin interferes with this process by reducing the clotting factor of these platelets thus lesser possibility of sticking together. This action is an effect of inhibiting the manufacture of prostaglandins (your family's health, 2006). Thus with low doses, aspirin, an NSAID, can be very helpful in preventing heart attacks or strokes. One type of NSAID is paracetamol. Paracetamol is commonly used to treat fevers especially on kids and even in adults. It comes in two forms either liquid or tablet. You can take paracetamol up to four times a day, every 4-6 hours. It is a safe medicine and side-effects are rare if you do not take more than the maximum recommended dose. However, it can be very dangerous if you take a paracetamol overdose. It is safe to take paracetamol with other medication. If in an instance, a child is taking antibiotics for an infection, keep giving paracetamol as well until the pain and fever ease. Be careful not to take too much paracetamol by taking paracetamol tablets or liquids in addition to other remedies that already contain paracetamol. (For example, some cold remedies contain several ingredients which include paracetamol.) Ibuprofen is also one of the drugs on non-steroidal anti-inflammatory drugs (NSAIDs) classification. Ibuprofen works by reducing hormones that cause inflammation and pain in the body. This is used to reduce fever and treat pain or inflammation caused by many conditions such as headache, toothache, back pain, arthritis, menstrual cramps, or minor injury. This medicine can increase your risk of life-threatening heart or circulation problems, including heart attack or stroke. This risk will increase the longer you use ibuprofen. Do not use this medicine just before or after having heart bypass surgery (also called coronary artery bypass graft, or CABG). This medicine can also increase your risk of serious effects on the stomach or intestines, including bleeding or perforation (forming of a hole). These conditions can be fatal and gastrointestinal effects can occur without warning at any time while you are taking ibuprofen. Older adults may have an even greater risk of these serious gastrointestinal side effects. Do not use this medication if you are allergic to ibuprofen, aspirin or other NSAIDs. Avoid taking ibuprofen if you are taking aspirin to prevent stroke or heart attack. Ibuprofen can make aspirin less effective in protecting your heart and blood vessels. If you must use both medications, take the ibuprofen at least 8 hours before or 30 minutes after you take the aspirin (non-enteric coated form). Do not use any other over-the-counter cold, allergy, or pain medication without first asking your doctor or pharmacist. Many medicines available over the counter contain aspirin or other medicines similar to ibuprofen (such as ketoprofen or naproxen). If you take certain products together you may accidentally take too much of this type of medication. Read the label of any other medicine you are using to see if it contains aspirin, ibuprofen, ketoprofen, or naproxen. Do not drink alcohol while taking this medication. Alcohol can increase the risk of stomach bleeding caused by this medication. Avoid exposure to sunlight or artificial UV rays (sunlamps or tanning beds). This medication can make your skin more sensitive to sunlight and sunburn may result. Use a sunscreen (minimum SPF 15) and wear protective clothing if you must be out in the sun. What then can we conclude about NSAIDs NSAIDs are very helpful in early stages of inflammation and should not be abused as a drug. Although it doesn't create dependency, continued usage may lead to other more serious problems. As a medicine or a synthetic drug, they have specific effects which are helpful for our body to recover from certain illnesses. On the other hand, synthetic drugs also bring about some side effects which may bring about more serious diseases and so we should be very careful in using these drugs. Although this is very helpful in patients with heart diseases, it is also very important to seek medical advice before using this since it would also have major effects on bleeding process. So before taking NSAIDs be sure to take full precautions. Reference: Ogbru, O. 2005, Nonsteroidal Antiinflammatory Drugs (NSAIDs) http://www.medicinenet.com/nonsteroidal_antinflammatory_drugs/article.htm Romanovsky, a. et.al., 2000. Neural Route of Pyrogen Signaling to the Brain (clinical Infectious Diseases2000;31:S162-S167 2000 by the Infectious Diseases Society of America. All rights reserved. 1058-4838/2000/3104S5-0004$03.00) http://www.journals.uchicago.edu/CID/journal/issues/v31nS5/000197/000197.html Dunitz, M., 2001. Non Steroidal Anti-Inflammatory Drugs in the Treatment of Sports Injury http://www.physioroom.com/injuries/supplements/nsaids.php Aspirin and Heart Disease (2006) http://www.yourfamilyshealth.com/cardiology/aspirin/ Aspirin in Heart Attack and Stroke Prevention (2007) http://www.americanheart.org/presenter.jhtmlidentifier=4456 December 2004. Public Health Advisory Non-Steroidal Anti-Inflammatory Drug Products (NSAIDS). http://www.fda.gov/CDER/Drug/advisory/nsaids.htm Read More