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Tag: NSAID

  • Five things to know about gout

    Five things to know about gout

    Gout can be a painful health condition, often a type of arthritis, which generally involves swelling in the joints and can be extremely painful. About 9.2 million Americans live with gout. With gout, your body produces more uric acid than your kidneys are able to filter out. Fortunately, gout can usually be treated, and you can live a productive life. Here are five things you should know about gout:

    1. Who is likely to get gout?
      • About nine million adults experience gout at some point in their lives. Adults are prone to get gout, particularly men between 40 and 50. Current thinking is that gout runs in families, so whether you get it may spend on your genes. People who are overweight, who drink a lot of alcohol, or eat a lot of purines, such as high-fructose corn syrup, beer and scallops, are also more prone to gout.
      • Older people are also more likely to get gout because their kidneys are not working effectively to remove uric acid in their systems. And some medications, such as diuretics, also can lead to gout.
    2. What causes gout? When you have an excess of uric acid in your system, needle-like crystals of uric acid can build up and end up in your joints or soft tissues. There, they cause gout, an inflammation and swelling, redness, heat, and stiffness in the joints that can be very painful.
    3. What are the symptoms of gout? Often, people get gout first in the big toe, but not always. Sometimes, people get gout in their feet or ankles, knees or wrists, fingers and elbows. And sometimes the uric acid crystals end up in the kidneys and cause kidney stones. You can have an excess of uric acid without experiencing any symptoms, and then there’s generally no cause for concern or treatment. Treatment is needed when there is intense swelling or pain in the joints.
    4. What are the triggers for painful symptoms of gout? Alcohol, drugs and stress are often triggers for a painful attack of gout, which usually begins at night and can last for three to ten days. The pain will typically end on its own, without treatment, but the swelling and pain can return at any time. There is an advanced and disabling stage of gout, in which the joints are permanently affected. With proper treatment, however, most people with gout never experience this stage.
    5. How is gout treated? Gout is commonly treated with Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), which are taken by mouth, or corticosteroids, which are taken by mouth or by injection. With proper treatment, most people with gout can live pain-free or close to it.

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  • Talk to your doctor before taking a cold medicine

    Talk to your doctor before taking a cold medicine

    With cold and flu season in full swing, people with high blood pressure that is not controlled well or who have heart disease need to be careful with over-the-counter cold medicines, as they may cause a spike in blood pressure.

    Many cold medicines contain decongestants and nonsteroidal anti-inflammatory drugs (NSAIDs), both of which can raise blood pressure. Examples of decongestants are pseudoephedrine and phenylephrine. Some NSAIDs are Advil (ibuprofen) and Aleve (naproxen).

    “People with uncontrolled high blood pressure or heart disease should avoid taking oral decongestants,” Sondra DePalma, a physician assistant at UPMC Pinnacle in Pennsylvania, told American Heart Association News. “And for the general population or someone with low cardiovascular risk, they should use them with the guidance of a healthcare provider.”

    Guidelines released last year by the American Heart Association and the American College of Cardiology dealing with high blood pressure management say that decongestants should be used for as short a time as possible, and to try alternatives such as nasal saline or antihistamines.

    Regarding NSAIDs, guidelines say to use Tylenol (acetaminophen) or topical NSAIDs as other options.

    Healthcare professionals also say if your cold symptoms are mild or moderate, rest and drink plenty of fluids. Avoiding dehydration can help reduce body aches and may reduce the need for decongestants.

    This article was originally published in Medshadow.org

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  • Advil and Aleve increase risk of stroke and heart attack

    Advil and Aleve increase risk of stroke and heart attack

    According to the FDA, use of NSAIDs, (nonsteroidal anti-inflammatory drugs,) such as Advil (Ibuprofen) and Aleve (Naproxen), increase your risk of stroke and heart attack. As a result, the FDA now requires drug labels for all prescription NSAIDs to warn people of this risk. Over-the-counter non-aspirin NSAIDs also must contain this information.

    People have been using NSAIDs since 1999 to treat pain and fever stemming from, among other things, colds, flu, arthritis and headaches. They offer less risk of gastrointestinal bleeding and other problems associated with other pain medications. But, over time, the FDA has seen greater risk from these drugs.

    How much Advil and other NSAIDs is too much, you ask? Read the label on the bottle, and talk to your doctor. Here’s more information from MedlinePlus, a resource of the U.S. Information Library of Medicine.

    The new FDA warning says:

    • The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID.
    • The risk appears greater at higher doses.
    • It was previously thought that all NSAIDs may have a similar risk. Newer information makes it less clear that the risk for heart attack or stroke is similar for all NSAIDs; however, this newer information is not sufficient for us to determine that the risk of any particular NSAID is definitely higher or lower than that of any other particular NSAID.
    • NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease. A large number of studies support this finding, with varying estimates of how much the risk is increased, depending on the drugs and the doses studied.
    • In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline.
    • Patients treated with NSAIDs following a first heart attack were more likely to die in the first year after the heart attack compared to patients who were not treated with NSAIDs after their first heart attack.
    • There is an increased risk of heart failure with NSAID use.

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  • Over-treatment remains a problem

    Over-treatment remains a problem

    A new JAMA Internal Medicine study reveals that over-treatment remains a problem, even though doctors know that some of the care they provide and tests they order are unnecessary. This unneeded care both drives up health care costs and can put patients at risk.  You should beware of unnecessary care.

    The researchers for this study looked at seven recommendations from the Choosing Wisely campaign–which works with doctors to identify and reduce the use of medical tests and treatments that have small clinical benefit–to see whether doctors were heeding their own advice.

    The researchers found a reduction in use for two out of seven health care services with low value.  People with simple headaches are getting fewer imaging services, including MRIs and CAT scans, from 14.9 percent to 13.4 percent. And cardiac imagining for people without heart conditions also fell from 10.8 percent to 9.7 percent.

    But, the researchers also found an increase in use for two other health care services with low value. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) for people with hypertension, heart failure, or chronic kidney disease grew from 14.4 percent to 16.2 percent. And, human papillomavirus testing for women under 30 also grew from 4.8 percent to 6 percent.

    Overall, the researchers found only small changes in physician behavior. They recommend interventions to reduce use of these low value services beyond the Choosing Wisely campaign. To avoid getting unnecessary care, check out the advice on the Choosing Wisely site.

    The Choosing Wisely campaign brings together doctors from more than 70 specialty societies in order to call out unnecessary procedures and limit overuse.  And, they have a list of more than 400 treatments and tests that should not be given without first discussing their risks as well as their benefits.