According to rheumatologist Daniel Feldman Pollak, a professor at Federal University of São Paulo (UNIFESP), patients with musculoskeletal conditions (which are very common and include more than 150 different diseases and syndromes, usually associated with pain and inflammation) has the worst quality of life . "There is evidence that the degree of their suffering is greater than that of patients who had a cerebrovascular accident (CVA). Chronic pain reduces the productivity of individuals, low self-esteem, cause depression. Therefore, it can not be ignored, "he explains.
Along with painkillers, anti-inflammatory drugs are the most commonly used drugs for the treatment of pain. But they are also targets of criticism and strict monitoring because of its side effects, particularly gastrointestinal problems. According to gastroenterologist DecioChizon, a professor at the Faculty of Clinical Medicine, University of São Paulo (USP), the large number of users of traditional anti-inflammatory and prolonged use of these drugs cause side effects purchase a proportion frightening. "For every pill prescribed, another seven or eight are taken on their own," he says.
How does Daniel Feldman, there are drugs that do not show adverse effects, but the main cause of the deterioration of these complications is the indiscriminate use of the drug. "Tracking the doctor is important to define which anti-inflammatory would be more appropriate, according to the intensity of pain, age and history of each patient. It is essential to assess the risks and benefits of each drug. Generally, the more efficient the substance, the greater the risk of developing ulcers or heart problems, "he warns.
Among the approximately 30 million people who take anti-inflammatory drugs per day in the West, 25% of users will develop chronic ulcer and 2% to 4% have more severe complications such as bleeding and perforation. Still, for Decio Chizon, when the drug is used properly, the benefits are much greater than the risks. "Nowadays it is possible to minimize the adverse effects of these drugs. The traditional anti-inflammatory drugs may be associated with other drugs such as inhibitors of proton pump inhibitors (PPIs), which protect the stomach. Another alternative is the use of coxibs, anti-inflammatory next generation, with less gastrointestinal effects, "he says.
Other risks
The use of coxibs, however, is controversial. In Brazil, they can only be sold by prescription, and retention of revenue. Many drugs, including Vioxx and Prexige, had prohibited the sale. This is because they are accused of causing liver complications, kidney and heart.
However, according to the cardiologist Paulo Bertini, medical researcher at the Clinical Unit of Atherosclerosis of the Heart Institute (InCor), all types of anti-inflammatory, both the traditional and the coxibs, can raise blood pressure and have similar risks for adverse effects diseases, such as myocardial infarction, stroke and heart failure, and renal failure. "It's a myth that only find coxibs cause cardiovascular risks. We now know that the incidence of this type of effect is itself in both mylar "he explains.
Besides increasing the chances of developing gastrointestinal problems and heart disease, abuse and prolonged of any anti-inflammatory medications may also undermine the effectiveness of these drugs, as explained in orthopedic Rogério Teixeira da Silva, President of the Committee of Sports Traumatology Brazilian Society of Orthopedics and Traumatology (SBOT). "Self-medication leads to chronic pain, ie, the lack of medical and surgical treatment becomes acute pain caused by a chronic injury. Studies indicate that uncontrolled pain is the leading cause of rehospitalization and treat pain properly improves the surgical outcome, "he says.
Anti-inflammatory
It all started with Aspirin
The first drug in human history with anti-inflammatory is acetylsalicylic acid (Aspirin) first synthesized in Germany in 1899. All anti-inflammatory drugs have the ability to inhibit the enzyme cyclooxygenase, which is presented in the form of COX-1 and COX-2, responsible for the production of the hormone prostaglandin, which protects the gastroduodenal mucosa, but at the same time, it transmits pain.
The anti-inflammatory drugs (NSAIDs) can be divided into two groups: the traditional and the coxibs. Traditional inhibit both forms of cyclooxygenase, reducing pain, but leaving the stomach and duodenum vulnerable due to the decrease of prostaglandin. Since the coxibs inhibit only COX-2.
The pain can also be treated with painkillers (when there is inflammation), or with opioids, commonly used in the treatment of acute pain and chronic pain in cancer patients.
Source: Gazeta do Povo
