Non-steroidal anti-inflammatory drugs (NSAIDs), i.e., antipyretic and analgesic anti-inflammatory drugs, are used for rheumatoid and rheumatoid arthritis, fever and pain due to various causes, and also for the prevention of myocardial infarction and cerebrovascular accidents. Representative drugs include aspirin, indomethacin, ibuprofen and naproxen.

Classical drugs in this class, such as aspirin: mainly used for antipyretic and analgesic, anti-inflammatory and anti-rheumatic, preventing thrombosis. While playing an anti-inflammatory role, but also brought the corresponding gastrointestinal and renal damage and other side effects to the gastrointestinal tract is more prominent, mainly for gastric and duodenal ulcers and ulcer-induced upper gastrointestinal bleeding. Clinically, aspirin-induced ulcers are more common in elderly women, mostly painless, easy to perforate and bleeding; in addition to this will cause loss of appetite, nausea, vomiting, epigastric discomfort or pain, etc., and can be disappeared after stopping the drug.

Proton pump inhibitors (omeprazole, etc.) are the preferred treatment for upper gastrointestinal tract injury caused by NSAIDs. If taking misoprostol can also reduce the incidence of ulcers, take after meals, choose enteric-coated tablets or take antacids at the same time can reduce the damage to the gastric mucosa. Generally should not be combined with glucocorticoid drugs (such as dexamethasone, etc.), easy to induce and aggravate ulceration and bleeding.

At the same time there are some NSAIDs that have fewer adverse effects on the gastrointestinal tract, with significantly lower incidence of ulceration and bleeding than traditional NSAIDs, and less liver and kidney damage. For example, the highly selective COX-2 inhibitor celecoxib, but long-term use may increase the risk of cardiovascular thrombotic adverse events, myocardial infarction and stroke, and should be used with caution in patients with a predisposition to pre-existing thrombosis. Rofecoxib is also available in the same class.

bibliography

[1] XU Shangdong,TANG Fulin. How to use nonsteroidal anti-inflammatory drugs correctly[J]. Chinese Journal of Internal Medicine,1994(02):120-123.

[2] SUN Li. Clinical diagnosis and treatment analysis of upper gastrointestinal tract injury in the elderly caused by nonsteroidal anti-inflammatory drugs[J]. China Geriatric Healthcare Medicine,2016,14(06):47-48

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NSAIDs are commonly known as non-steroidal anti-inflammatory drugs, also called antipyretic and analgesic drugs, which are represented by aspirin, acetaminophen, diclofenac sodium, indomethacin, nimesulide, and others.

One of the same side effects of all these drugs is that they can damage the gastric mucosa, leading to gastrointestinal reactions and stomach disorders in patients. According to statistics in the clinic taking NSAIDs in patients with the occurrence of gastric disease is about 10%. These stomach diseases mainly include acute and chronic gastritis, peptic ulcer, erosive gastritis and so on.

About how NSAIDs can cause gastric mucosal damage and gastric disorders, Kirk is here to give you a brief explanation:

Non-steroidal drugs contain non-specific COX, this substance can make the gastric mucosa regeneration of prostaglandin E deficiency, leading to gastric mucosal repair disorders, resulting in erosion and bleeding, lesions occur in the gastric sinus and duodenal bulb, so the clinical emergence of enteric-soluble non-steroidal drugs, such as aspirin enteric-coated tablets, but enteric-soluble non-steroidal drugs, although it can alleviate the damage to gastric mucosa, but because non-steroidal drugs are mainly absorbed in the small intestine, so the non-steroidal drugs can still lead to the occurrence of acute gastritis. However, although enteric non-steroidal drugs can reduce the damage to the gastric mucosa, because non-steroidal drugs are mainly absorbed in the small intestine, so enteric soluble non-steroidal drugs can still lead to the occurrence of acute gastritis.

Therefore, Xiao Ke suggests that for patients who must take non-steroidal drugs can choose the type of drugs that are less harmful to the gastric mucosa, and can also add gastric mucosal protective agents when taking these drugs, such as magnesium aluminum carbonate, bismuth pectin and other drugs.

These are the views of Xiao Ke, welcome your questions and additions, pay attention to Xiao Ke, to learn more about health knowledge.

When it comes to NSAIDs, rheumatologists should be familiar with them. It is used as a first-line drug in the treatment of rheumatic diseases and is itself a large class of drugs that are corticosteroid-free and have anti-inflammatory, antipyretic and analgesic effects.

These medications we take everyday are also NSAIDs

But in fact, we everyday people commonly use them as well, like aspirin, indomethacin, ibuprofen and its extended-release capsules, fuselin, dyfenacin, loxoprofen sodium tablets, nimesulide, meloxicam, clonoxicam, celecoxib (Celebrex), erliximab, etoricoxib, and so on which all belong to the group of non-steroidal anti-inflammatory drugs (NSAIDs).

However, drugs have certain side effects. Especially for patients who need to take medication for a long period of time, this effect will be even greater.

Gastrointestinal discomfort is the most common adverse reaction

In contrast, the most common adverse effects of NSAIDs are gastrointestinal disturbances (including poor appetite, anorexia, abdominal pain, etc.), followed by abnormalities of liver and kidney function.

Specifically, there are also these adverse reactions:

1, Gastrointestinal injury, high incidence, mainly manifested as nausea, vomiting, epigastric pain, reflux esophagitis and so on.

2, renal damage, mainly nephritis, edema, with diuretics, hormones may increase the incidence of renal damage.

3, liver damage, can cause different degrees of liver damage, but rarely occur serious liver damage and jaundice. Reasonable application, generally will not occur. It is recommended to take it after meals, usually half an hour after meals, and drink water appropriately.

4, allergic reactions, aspirin is more often caused, the most common is asthma, asthma is prohibited. So try to choose the construction of simple drugs or drugs that do not contain nitrogen, choose drugs with a short half-life, such as naproxen, loxoprofen sodium, etc., the use of suppositories, creams, flurbiprofen babu cream, etc., to avoid the use of drugs with a long half-life, such as aspirin, anti-inflammatory pain and so on.

How to deal with gastrointestinal damage

The most common adverse reaction to NSAIDs is gastrointestinal, but it is completely avoidable and should be weighed against the pros and cons of being a first-line drug in the treatment of rheumatic diseases.

Use agents with low gastrointestinal irritation, such as enteric solvents, extended-release agents, suppositories, creams, flurbiprofen barb cream, and other topical medications.

Precursor drugs, it as inactive drugs absorbed through the gastrointestinal, in the body in the conversion to active drugs and play a role in severe gastrointestinal disorders can be used as the preferred agent, such as fen-phen, loxoprofen sodium and so on.

Selective prostaglandin analog (pain-causing substance) synthesis inhibitors that inhibit prostaglandin synthesis strongly at the site of inflammation with little gastrointestinal and renal damage, e.g., ibuprofen, naproxen.

Cyclooxygenase-2 selective inhibitors with minimal gastrointestinal irritation are used, e.g., cilostro, etoricoxib.

I hope you all know about these medications and take them scientifically in order to minimize the side effects Oh.