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Monday, February 15, 2016

Physiotherapy and NSAID (Nonsteroidal anti-inflammatory drug) effect.

Bismillahirahmanirahim, I have some of the info to share regarding using NSAID without proper consultation by the Dr. This advise I always give concern to my patient for their understanding , Not depend on pain killer as it can cause a lot a trouble without you notice Of course some of you are familiar taking a painkillers types ibuprofen, mefenamic acid (constant) and diclofenac (Voltaren) for various problems.It's known pain medication is easily available as it can be bought in pharmacies and their prices are cheaper. Not only that, it is also effective to relieve headaches, joint pains and aches and pains quickly. Thus it became the drug of choice for some patients who experience frequent symptoms of migraine, gout and rheumatoid , muscle ache such as back and neck pain to. For you understanding Pain medications are categorized as NSAIDs  and  NSAIDs are non-steroidal anti-inflammatory drugs or anti-inflammatory drugs is not the kind of steroids.

Type of NSAID on market 

How NSAID react  in our body ?
When the body is inflamed, a chemical in the body called prostaglandin secreted who sent the message "sick" to the body. This prostaglandin production process catalyzed by an enzyme called cyclooxygenase (COX for short). There are two types of COX cyclooxygenase-1 and cyclooxygenase-2.Most analgesics inhibit both cyclooxygenase and ultimately inhibit prostaglandin. But there are newer drugs that are more sophisticated and very specific that only inhibit COX-2 only, is called "Cox-2 inhibitor." Two major effects of NSAIDs such as constant, ibuprofen and Voltaren, this is the effect of the stomach and affects the kidneys.

NSAID effect on the stomach

The stomach, the effect of NSAIDs is dependent on the dose taken.
Effects on the stomach:
-          Begins with a sense of abdominal discomfort, bloating and wind out.
-          Stomach pain (gastritis)
-          Stomach ulcers (gastric ulcer)
-          Stomach started bleeding (gastrointestinal bleeding)
-          Perforated stomach (gastro perforation)
The effects of the stomach caused by two things, namely irritation to the stomach lining cells directly or indirectly.
Some NSAIDs consists of acid molecules that can cause injury to the lining of the stomach directly. Indirectly, the obstruction to the enzyme cyclooxygenase-1 causes prostaglandin that protects the stomach stops. This causes abdominal wound exposed to acid produced by the stomach cells themselves.
The use of NSAIDs in an uncontrolled manner, particularly to patients who are aged 60 years and above can cause serious stomach bleeding. Sometimes a Voltaren injection in patients who are elderly may cause bleeding which eventually led to hospitalization. Sometimes the bleeding is not noticed by the patient and at first did not hurt.

NSAID Effect on the Kidney

One of my Friend is  a Nephrology and internal physician ,he talked and mention to me  many younger patients get into position he was in charge due to a late-stage kidney failure (end stage renal failure) caused by taking painkillers in an uncontrolled manner. If this happens, the patient had to undergo continuous hemodialysis because of kidney failure. In general, NSAIDs can cause decreased blood flow to the kidneys caused by contraction of blood vessels. This mechanism occurs due to lack of prostaglandin whose function is to expand the blood vessels to the kidneys. Chronic kidney patients where renal still have some function, or having only one kidney only, you can not take this kind of pain medication. The term is advice by him and I always use it to give advice to my patient .

NSAID effect on pregnancy
NSAIDs should be avoided for pregnant women after 6 months. It is not classified in the drugs that can cause disability but there is a risk to cause heart and kidney problems to the content at a later date.

NSAIDs inhibit the production of prostaglandins by blocking both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) are not specific to any action on COX-1 causes a lot of problems to the body.

What if scientists produce a selective NSAIDs only on COX-2?
Therefore drugs selective COX-2 was produced as Celecoxib (Celebrex) and Eterocoxib (Arcoxia).these drugs reduce the effect of gastritis patients who do not have stomach problems before.However, if there is a problem of bleeding in the stomach before, this use is also not recommended.Rofecoxib (Vioxx) is a popular pain medication but has withdrawn its application for a study on high heart problems by users. For kidney patients, a barrier selective COX-2 is also to be avoided.

As a Physiotherapist I know its not in my position to talk regarding a drug user , but as ethic in my profession I always mention to all my patient Please be careful in the use of pain medication to excess. One of them is the use of NSAIDs as drugs in the long term. This medicine can cause stomach bleeding problems and kidney problems that remain. Please see a doctor when taking medication, that medication is more appropriate to the patient's condition can be given. Avoid becoming a doctor or get advice from a doctor backyard (neighbors or relatives who do not have credentials) while taking pain medication. Avoid taking excessively. Wallahuaklam.

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