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Summary NSAIDs are most effective for mild to moderate pain accompanied by swelling and inflammation. These drugs relieve pain by inhibiting an enzyme in your body called cyclooxygenase. This enzyme makes hormone-like substances called prostaglandins, which are involved in the development of pain and inflammation. NSAIDs are especially helpful for arthritis and pain resulting from muscle sprains, strains, back and neck injuries or cramps. When taken as directed, NSAIDs are generally safe. But if more than the recommended dosage is taken — and sometimes even the recommended dosage — NSAIDs may cause nausea, stomach pain, stomach bleeding or ulcers. Large doses of NSAIDs can lead to kidney problems and fluid retention. Risk increases with age. If you regularly take NSAIDs, talk to your doctor so that he or she can monitor you for side effects. NSAIDs have a so-called ceiling effect, or limit to how much pain they can control. This means that beyond a certain dosage, they don't provide additional benefit. If someone has moderate to severe pain, exceeding the dosage limit may not help relieve the pain. Many NSAIDs require a prescription, but some lower-dose NSAIDs, such as aspirin and ibuprofen, are available over-the-counter.
Indomethacin is a non-steroidal anti-inflammatory drug commonly used to reduce fever, pain, stiffness, and swelling. It works by inhibiting the production of prostaglandins, molecules known to cause these symptoms. It is marketed under many trade names, including Indocin, Indocid, Indochron E-R, and Indocin-SR. Clinical indications for indomethacin include:
Indomethacin has also been used clinically to delay premature labor, reduce amniotic fluid in polyhydramnios, and to treat patent ductus arteriosus. Indomethacin is a potent drug with many serious side effects and should not be considered an analgesic for minor aches and pains or fever. The drug is more potent than aspirin, but is not a better analgesic. In mild to moderate pain a standard oral dose of indomethacin proved as effective as 600mg aspirin. Side effects Since indomethacin inhibits both COX-1 and COX-2, it inhibits the production of prostaglandins in the stomach and intestines which maintain the mucous lining of the gastrointestinal tract. Indomethacin, therefore, like other nonselective COX inhibitors, can cause peptic ulcers. The ulcers can result in serious bleeding and/or perforation requiring hospitalization of the patient. Some even die from these complications. To reduce the possibility of peptic ulcers, indomethacin should be prescribed at the lowest dosage needed to achieve a therapeutic effect, usually between 50–200 mg/day. It should always be taken with food.
Source: Marketdata Enterprises, Inc., Chronic Pain Management Programs: A Market Analysis, Wikipedia, various other sources
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