| NSAIDs
are frequently prescribed for many types of pain disorders. NSAIDs
are most useful for mild to moderately severe pain. They can be prescribed
as the only pain medicine but are commonly prescribed in combination
with other pain medicines, particularly when the pain is more severe.
How Do NSAIDs work?
NSAIDs work
in two ways to reduce and relieve pain. First, these medicines act
in the periphery (that is, the limbs, joints and trunk of the body)
to reduce inflammation that can be a primary reason for pain. Second,
NSAIDs work like other pain medicines such as narcotics to alter
the way in which the central nervous system- the spinal cord and
brain- interpret the pain signals coming from the nerves so that
the intensity of the pain signal can be reduced or eliminated. For
this reason your doctor may prescribe an anti-inflammatory medicine
for you even though you do not have a pain problem that is caused
by inflammation.
Each NSAID
has a maximum dose of effectiveness. That means that taking doses
above the prescribed dosage level will not produce any greater pain
relief and may lead to serious side effects or medical complications.
Do not take NSAIDs above the recommended dosage schedule. However,
many patients are reluctant to take their medicines and tend to
limit how often they take them, frequently taking less than is prescribed.
For many pain problems it is best to take NSAIDs on a regular schedule
to keep the pain under control. If your physician prescribes NSAIDs
for you on a regular time schedule (for example, every 6 or 12 hours),
it is advisable to keep to the schedule even when your pain does
not feel too bad. In this way you can avoid times when your pain
escalates to more severe levels.
The Family of NSAIDs
There are
more than 20 different kinds of NSAIDs. Some of these are well known,
such as Ibuprofen. Some NSAIDs are now available over-the counter
and do not require a physician's prescription. Examples of these
NSAIDs include Motrin IB, Nuprin and Alleve. NSAIDS that are available
over-the counter require a physician's prescription at higher doses.
Since there
is such a large family of NSAIDs, finding the right medicine for
you may take some trial and error. It is well known that a person
with a pain problem may respond to one NSAID but not another. As
a result, the only way to know if a particular NSAID is best for
your pain problem is to try it out and observe the results. If the
first NSAID that is prescribed does not adequately reduce your pain,
try not to get too discouraged. There are many NSAIDs to choose
from, and for the majority of patients an effective NSAID with minimal
side effects can be found.
Side Effects
of NSAIDs
Stomach upset
and indigestion are the most common side effects of NSAIDs. Taking
them with food or milk or immediately after a meal can reduce or
eliminate stomach upset. NSAIDs can also cause vomiting, constipation
and bleeding in the stomach. Signs of bleeding include if your stools
become bloody or darker than normal or if you notice that you are
bruising more easily. If this occurs, consult your physician or
nurse. Your physician may be able to change your NSAID prescription
to one that is less likely to upset you stomach or cause bleeding.
Some people
with bleeding or clotting disorders may not be able to take NSAIDs.
This is because NSAIDs prevent platelets- blood cells that help
blood to clot- from working correctly. When platelets don't work
well bleeding is more difficult to stop. This is why some people
who are receiving chemotherapy drugs that can lower platelets may
be cautioned against taking NSAIDs. Also, persons who are scheduled
to have surgery may be asked to stop their NSAIDs so that there
will be no problem with excessive bleeding during surgery.
Other potential
side effects of NSAIDs are dizziness, headache, ringing in the ears,
fluid retention, dry mouth, and increased heart rate. NSAIDs may
also produce kidney problems and stomach ulcers. Some NSAIDs can
cause liver damage and for this reason, people taking these medicines
should limit their intake of alcohol.
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