消炎止痛药 –小心使用

专家解读“麻醉痛症专科”(亦称“疼痛科”)及"麻醉科"专业知识及应用问题 - pain management
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消炎止痛药 小心使用

不少人在疼痛时服用药房自购止痛药,值得大家注意的是:所有的消炎止痛药都有三大副作用: 胃肠出血,心肌梗死和中风。 

Any use of nonsteroidal anti-inflammatory drugs may increase the risk for stroke among healthy individuals, according to a study presented at the 2010 European Society of Cardiology Congress.

The increased risk was highest with diclofenac and lowest with ibuprofen, reported senior author, Gunnar Gislason, MD, from Gentofte University Hospital, in Hellerup, Denmark. Dr. Gislason and his group previously reported that diclofenac and rofecoxib were associated with increased risk for cardiovascular death (coronary death or nonfatal myocardial infarction, and fatal or nonfatal stroke) in healthy Danes. The increased risk was dose-dependent (Circ Cardiovas Qual Outcomes 2010;3:395-405).

“NSAIDs affect the system in many different ways,” Dr. Fosbøl said. “The most frequent side effect is still gastrointestinal bleeding, which should be included in the decision chain when starting NSAID treatment.”

Naproxen and low-dose ibuprofen show the most neutral cardiovascular safety profile, he added. “However, the risk for upper gastric bleeding should always be incorporated in the decision.”

Acetaminophen is heart (and likely brain) risk-neutral and even if you can’t avoid having to take an NSAID every now and again, decreasing the intensity of NSAID dosing or avoiding it from time to time is likely worthwhile.”

Dr. Fosbøl agreed that the dangers posed by NSAID use are a public health problem. “NSAIDs are sold OTC [over the counter] in many countries and the general perception is they are not harmful.” However, based on the current data, “some NSAIDs are not suited for OTC sales [even at lower doses], and those sales should be re-evaluated.”

 

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