Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.2 9/18/84; site bbncc5.UUCP Path: utzoo!watmath!clyde!burl!ulysses!mhuxr!mhuxn!ihnp4!bbncc5!sdyer From: sdyer@bbncc5.UUCP (Steve Dyer) Newsgroups: net.med Subject: Re: anti-inflammatories Message-ID: <392@bbncc5.UUCP> Date: Fri, 16-Aug-85 02:10:44 EDT Article-I.D.: bbncc5.392 Posted: Fri Aug 16 02:10:44 1985 Date-Received: Mon, 19-Aug-85 08:35:31 EDT References: <3298@topaz.RUTGERS.EDU> Organization: Bolt Beranek and Newman, Cambridge, MA Lines: 42 > 1) Is there any evidence that anti-inflammatories really help arthritis? It is generally agree upon that the anti-inflammatory drugs (aspirin, ibuprofen, indomethacin, etc.) provide varying degrees of symptomatic relief of arthritis, but do not influence the underlying condition. > 2) What causes the bad reactions (nothing terrible, just feeling awful)? The two drugs you have mentioned, indomethacin and sulindac, are among the least well-tolerated of the anti-inflammatory drugs. They are also two of the most powerful. You haven't been particularly descriptive of your side effects, but both have been known to affect mood and cause headache in certain patients. It's fair to say that the mechanism of many of these side-effects hasn't been elucidated, though its a fair bet that the same mechanisms responsible for their therapeutic actions (inhibition of prostaglandin synthesis) may also contribute to the side effects. > 3) What side-effects do these drugs usually have? Up to 50% of patients treated with indomethacin, and 25% of those treated with sulindac report some kind of side-effect. Speaking VERY GENERALLY, the second class of drugs (ibuprofen, other fenamates, tolmetin, aspirin) are somewhat better tolerated. It's a clinical call for the doctor to decide exactly which one to prescribe, when to use the "big guns", and personal clinical experience probably goes a long way. You should speak up if the prescribed therapy doesn't agree with you. Individual idiosyncracy seems to be the rule with this class of drugs. The one side-effect that they all have in common is stomach upset. Much is made of the fact that one drug causes less of this than another, but given the right person with the right history and enough drug, you can probably expect some kind of gastrointestinal side-effects ranging from heartburn to ulcers. Many of these (not all) are also associated with increased gastric bleeding. Many of these also cause some degree of CNS effects in sensitive patients, such as headache, dizziness, light-headedness and other reactions. If you look into the literature, there are many other reported side-effects, but they are so varied, and so idiosyncratic that they're not worth excessive worrying about beforehand. -- /Steve Dyer {decvax,linus,ima,ihnp4}!bbncca!sdyer sdyer@bbnccv.ARPA