Posts Tagged ‘Cox 2 Inhibitors’

Tramadol…safe and Effective

Jennifer Alinio asked:




In the wake of growing concerns over the fatal effects of some pain relievers in the market, pain specialists continue developed recommendations for alternatives – as effective yet not as dangerous.

News on the rising deaths of patients using COX-2 inhibitors and traditional NSAIDS (Nonsteroidal Antiinflammatory Drugs) has prompted medical experts to recommend the ban or withdrawal of drugs with these ingredients from the market.

After discussing the safety data for both NSAIDs and the COX-2 inhibitors, the group endorsed an expanded role for weak opioids, which are more effective in moderate-to-severe pain than NSAIDs. At the same time these possess other significant advantages included titratability, reversibility and lack of prostaglandin-associated side effects.

The role of combinations of weak opioids and other analgesic agents – in particular, tramadol plus paracetamol – merits particular attention.

A group of international pain specialists considered that tramadol and tramadol combinations offered a useful advantage in that they were ‘NSAID-sparing’. The drug could be used in combination with lower-than-usual doses of NSAIDs. Use of tramadol is recommended by medical societies.

The panel also recommended the proper utilization of weak opioids. Side-effects, they stressed, are a common reason given for non-compliance.

The panel agreed that a policy of ‘go low, go slow’ – starting with a low dose and increasing it gradually – should be used to achieve good analgesia without intolerable side-effects.

After thorough deliberations, the group concluded that it is very important to communicate clear guidance to physicians on appropriate prescribing of analgesics in this new climate of uncertainty regarding the continuing use of COX-2 inhibitors.

Way back in 2004, there was a move for the global withdrawal of rofecoxib (Vioxx), which and concerns regarding use of other COX-2 inhibitors. Rofecoxib is used to relieve pain, tenderness and stiffness caused by arthritis. It is in a class of COX-2 exhibitors.

This then raised concerns for the need of prompt and clear guidance to physicians regarding prescription of drugs with these compositions.

NSAIDS and Cox-2

There actually are two Cox enzymes, Cox 1 and Cox-2. Both enzymes produce prostaglandins that promote inflammation, pain, and fever. However, only Cox-1 produces prostaglandins that support platelets and protect the stomach.

NSAIDs block the Cox enzymes and reduce prostaglandins throughout the body. As a consequence, ongoing inflammation, pain, and fever are reduced.

Since the prostaglandins that protect the stomach and support the platelets and blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and promote bleeding.

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Migraine Prescription Medications For Pain Relief

Lana R. Howard asked:




Today when people discuss migraine prescription medication usually they are referring to preventative or abortive medications. In years past before these options were available, prescription painkillers were the only option available for migraine sufferers. Prescription painkillers are now most commonly prescribed as a last option for people who need emergency pain relief and those whose conditions are not well controlled by preventative or abortive medications.

Why is this? Prescription pain medications run the risk of being addictive in addition to impairing normal function while in use. Unfortunately, not all patients fully understand the nature of what they are taking when the medication is originally prescribed and many are surprised by the problems they encounter. That much being said, prescription pain killers do have their place in an effective treatment regime as determined by you and your doctor.

The most common categories of migraine prescription medication for pain relief:

Non-steroidal Anti-inflammatory drugs (NSAIDS)

NSAIDS are most commonly associated with over-the-counter pain relievers like ibuprofin. Prescription NSAIDs come in two varieties – COX-1 and COX-2 inhibitors. These medications have the ability to completely block the chemicals the cause inflammation.Common prescription NSAIDs include diclofenac, meloxicam, nabumetone, and celecoxib. Gastrointestinal pain, discomfort, and in extreme cases damage can range from mild to severe with NSAIDs.

Narcotics

Narcotics work by interfering with your body’s ability to feel pain. Narcotics are highly addictive and when being used interfere greatly with one’s ability to go about normal activities. Feelings ranging from dizziness to loss of consciousness are most commonly reported. The consciousness affecting side effects of narcotics makes it impossible for one to drive or work while under the influence. The most common narcotics include oxycodone (similar to morphine), hydrocodone, and propoxyphene. Sometimes narcotic/acetaminophen blends are also prescribed.

Other than the risk of physical addiction and very unpleasant withdrawal side effects, narcotics are also not safe for pregnant or nursing mothers, in combination with alcohol and prescription medications such as anti-depressants, tranquilizers, and sedatives.

Barbiturates

Barbituates are essentially sedatives that work by depressing one’s central nervous system. he most commonly prescribed barbiturates for headaches and migraines are typically a combination of acetaminophen, caffeine, and barbiturates (example – Fioricet.) Like narcotics, barbiturates are also highly addictive, not safe for pregnant or nursing mothers, should not be combined with alcohol or other prescriptions drugs unless approved by your doctor. As many of these medications already contain acetaminophen, it is important not to take more than the recommended amount of medication. When taken in excess acetaminophen can cause liver damage and even death.

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This page is provided for educational and informational purposes only and is not intended as a substitute for the advice of a medical doctor, nurse, nurse practitioner or other qualified health professional.