DRUGS USED INAPPROPRIATELY CAN BE DESTRUCTIVE PAIN KILLERS

DRUGS USED INAPPROPRIATELY CAN BE DESTRUCTIVE
PAIN KILLERS
The major problem with non-steroidal anti-inflammation agents (NSAIDS) like butazolidine, indomethacin (indocid), diclofenac, naproxen, piroxicam, ketoprofen is gastro intestinal toxicity.
Prostaglandins of the E series play a major role in gastrointestinal defence mechanisms. By depleting mucosal prostaglardin levels, aspirin and NSAIDS impair this cytoprotection resulting in mucosal injury, erosions and ulceration.
NSAIDs can lead to gastric ulcers (ulcers of the stomach). They also reduce the integrity of the duodenal mucosa (inner lining of the duodenum).
They are responsible for some cases of duodenal ulcer.
They greatly increase the risk of bleeding or perforation from pre-existing gastric (stomach) and duodenal ulcers.
Giving these drugs to the following people increase these risks:
 Over the age of 60
 With a past history of peptic ulcer
 Using a corticosteroid such as prednisolone
 Using a high dose of the drug or using multiple NSAIDs
Individual NSAIDs with the highest risk for ulcer include
 Piroxicam
 Ketoprofen
Individual NSAIDs with the least risk is Ibuprofen.
These NSAIDs and aspirin are pain killers. Many elderly people especially in the rural areas have various degrees of joint and bone pains for which they take pain killers regularly. Some patent medicine dealers and health workers occasionally combine these drugs and give people. This has led to an upsurge in cases of ulcer or gastrointestinal disturbances noticed these days.
It is important to note the following:
 Paracetamol remains the safest pain killer and can be used in the elderly and those who have ulcer
 Ulcer must be ruled out before a NSAID or Aspirin is prescribed.
 There is need to avoid prescribing two or more NSAIDs for one patient at the same time. Feldene and Ibuprofen should not be prescribed at the same time.
 There is need to use NSAIDs with least toxicity as much as possible like ibuprofen.
 Omeprazole is more effective than either misoprostol or ranitidine (Zantac) in healing peptic ulcers in patients taking NSAIDs.
 Omeprazole also prevents NSAIDs – induced ulcer formation.
TRADITIONAL HERBAL CONCOTIONS
Some Traditional Herbal Practitioners have claimed that they have remedies that can cure AIDS (acquired immune deficiency syndrome), diabetes mellitus, asthma, hypertension, peptic ulcer disease, etc. They give various concoctions to effect such cure. It has been observed that many people who take such treatments end up in the Teaching Hospitals with renal failure or liver failure and many die. Some had injury to the urinary bladder with bloody urine in taking herbal remedies.
There is need to standardize traditional herbal practice. Dosages of drugs should be standardized to avoid over-dosage which can damage the kidneys and/or the liver.
Chemical Constituents of each herbal concoction should be known and toxic substances that can damage the kidney and/or the liver cells or other cells of the body removed. Only chemical constituents necessary to cure a particular ailment should be given to patients. There is need to develop this sector to meet the criteria for standard medical practices across the World.
CHAPETR