What do ibuprofen and other anti-inflammatory medications do to the body? How do they work and
what are some common side effects that you should watch out for? There are definitely some things
that you should know about these medications before taking them. So let's get started.
I once had someone tell me that they were taking an ibuprofen daily. This hadn't
been recommended by their doctor or anyone else, but they just found that it made them
feel better and they really didn't think that there could be any harmful effect.
Now the problem is that this person was actually diabetic. They also had high
blood pressure and they could have had compromised renal function. Now,
a lot of these medications like Ibuprofen, Naproxen, and Diclofenac are available at
your local pharmacy without a prescription. Because of this, it leads a lot of people
to believe that the side effects that these medications present would not be very harmful.
But there are some things that we should keep in mind. So how do anti-inflammatory medications
like these ones work in the body anyway? These medications belong to a class of medications
called NSAIDs or non-steroidal anti-inflammatory drugs. These drugs work by inhibiting enzymes
called cyclooxygenase enzymes or COX-1 and COX-2 for short. COX-1 is responsible for the synthesis
of prostaglandins that are responsible for some of the physiological processes in the body,
including blood clotting and protection of the stomach lining. COX-2 is mostly associated with
pain and inflammation, and so it's really COX-2 that we want to be targeted however, Being that
these are non-selective anti-inflammatory drugs, they do not selectively target the COX-2 enzyme.
So essentially these NSAIDs inhibit both COX-1 and COX-2. However, they do have a greater ability to
inhibitCOX-2, but not without these side effects caused by inhibiting COX-1. So by inhibiting
these enzymes, medications like NSAIDs do work to inhibit pain and make pain feel more manageable.
However, there are certain side effects that are caused by this mechanism of action. With
prolonged use, these medications can cause gastric ulcers. They can also increase risk
of bleeding. They can cause issues with blood pressure, and yes, they can also compromise
kidney function in some people. In regards to kidney function, NSAIDs have the ability to
decrease blood flow to the kidneys, and in this case it can cause compromised kidney function.
Like I said, especially if use over a prolonged period of time, if you are
already on medications like an ACE inhibitor or an angiotensin receptor blocker seen here,
this can put you also at increased risk if you are using an NSAID. In addition,
if you are on any kind of diuretic and or something called an SGLT2 inhibitor for diabetes,
this would put you at increased risk for compromised renal function.
if you're getting value out of this video, don't forget to subscribe with notifications
for future videos. Now, it's important to be aware that the risk of acute kidney injury
increases if the patient is dehydrated and this can happen due to high temperature or in
the case of a viral illness if the person is not maintaining adequate hydration.
This can have a domino effect for patients who are taking medications that are cleared
by the kidneys, such as Sulphonylureas seen here. What happens is these medications can
start to build up in the body and cause something called hypoglycemia,
and so we definitely don't want that happening if it's at all avoidable.
In these cases, there are other options that may be more realistic and more beneficial. In your
particular case, there are non-drug measures that we can use to help you cope with pain
and to help lessen your pain. Sometimes acetaminophen is a better option over a
non-steroidal anti-inflammatory medication and other times we have topical creams or ointments
that can be available over the counter or even be specially made by prescription that often has
the same ingredients that you would find over the counter orally, but are given in a topical cream
and thus have less systemic side effects. If you are interested in more information
on what these topical creams are and what the active ingredients are, I will refer you to
this interview with Graham Mackenzie who compounds medications for pain that can be used topically.
It's a fascinating interview. You will learn a lot, and he actually uses dermatome maps to
target the specific area of pain, sometimes even using multiple ingredients, but again,
without the systemic side effects that we see with oral medications.
As healthcare professionals, we know that it is always the best option to
use the lowest dose of medication for the shortest period of time.
But there are occasions where a person needs to be on one of these pain relievers long-term. In
this case, it's a good idea to ask your healthcare provider for follow-up lab work within two weeks
of starting one of these medications orally, and then periodically every so often after. It's very
simple for your doctor to check your kidney function via blood work and sometimes via a
urinalysis just to make sure that your kidneys are not suffering any consequences of being on this
medication or of any possible interactions with the medications that you are taking. Remember,
if you are on anti-inflammatories, it's very important that you stay well hydrated.
It's also important to watch out for any of the more common side effects
with these medications and seek care immediately. If you experience any side
effects such as stomach pain, unusual bruising, swelling, lower urine output,
or confusion, or any other symptoms that may be bothersome, I hope this has been helpful.
Thank you so much for joining me. Take care and stay healthy.