This article is in our series on Medications for Pain…  What are your choices?  How do various medications work?  What are the pros and cons?  How about side effects?

Today we’ll discuss a class of medication called NSAIDS (Non-Steroidal Anti-Inflammatory Drugs).  The 3 types of medication in this class are:

• Aspirin
• “Non-selective” cox inhibitors, e.g. Motrin (Ibuprophen).  (The “cox” simply relates to an enzyme in our bodies involved in inflammation.)
• “Selective” cox-2 inhibitors, e.g. Celebrex

Effect of NSAIDS:  NSAIDS block inflammation from occurring, and thus stop the pain that’s caused by inflammation.

Uses of NSAIDS:  Because NSAIDS block inflammation, they’re helpful in disorders that have inflammation, such as arthritis and some types of back pain.  They don’t help in pain disorders that don’t have inflammation, such as fibromyalgia.

Potential Side Effects:

• Bleeding
• Stomach upset
• Asthma (in 10% of people)
• Kidney problems
• Cox-2 medications increase clotting, which can cause heart attacks and stroke.  This is why some of these medications have been taken off the market.
• Liver toxicity above recommended doses

While these medications can be helpful, don’t eat them like candy.  They’re not benign!  Many people don’t recognize this, as they’re sold over the counter, and so are assumed to be perfectly safe.  There is even discussion going on currently that some dosages of these medications should not be available without a prescription.  We’ll have to see how this debate ends.

Interesting fact:  In studies, there is no difference in effectiveness between 1 medication in a class and another.  Therefore generic aspirin is just as good as Bayer.

In this series:

1. Medication for Pain Series 2009
2. Aspirin, Motrin and NSAIDS
3. Anticonvulsants
4. Antidepressants
 

 

 

 

 

 

 

 

 

5. Anesthetics
6. NMDA receptor antagonists (e.g. Ketamine)
7. Muscle relaxants
8. Blood Pressure Medication 
9. Narcotics (Opiates)
10. Anti-Psychotics 
11. Medication Advances Coming Soon
12. Research Advances

 

Thanks to Canardo at Flickr for the photo.