What Are the Most Common NSAID Side Effects?

Anti-inflammatory drugs are drugs used to treat inflammation that occurs in response to tissue damage. There are two major classes of anti-inflammatory drugs: one is a steroidal anti-inflammatory drug, and the other is a non-steroidal anti-inflammatory drug, which is an antipyretic and analgesic anti-inflammatory drug referred to in medical practice, such as aspirin.

Anti-inflammatory drugs

Anti-inflammatory drugs are drugs used to treat inflammation that occurs in response to tissue damage. There are two major classes of anti-inflammatory drugs: one is a steroidal anti-inflammatory drug and the other is

Non-steroidal

Antipyretic and analgesic anti-inflammatory drugs are a class of drugs that have antipyretic and analgesic properties, and most have anti-inflammatory and anti-rheumatic effects. Because its chemical structure and anti-inflammatory mechanism are different from glucocorticoid steroidal anti-inflammatory drugs (SAIDS), it is also called

Mechanism of NSAID

Different types of NSAIDs have the same mechanism of action. They are through inhibition

(One)

1. Individual dose. It should be clear that even if administered by weight, blood drug concentrations can still vary from individual to individual. Different doses should be selected for different patients in conjunction with the clinic. The elderly should use drugs with short half-life.

2. Generally, one NSAID is selected, and it is not effective after 2 to 3 weeks of full use, then the other is replaced, and the dose is gradually reduced after it is effective.

3 It is not recommended to use two NSAIDs at the same time because the efficacy does not increase and the side effects increase.

4 When there are 2 or 3 gastrointestinal risk factors, drugs to prevent ulcer disease should be added, or a selective COX-2 inhibitor (such as celecoxib) should be selected with high gastrointestinal safety.

5. Use a suitable NSAID (such as sulindac) when there is one kidney risk factor. Avoid NSAID when there are more than two kidney risk factors.

6. When using NSAID, pay attention to the interaction with other drugs, such as -receptor blockers can reduce the efficacy of NSAID; when using anticoagulants, avoid taking aspirin at the same time; when combined with digitalis, pay attention to prevent digitalis poisoning.

Non-steroidal anti-inflammatory drugs are relative to hormones. Their chemical structure lacks the steroid ring of hormones, hence the name. It has antipyretic, analgesic and anti-inflammatory effects and is the first-line drug for rheumatic diseases. For some rheumatic diseases, such as early rheumatoid arthritis, senile arthritis and early ankylosing spondylitis are the drugs of choice. There are many types of these drugs, currently the most commonly used are acetylsalicylic acid (that is, aspirin), indomethacin, ibuprofen, fenbutide, vortalin, celecoxib, and chinolide. Although this type of drug works by reducing the synthesis of prostaglandins in the body, there are some subtle differences between various drugs, such as selective non-steroidal anti-inflammatory drugs (such as celecoxib) can be selected It can reduce the synthesis of prostaglandin and reduce side effects such as gastrointestinal damage. So what to use and how to use it, doctors need to give guidance according to the specific situation of the patient. A common phenomenon in the use of non-steroidal anti-inflammatory drugs by patients is that many patients cannot take the drug continuously because of fear of side effects of the drug, often "three days fishing, two days exposure to the net", only when the symptoms are severe The drug is only used when the pain can not be tolerated, which affects the efficacy. The patient has a question of "whether the drug is effective". It should be pointed out that most non-steroidal anti-inflammatory drugs are relatively safe. Can get better results.

There are many commonly used non-steroidal anti-inflammatory drugs, which can be roughly divided into the following categories:

(1) Salicylic acid: The most commonly used is acetylsalicylic acid, which is aspirin. Its efficacy is relatively positive, but the side effects are also very obvious. Aspirin preparations are mostly enteric-coated tablets. When used for antipyretic and analgesic use, they are usually 0.3 to 0.5 g each time, 3 times a day, and taken orally after a meal. When used against rheumatism, 3 to 4 times a day, 1.0-1.5 grams each time. Pay close attention to its side effects, such as the drug has an anti-platelet agglutination effect, so there may be bleeding when taken continuously for a week.

(2) Propionic acid: The common varieties in the market are: ibuprofen, fenbilide, naproxen and so on. Fenbid is a slow-release agent of ibuprofen, which has fewer adverse reactions and is easy for patients to receive. Naproxen has a longer half-life of 14 to 16 hours, which can be taken 1 to 2 times a day. Usage: Ibuprofen 0.4-0.6 grams each time, 3 times a day; fenpyridine 0.3-0.6 grams each time, 2 times a day; naproxen 0.5-0.75 grams each time, 1 or 2 times a day.

(3) Indole: there are indomethacin (indomethacin), chinolide (sulindac), and the like. These drugs have outstanding anti-inflammatory effects, and their antipyretic and analgesic effects are similar to those of aspirin. Among this class of drugs, indomethacin has the strongest anti-inflammatory effect, and Chinory has the smallest renal toxicity. Usage: Indomethacin is taken orally 3 times a day at 50 mg each time; Chinoris 2 times a day at 0.2 to 0.4 g each time. The elderly and those with renal dysfunction should be listed as the first choice.

(4) fenamic acid: mefenamic acid, chlorfenamic acid, diclofenac and flufenamic acid. Clinically, flufenamic acid is used more frequently, 0.2 g 3 times a day.

(5) Acetic acid: Diclofenac sodium, that is, voltafil is the most commonly used. Usage: 50 mg 3 times a day. It has not only oral preparations, but also latexes and slow-release agents that can be applied topically to reduce gastrointestinal side effects. Its efficacy is certain.

(6) Xikang: Inflammatory Xikang, etc., because of its large side effects, it has been rarely used.

(7) Pyrazolones: There are Butaxone, Hydroxyl Butaxone, etc. Due to its high toxicity, this medicine has been rarely used.