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posted by janrinok on Tuesday February 11 2020, @08:15PM   Printer-friendly
from the its-a-pain dept.

Choosing common pain relievers: It's complicated: Researchers examine benefits and risks of nonsteroidal anti-inflammatory drugs:

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


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  • (Score: 2) by RS3 on Tuesday February 11 2020, @09:35PM (11 children)

    by RS3 (6367) on Tuesday February 11 2020, @09:35PM (#956976)

    Awesome list. And in the elderly, especially if they have any other medical problems, fragility, etc., Fentanyl, Tramadol, and all opioids and synthetic opioids cause brain damage, sometimes life and personality-altering permanent brain damage.

    Starting Score:    1  point
    Karma-Bonus Modifier   +1  

    Total Score:   2  
  • (Score: 4, Interesting) by Freeman on Tuesday February 11 2020, @09:43PM (10 children)

    by Freeman (732) on Tuesday February 11 2020, @09:43PM (#956979) Journal

    Definitely sounds like something best left untouched. Even with all the stigma around weed, it does seem to be at least within the ballpark of alcohol trouble. Perhaps even less trouble than Alcohol, in which case, it should definitely be legalized. At least, I've not heard of a weed addict becoming horribly violent while under the influence. Then again, perhaps, it's just due to sample size and/or the fact that people don't want to get in trouble for partaking in an illegal substance. Still, would at least be worth it to do major studies to decide whether or not to make it legal.

    --
    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: 3, Funny) by RS3 on Tuesday February 11 2020, @10:07PM (7 children)

      by RS3 (6367) on Tuesday February 11 2020, @10:07PM (#956995)

      Weed addicts can get aggressive when they get the munchies, and only get violent if you take away their pizza.

      • (Score: 0) by Anonymous Coward on Tuesday February 11 2020, @11:27PM

        by Anonymous Coward on Tuesday February 11 2020, @11:27PM (#957012)
      • (Score: 0) by Anonymous Coward on Wednesday February 12 2020, @08:57AM (1 child)

        by Anonymous Coward on Wednesday February 12 2020, @08:57AM (#957135)

        The problem with Weed, at least, locally, is that there's a sizeable percentage of the population here using the stuff, and a number of them are innately violent shitheads, coming from families who have been innately violent shitheads for generations (verifiable, in some cases, at least back to early Victorian times through court records and newspaper archives).

        The local strain of choice is Skunk [wikipedia.org], and that really seems to bring out the 'best' in these stabby little fuckers..the sooner they all graduate to becoming spice [wikipedia.org] zombies, the better for the rest of us..

        It's disconcerting, to say the least, to travel on a bus where the driver stinks strongly of skunk, in fact, when you see someone lighting up on the streets it's more common for it to be skunk, any very uncommon now for it to be a plain old tobacco cigarette...

        • (Score: 0) by Anonymous Coward on Wednesday February 12 2020, @09:26AM

          by Anonymous Coward on Wednesday February 12 2020, @09:26AM (#957139)

          Chances are that flat screen TVs, video games, smartphones, weed and other decadence are pacifying the population.

      • (Score: 2) by Freeman on Wednesday February 12 2020, @04:23PM (3 children)

        by Freeman (732) on Wednesday February 12 2020, @04:23PM (#957220) Journal

        Same can be said for someone that's hypoglycemic.

        --
        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: 2) by RS3 on Wednesday February 12 2020, @06:01PM (2 children)

          by RS3 (6367) on Wednesday February 12 2020, @06:01PM (#957296)

          Interesting, but that has not been my experience.

          I had a brother who was an extremely "brittle" type-1 diabetic. He would often become hypoglycemic. He only got silly, goofy, giddy, etc. Convincing him to eat or drink anything was difficult. Many times he went into shock and became unconscious. Fortunately EMTs got there in time to give him IV dextrose. At least one time I had to give him a glycogen shot that saved his life, although he ended up in coma for 2 weeks. They said his blood sugar was 15, and likely much lower just before I administered glycogen.

          • (Score: 2) by Freeman on Thursday February 13 2020, @12:38AM (1 child)

            by Freeman (732) on Thursday February 13 2020, @12:38AM (#957508) Journal

            I don't doubt your experience and perhaps, the irritability is only in some people or in less severe cases, but it's definitely a possible symptom.

            If blood sugar levels become too low, signs and symptoms may include:

                    An irregular heart rhythm
                    Fatigue
                    Pale skin
                    Shakiness
                    Anxiety
                    Sweating
                    Hunger
                    Irritability
                    Tingling sensation around the mouth
                    Crying out during sleep

            https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685 [mayoclinic.org]

            --
            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: 3, Interesting) by RS3 on Thursday February 13 2020, @02:27AM

              by RS3 (6367) on Thursday February 13 2020, @02:27AM (#957556)

              Always remember the 2 words before that symptom list: "may include".

              With my brother we didn't know anything about his heart rhythm.

              Not sure about fatigue- his episodes came on very suddenly- he would go from normal to unconscious in a few minutes.

              Didn't notice pale skin (maybe happened too fast for color flush?)

              He would get shaky, but again, with him acting silly it's not easy to see shaky.

              Didn't notice anxiety- quite opposite- giddy.

              He would get sweaty- even his face would sweat.

              No change in hunger- had to convince him to drink something, like OJ, soda, dextrose tablet, etc.

              Not really irritable, mostly silly / giddy.

              Again, his hypoglycemic attacks were sudden, fast, and hard.

    • (Score: 3, Interesting) by dry on Wednesday February 12 2020, @06:50AM (1 child)

      by dry (223) on Wednesday February 12 2020, @06:50AM (#957117) Journal

      Weed when mixed with other drugs, especially alcohol, can lead to violence and likely occasionally on its own. Some people who are border line insane really shouldn't take weed. It has been known to kill people too, usually when a ton of it hits you in the head.

      • (Score: 2) by Freeman on Wednesday February 12 2020, @04:26PM

        by Freeman (732) on Wednesday February 12 2020, @04:26PM (#957222) Journal

        Well, I'd think it's quite likely for someone to die when a ton of anything hits you in the head.

        --
        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"