Non steroidal anti inflammatory

When and how much to take
NSAIDs should ideally be taken with some food, or at least with milk or yoghurt to avoid irritation of the gastric mucosa (. the inner lining of the stomach). It is important not to exceed the recommended dose to avoid possible serious side-effects. There is also no benefit in taking more than a certain dose, since these drugs have a ceiling effect. This means that above a certain dose, taking even more of this medication will not yield any extra beneficial effects, but will considerably increase the risk for side-effects.

NSAIDs have anti-inflammatory (reduce inflammation), analgesic (relieve pain) and antipyretic (lower temperature) effects. Although different NSAIDs have different structures, they all work by blocking cyclooxygenase (COX) enzymes. There are two main types of COX enzymes: COX-1 and COX-2. Both types produce prostaglandins; however, the main function of COX-1 enzymes is to produce baseline levels of prostaglandins that activate platelets and protect the lining of the gastrointestinal tract, whereas COX-2 enzymes are responsible for releasing prostaglandins after infection or injury. Prostaglandins have a number of different effects, one of which is to regulate inflammation. Most NSAIDs inhibit both enzymes, although a few are available that mainly inhibit COX-2. The pain-relieving and anti-inflammatory effects of NSAIDs are mainly due to inhibition of COX-2, and their unwanted side effects are largely due to inhibition of COX-1.

Formulations of topical diclofenac, ibuprofen, ketoprofen, piroxicam, and indomethacin demonstrated significantly higher rates of clinical success (more participants with at least 50% pain relief) than matching topical placebo (moderate or high quality data ). Benzydamine did not. Three drug and formulation combinations had NNTs for clinical success below 4. For diclofenac, the Emulgel® formulation had the lowest NNT of (95% CI to ) in two studies using at least 50% pain intensity reduction as the outcome . Diclofenac plasters other than Flector® also had a low NNT of ( to ) based on good or excellent responses in some studies. Ketoprofen gel had an NNT of ( to ), from five studies in the 1980s, some with less well defined outcomes. Ibuprofen gel had an NNT of ( to ) from two studies with outcomes of marked improvement or complete remission. All other drug and formulation combinations had NNT values above 4, indicating lesser efficacy .

Studies have shown that people who take anti-inflammatory painkillers have a small but significant increase in the risk of developing a heart attack  or stroke . Although it can occur in anybody, the risk is mainly in people already known to have cardiovascular problems such as angina or peripheral arterial disease , and in the elderly. Perhaps the highest risk is in people who have previously had a heart attack. For example, one research study looked at people who had previously had a heart attack. The results showed a marked increase in the rate of a second heart attack in people who were taking an anti-inflammatory compared to those who were not.

Non steroidal anti inflammatory

non steroidal anti inflammatory

Studies have shown that people who take anti-inflammatory painkillers have a small but significant increase in the risk of developing a heart attack  or stroke . Although it can occur in anybody, the risk is mainly in people already known to have cardiovascular problems such as angina or peripheral arterial disease , and in the elderly. Perhaps the highest risk is in people who have previously had a heart attack. For example, one research study looked at people who had previously had a heart attack. The results showed a marked increase in the rate of a second heart attack in people who were taking an anti-inflammatory compared to those who were not.

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