Usually, there is a pain in the waist and legs, headache and fever. People will use this medicine more often. The effect seems to be OK, but if you don’t use it well, it may cause gastrointestinal bleeding, liver, kidney and other organ damage.
1. Introduction to non-steroidal anti-inflammatory drugs
The type of drugs I talk about today are non-steroidal anti-inflammatory drugs (NSAIDs), which have antipyretic, analgesic, and anti-inflammatory effects. They are widely used in rheumatic diseases, inflammatory diseases, pain, soft tissue diseases, exercise injuries and Alzheimer's disease. Common drugs include aspirin, ibuprofen , diclofenac , indomethacin, celecoxib, etocoxib, etc. If you use one of these drugs, today's knowledge is very important to you and can help you use the drugs correctly and safely.
Nonsteroidal anti-inflammatory drugs mainly affect PG metabolism by combining a substance (cyclooxidation enzyme: COX), and ultimately exert antipyretic, analgesic and anti-inflammatory effects. classification: can be divided into long-acting (such as piroxicam, nabumeone ) and short-acting (such as ibuprofen, diclofenac sodium ). According to the specificity of COX, it can be divided into non-selective inhibitors (such as naproxen , ibuprofen, dichlorophenic acid, indomethacin, flubiprofen ester, ketorolac), selective cyclooxygenase-1 inhibitors (such as aspirin), selective cyclooxygenase-2 inhibitors (such as nimesulil , meloxicam, celecoxib, rofecoxib , loxoprofen, etc.). Different types of drugs, the length of time the drug acts, and the occurrence of adverse reactions are also different.
2, Common side effects of non-steroidal anti-inflammatory drugs
Adverse reactions (side effects) are mainly manifested in the following aspects:
1. Gastrointestinal damage: mainly manifested in gastric and duodenal erosion, ulcers, and life-threatening gastrointestinal perforation and bleeding. (Nonselective NSAIDs > Selective COX-2 inhibitors)
2. Renal damage: mainly manifested as acute renal insufficiency, interstitial nephritis, renal papillary necrosis, water and sodium retention, hyperkalemia , etc. Indomethacin can cause renal failure and edema, and ketoprofen can cause membranous nephropathy .
3. Liver damage: It is mainly manifested as abnormal liver function indicators (hepatic enzymes), from mild liver enzyme to severe hepatocyte necrosis.
4. Hematological system damage: Almost all NSAIDs can inhibit platelet aggregation, prolong bleeding time, and can also lead to aplastic anemia and granulocyte reduction.
Although there are the above common adverse reactions, it should be noted that not everyone will. As long as it is used correctly, the safety of this type of drug is good. If there are any indications in life, you must use it according to the specific circumstances under the guidance of a doctor.
3. Nonsteroidal anti-inflammatory drugs are not suitable for the population
There are some people who are not suitable for use, the details are as follows:
① Active gastrointestinal ulcers or recent gastrointestinal bleeding are prohibited, coronary artery bypass surgery is prohibited;
② Those who are allergic to aspirin or other NSAIDs, or have a history of allergic diseases caused by other causes, including asthma , bronchospasm , rhinitis , angioedema, and urticaria, should be taken with caution.
③For renal insufficiency, propionic acids such as ibuprofen and ketoprofen should be used with caution.
④ For hypertension and congestive heart failure, NSAIDs can easily cause water and sodium storage, and antagonistic diuretic effect will aggravate the condition, so use it with caution.
⑤ Use caution for people with liver insufficiency and leukopenia.
⑥ Pregnancy and during lactation, generally, you should avoid using it. If you really need to use it, you must weigh the pros and cons (low dose, low frequency).
⑦ For the elderly, those who take oral anticoagulants and hypoglycemia drugs, attention should be paid to the interaction between drugs.
⑧ Those who are allergic to sulfonamide drugs will be prohibited from using non-steroidal anti-inflammatory drugs containing sulfonamide structures.
4. Precautions for using non-steroidal anti-inflammatory drugs
When using non-steroidal anti-inflammatory drugs, the following issues need to be paid attention to:
(1) Potential side effects of non-steroidal anti-inflammatory drugs must be monitored for relevant indicators (full blood cell count, renal function, liver function and blood pressure, etc.);
(2) Dosage Individualization: The elderly choose drugs with half-life short;
(3) For patients at risk of gastrointestinal bleeding, it is recommended to use selective COX-2 inhibitors, or misoprostol or PPI treatment to reduce the risk of gastrointestinal bleeding;
(4) Use one NSAIDs drug, gradually increase the dosage, and if the dose is ineffective after sufficient treatment for 2 to 3 weeks, the other type can be changed, and the dosage will be gradually reduced after effective. It is not recommended to use two NSAIDs at the same time, because the efficacy does not increase, and the side effects increase;
(5) When there are 2 to 3 gastrointestinal risk factors, it is recommended to add drugs to prevent ulcer disease, and the first choice is PPI with strong acid inhibition;
(6) If the patient is at a moderately high risk of cardiovascular events and is taking small doses of aspirin, in the treatment of relieving joint pain, it is recommended to give acetaminophen or naproxen, because selective NSAIDs and other non-selective NSAIDs may increase cardiovascular risk.
(7) For patients with renal insufficiency, it is recommended to avoid the use of selective and non-selective NSAIDs;
(8) Patients with abnormal liver function should be cautious when using NSAIDs, and liver function monitoring should be carried out during use;
(9) If patients use warfarin, heparin and other anticoagulants, or if the patient has thrombocytopenia , non-selective NSAIDs should be avoided because it may increase the risk of bleeding;
(10) Pay attention to the interaction with other drugs, and use the drug in combination (at the same time, low-dose aspirin, glucocorticoid or anticoagulant) significantly increases the risk of NSAIDs-related gastrointestinal damage.
(11) Do not take non-steroidal anti-inflammatory drugs after drinking to prevent further gastrointestinal bleeding.
5. Summary
In daily life, people are mostly exposed to non-steroidal anti-inflammatory drugs, using this type of drugs to relieve pain and reduce fever. I would like to remind everyone that there are individual differences in the tolerance and efficacy of different drugs. It is not recommended to take it yourself or for a long time. To ensure safety and reduce the risk of adverse drug reactions. Please use it reasonably under the guidance of a doctor or professional to maximize the value of drug treatment and ensure the safety of medication.
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