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To provide guidance to health care providers and their patients in their clinical decision-making, researchers from Florida Atlantic University's Schmidt College of Medicine have published a review in the Journal of Cardiovascular Pharmacology and Therapeutics addressing cardiovascular risks and beyond, which include gastrointestinal and kidney side effects of pain relievers. They examined the benefits and risks of over-the-counter and prescription drugs for pain relief such as aspirin, ibuprofen (Motrin or Advil), naproxen (Aleve), and prescription drugs such as diclofenac (Voltaren), a non-aspirin NSAID [Non-Steroidal Anti-Inflammatory Drugs], and selective cyclooxygenase-2 inhibitors such as celecoxib (Celebrex) as well as acetaminophen (Tylenol).
NSAIDs include aspirin, traditional non-aspirin NSAIDs such as ibuprofen, (Motrin or Advil), naproxen, (Aleve) and diclofenac, (Voltaren) as well as selective cyclooxygenase 2 inhibitors (COXIBs), such as celecoxib (Celebrex), and acetaminophen (Tylenol).
All of these drugs have benefits and risks. Aspirin decreases inflammation as well as coronary events and stroke, but increases gastrointestinal symptoms and bleeding, however, without adverse hepatic or renal consequences. Non-aspirin NSAIDs decrease inflammation, but have been associated with adverse major coronary events and stroke with long-term use as well as major upper gastrointestinal and kidney side effects, as well as electrolyte imbalances such as high sodium or potassium and even heart failure.
Cyclooxygenase 2 (COX2) inhibitors were developed primarily because of their more favorable gastrointestinal side effect profile relative to aspirin and traditional non-aspirin NSAIDs, but confer adverse cardiovascular as well as hepatic and renal effects. Acetaminophen has no clinically relevant anti-inflammatory properties and accounts for more than 50 percent of drug overdose related liver failure and about 20 percent of liver transplant cases, as well as kidney disease.
[...] "The factors in the decision of whether and, if so, which drug to prescribe for relief of pain and inflammation, should not be limited to risks of cardiovascular or gastrointestinal side effects. These considerations should also include potential benefits including improvements in overall quality of life resulting from decrease in pain or impairment from musculoskeletal pain syndromes," said Charles H. Hennekens, M.D., Dr.P.H., corresponding author, first Sir Richard Doll Professor and senior academic advisor in FAU's Schmidt College of Medicine.
Journal Reference:
Manas A. Rane, Alexander Gitin, Benjamin Fiedler, Lawrence Fiedler, Charles H. Hennekens. Risks of Cardiovascular Disease and Beyond in Prescription of Nonsteroidal Anti-Inflammatory Drugs$. Journal of Cardiovascular Pharmacology and Therapeutics, 2019; 25 (1): 3 DOI: 10.1177/1074248419871902
(Score: 3, Insightful) by Freeman on Tuesday February 11 2020, @08:30PM (7 children)
. . . ignorance is bliss?
Joshua 1:9 "Be strong and of a good courage; be not afraid, neither be thou dismayed: for the Lord thy God is with thee"
(Score: 5, Insightful) by ikanreed on Tuesday February 11 2020, @08:45PM (6 children)
I mean technically, I wouldn't think a lay person should derive medical advice from reading medical journals, especially single articles, as that can lack the holistic understanding that overall best practices are derived from, and the general expertise of an actual doctor. AC is right, don't get medical advice from the internet. Trying to do that makes you go crazy, and conjoined with how the internet unevenly spreads information(much less disinformation), you're gonna end up in a quack's scam following whatever you read online.
On the other hand, learning never hurt anyone, and as long as you don't get ultracrepidarian about it, learn as much as you can, the information could prove useful to you someday.
(Score: 2) by barbara hudson on Wednesday February 12 2020, @02:35AM (5 children)
SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
(Score: 2) by ikanreed on Wednesday February 12 2020, @02:19PM (4 children)
I would seriously argue that even if you kept up with an entire field of literature, and were generally a well educated person, there's still important things a bottom-of-class in medical school doctor might still be able to do better than you. Like diagnosis, which doesn't just entail knowledge of symptoms, but also the intuition derived from seeing hundreds of cases, and recognizing when something is "off" from the normal progression of a disease.
(Score: 2) by barbara hudson on Wednesday February 12 2020, @02:54PM (3 children)
SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
(Score: 2) by ikanreed on Wednesday February 12 2020, @02:57PM (2 children)
And you think that compares favorably to professional diagnosis?
(Score: 2) by barbara hudson on Wednesday February 12 2020, @04:30PM (1 child)
I've had 25 or 26 bone fractures - I'll trust my diagnosis over an xray because they miss half of them until years later when you can see the bone callus that forms around the break. Especially if you have preternaturally not-dense-enough bones to begin with (osteopenia, not osteoporosis - I've been breaking bones since my late 20s that shouldn't have broken).
In the end, any health care decisions are up to the patients, so might as well use the resources out there, such as the online libraries at the national institutes of health, to better inform your decisions, and know what questions to ask.
SoylentNews is social media. Says so right in the slogan. Soylentnews is people, not tech.
(Score: 2) by ikanreed on Wednesday February 12 2020, @04:35PM
I don't think people are stupid, save for a few specific counter examples that have removed all doubt as to that truth. I think medicine is a field where actual expertise matters.