Medications and Drugs

Nonsteroidal Antiinflammatory Drugs (NSAIDs)

What are NSAID's and how do they work?

Prostaglandins are a family of chemicals that are produced by the cells of the body and have several important functions. They promote inflammation, pain, and fever; support the blood clotting function of platelets; and protect the lining of the stomach from the damaging effects of acid.

Prostaglandins are produced within the body's cells by the enzyme cyclooxygenase (COX). There 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. Nonsteroidal antiinflammatory drugs (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 platelets and blood clotting also are reduced, NSAIDs can cause ulcers in the stomach and promote bleeding.

For what conditions are NSAIDs used?

NSAIDs are used primarily to treat inflammation, mild to moderate pain, and fever. Specific uses include the treatment of headaches, arthritis, sports injuries, andmenstrual cramps. Ketorolac (Toradol) is only used for short-term treatment of moderately severe acute pain that otherwise would be treated with opioids. Aspirin (also an NSAID) is used to inhibit the clotting of blood and prevent strokes and heart attacks in individuals at high risk. NSAIDs also are included in many cold and allergy preparations.

Are there any differences between NSAIDs?

NSAIDs vary in their potency, duration of action, how they are eliminated from the body, how strongly they inhibit COX-1 and their tendency to cause ulcers and promote bleeding. The more an NSAID blocks COX-1, the greater is its tendency to cause ulcers and promote bleeding. One NSAID, celecoxib (Celebrex), blocks COX-2 but has little effect on COX-1, and is therefore further classified as a selective COX-2 inhibitor. Selective COX-2 inhibitors cause less bleeding and fewer ulcers than other NSAIDs.

Aspirin is a unique NSAID, not only because of its many uses, but because it is the only NSAID that inhibits the clotting of blood for a prolonged period (4 to 7 days). This prolonged effect of aspirin makes it an ideal drug for preventing blood clots that cause heart attacks and strokes.

Most NSAIDs inhibit the clotting of blood for only a few hours. Ketorolac (Toradol) is a very potent NSAID and is used for moderately severe acute pain that usually requires narcotics. Ketorolac causes ulcers more frequently than other NSAID. Therefore, it is not used for more than five days. Although NSAIDs have a similar mechanism of action, individuals who do not respond to one NSAID may respond to another.

What are the side effects of NSAIDs?

NSAIDs are associated with several side effects. The frequency of side effects varies among NSAIDs. The most common side effects are nausea, vomiting, diarrhea,constipation, decreased appetite, rash, dizziness, headache, and drowsiness. NSAIDs may also cause fluid retention, leading to edema. The most serious side effects arekidney failure, liver failure, ulcers and prolonged bleeding after an injury or surgery.

Without substance: ADHD meds don't up kids' drug abuse risk

Stimulants have long been prescribed to children diagnosed with attention-deficit hyperactivity disorder, or ADHD. Over the past decade, child psychiatrists have debated the long-term potential for these medications to trigger drug abuse. Two new studies indicate that the stimulants do not increase children's risk of abusing cocaine, nicotine, and other drugs as adults.Although these findings come as a relief to child psychiatrists, not all the news is good.

WHEN THE TREATMENT WOULD BE MORE EFFECTIVE?

The new investigations, already published online and slated to appear in the May American Journal of Psychiatry, underscore earlier evidence that youngsters with ADHD frequently become drug abusers, whether or not they take prescribed stimulants. is still critical that young people with ADHD be screened for substance abuse," says Nora D. Volkow, director of the National Institute on Drug Abuse in Bethesda, Md.Boys with ADHD who start stimulant treatment early, at age 6 or 7, face a lower risk of later drug abuse than do those who begin taking medication later, between ages 8 and 12, report psychologist Salvatore Mannuzza of New York University's Child Study Center and his colleagues.In the 17-year study, 27 percent of early-treated participants abused drugs by their mid-20s. That roughly equaled the drug abuse rate among young men who had never had any psychiatric ailments.In contrast, 44, percent of late-treated boys became drug abusers by young adulthood, a rate comparable to earlier estimates for ADHD kids regardless of their treatment. Most of these late-treated children were diagnosed as grown-ups with another psychiatric ailment--antisocial personality disorder, a condition often accompanied by drug abuse.

These volunteers likely became adult drug abusers because of this condition, not because of stimulant treatment as children, Mannuzza says.

THE 2 STUDIES MADE BY MANNUZA AND BIEDERMAN

Mannuzza's team studied 176 white, middle-class boys, ages 6 to 12, who were treated for ADHD with methylphenidate, often marketed as Ritalin. None of these youngsters displayed conduct disorder, regarded as a precursor of antisocial personality disorder.Follow-up interviews with volunteers occurred at around ages 18 and 25. The researchers also tracked 178 psychiatrically healthy males from age 18 to 25.Early stimulant treatment may protect kids with ADHD against conduct disorder, thus lowering later drug abuse rates, Mannuzza suggests.Yet preliminary results from a large study of ADHD treatments, published in 2007, don't support that hypothesis, remarks psychologist James M. Swanson of the University of California, Irvine, a coauthor of the article. Over that study's first three years, early-treated children showed no decreased chance of acquiring conduct disorder, says Swanson.The second new study, directed by psychiatrist Joseph Biederman of Massachusetts General Hospital in Boston, evaluated 112 boys with ADHD, ages 6 to 17, and then re-examined them 10 years later. Of those boys, 82 received stimulant treatment for all or part of the follow-up period.In early adulthood, treated and untreated boys displayed comparable drug abuse rates, similar to those reported for late-treated boys by Mannuzza. But Biederman's group found no tendency for early stimulant treatment to protect against later drug abuse.

what's drugs???

A drug, broadly speaking, is any substance that, when absorbed into the body of a living organism, alters normal bodily function. There is no single, precise definition, as there are different meanings in drug control law, government regulation , medicine, and colloquial usage.

IN PHARMACOLOGY:

A drug is "a chemical substance used in the treatment, cure, prevention, or diagnosis of disease or used to otherwise enhance physical or mental well-being." Drugs may be prescribed for a limited duration, or on a regular basis for chronic disorders.

THE OTHER EFFECTS:

Recreational drugs are chemical substances that affect the central nervous system, such as opioids or hallucinogens They may be used for perceived beneficial effects on perception, consciousness, personality, and behavior.Some drugs can cause addiction and habituation.

WHAT FOR?

Drugs are usually distinguished from endogenous biochemicals by being introduced from outside the organism.^] For example, insulin is a hormone that is synthesized in the body; it is called a hormone when it is synthesized by the pancreas inside the body, BUT if it is introduced into the body from outside, it is called a drug.