You can stock up on nonsteroidal anti-inflammatory drugs, but don’t take them randomly

This is the 4164th article of Da Yi Xiao Hu

After the comprehensive optimization of the epidemic prevention policy, many friends have started to stock up medicines in various ways. There are even "COVID-19 medicine order charts" and "COVID-19 medicine stockpiling lists" circulating online, which have gone viral on social platforms, and ibuprofen and acetaminophen have become hot search terms. Don't take so many medicines randomly after stockpiling them.

Tylenol, Tylenol, Gankang, Baijiahei, Keganmin, Day and Night Baifuning, Lesong, Difen, all have the effect of reducing fever, relieving pain and anti-inflammatory. Their main ingredients are all a class of drugs: called non-steroidal anti-inflammatory drugs. It’s just that some of them are combined with other ingredients to relieve symptoms such as nasal congestion and runny nose. Next, Dr. Han will take you to learn about non-steroidal anti-inflammatory drugs in all aspects.

What are nonsteroidal anti-inflammatory drugs?

Non-steroidal , literally, means anti-inflammatory drugs that do not contain steroidal structures. Generally speaking, they are a class of anti-inflammatory drugs other than steroid hormones. Since the first synthesis of aspirin in 1898, there have been more than 100 types and thousands of brands of this type of drug on the market, including ibuprofen (Fenbid), acetaminophen (Tylenol), loxoprofen (Lesong), diclofenac sodium (Difen) and many other familiar drugs.

Anti-inflammatory drugs are not the same as the anti-inflammatory drugs we usually refer to. The anti-inflammatory drugs we usually refer to are antibiotics that resist bacterial infections, such as penicillin, cephalosporin, levofloxacin, etc. Non-steroidal anti-inflammatory drugs resist non-infectious inflammations such as rheumatoid arthritis and ankylosing spondylitis.

Role of nonsteroidal anti-inflammatory drugs

Simply put, it can relieve fever, relieve pain and fight inflammation.

Antipyretic

It restores the set point of the temperature regulation center in the brain to normal to lower body temperature, but it will not affect the body temperature of normal people.

Analgesia

It is mainly effective for moderate dull pain such as headache, toothache, neuralgia, joint and muscle aches, menstrual pain, etc. It is ineffective for severe pain such as gastrointestinal spasms, colic or trauma. It is generally not addictive when used for a long time.

Anti-inflammatory

We need to know the process of inflammation in the body, which requires us to understand an enzyme called cyclooxygenase (COX), which can convert arachidonic acid metabolites into prostaglandins and other inflammatory and pain-inducing substances, thus inducing inflammation. Nonsteroidal anti-inflammatory drugs play an anti-inflammatory role by inhibiting COX and reducing the production of prostaglandins.

Side effects of NSAIDs

All medicines are toxic. Although nonsteroidal anti-inflammatory drugs are effective, side effects are also common, so you should not take too much, let alone take them repeatedly. The main side effects are as follows.

Gastrointestinal reactions

The most common reaction is gastrointestinal reaction: stomach pain, nausea, acid reflux, heartburn, vomiting, etc. Especially for those with gastric ulcer or chronic gastritis or long-term use, it may cause gastrointestinal ulcer or even bleeding.

Renal impairment

It can cause edema, decreased renal function, etc. Especially for patients with renal insufficiency, they should try to avoid self-use of non-steroidal drugs.

Liver damage

It may cause elevated liver enzymes, especially when taking medicine after drinking alcohol, which is more likely to cause liver damage and in severe cases may cause liver cell necrosis.

Cardiovascular adverse reactions

Long-term use may increase the risk of cardiovascular disease, hypertension, and stroke.

Blood system damage

It can cause a decrease in white blood cell and platelet counts, inhibit platelet aggregation, prolong bleeding time, and may even cause hemolytic anemia.

Induce allergic reaction

For example, skin rashes, allergic rhinitis, asthma, and a few people may experience dizziness, tinnitus, hearing loss, and trance.

How to take nonsteroidal anti-inflammatory drugs?

1. Eat after meals

In order to avoid gastrointestinal side effects, nonsteroidal anti-inflammatory drugs should be taken 15 to 30 minutes after a meal, or eat something before taking the medicine. This can significantly reduce the irritation of the drug to the gastrointestinal tract.

2. Don’t drink alcohol

Alcohol can increase the side effects of drugs on liver damage and gastric mucosal damage. So remember not to drink alcohol when taking medicine.

3. Not used in combination

Do not use two or more nonsteroidal anti-inflammatory drugs at the same time.

4. Do not exceed the amount

Non-steroidal anti-inflammatory drugs have a ceiling effect. Even if you take more, the efficacy will not increase, but the side effects will increase significantly.

5. Not suitable for use with anticoagulants

Such as warfarin, because it may increase the risk of bleeding.

6. Not taking precautions

Nonsteroidal anti-inflammatory drugs only have an antipyretic effect after fever and an analgesic effect after pain, but cannot prevent fever and pain.

7. Not commonly used

For pain caused by migraine, muscle and joint pain, and rheumatic diseases, you should focus on controlling the disease itself, try to avoid long-term use, and must use it according to the doctor's advice.

Author: East China Hospital Affiliated to Fudan University

Han Rui, attending physician of the emergency department