MEDICATIONS
Pain RX
Arthritis RX
Anti-depressant RX
Muscle Relaxant RX
Herbal RX
Complementary RX
Pain RX:
Analgesic medication for pain control can include over the counter acetaminophen or
Tylenol as well as aspirin or aspirin-like drugs which are anti-inflammatory drugs such as
ibuprofen containing Advil, Nuprin or Motrin and ketoprofen containing Orudis. Caution
should be used with even over the counter drugs as excessive acetaminophen can damage the
liver and the anti-inflammatory drugs can upset the stomach, cause bleeding ulcers and
damage the kidneys with prolonged use.
Narcotics can provide potent relief but require medical management to prevent tolerance,
side effects and chemical dependency. Synthetic codeine may offer less problems with an
upset stomach than codeine containing drugs like Tylenol #3. There are new prescription
drugs providing an alternative to both codeine and synthetic codeine and new combination
drugs offering anti-inflammatory agents with a narcotic analgesic.
Links:
Worldwide Congress on Pain
Arthritis RX:
New advances in arthritis treatment include a new class of nonsteroidal anti-inflammatory
drugs (NSAID's) to treat arthritis pain and stiffness with fewer side effects.Selective
COX-2 inhibiting arthritis drugs block the
production of prostaglandins causing pain, stiffness and swelling in the joints while
leaving alone the formation of prostaglandins necessary to protect the lining of the
stomach and to maintain blood flow to the kidneys.
These drugs also do not thin the blood or prolong the bleeding time.
The first FDA approved selective Cox-2 inhibiting arthritis drug was Celebrex
from Searle and Pfizer. It is approved for treatment of osteoarthritis and rheumatoid arthritis. Vioxx from Merck was also
introduced in 2000 for treatment of pain in osteoarthritis, as well as for dental, postsurgical and
menstrual pain. Newer Cox-2 drugs are already in various stages of research and development.
Disease modifying drugs are now recommended for rheumatoid arthritis to prevent X-ray
changes and deformities. These include Plaquenil, Azulfidine, Gold, Methotrexate and
Minocin. Newer disease modifying drugs which can be added to Methotrexate might include
the newer oral immunosuppressant drug Arava by Hoechst and injectable Enbrel by Immunex
which blocks the effects of tumor necrosis factor in affected joints.
Links:
National Arthritis Foundation
Anti-depressant RX:
Treatment of pain problems often includes the use of anti-depressant drugs for a variety
of reasons utilizing particular benefits of specific drugs for selected patients. These
medications may improve the patient's mood, sleep pattern, mental focus, energy level and
raise the threshold for perception of pain. Newer agents also may help control weight and
appetite problems, assist in cessation of smoking and address obsessive /compulsive
tendencies. These drugs are usually well tolerated and not habit forming.
Muscle Relaxant RX:
Muscle relaxants can help control muscular discomfort due to injury and disease. Newer
less sedating alternatives exist for those remembering being too groggy from older agents.
Quinine containing tonic water or quinine containing pills can alleviate leg muscle cramps
associated with a pinched nerve in the low back or vigorous exercise. Combination use of
muscle relaxants with anti- inflammatory agents and anti-depressant drugs is commonly used
in fibromyalgia and other musculoskeletal conditions to take advantage of synergistic
properties of these medications.
Herbal RX:
Herbal medicine supplement sales total over $7 billion and have been increasing by an estimated 25% per year. Herbal ingredients may be present
in one out of four prescription drugs. The World Health Organization estimates over 4 billion people use these natural remedies and yet only one
in three admit herbal use to their doctors.
Herbal Common Sense For Consumers:
1. Avoid use in pregnant patients.
2. Clean wounds before applying anything.
3. Those with stomach problems should avoid herbs stimulating gastric juices.
4. Stop herbal remedies if you have persistent diarrhea.
5. Stop herbal treatment of cough lasting more than a few days.
6. Beware of diuretics touted as weight reduction aids.
7. Individuals with serious illness affecting the ability of the liver or kidney to process a drug should consult their physician before using herbal treatment.
8. Avoid the FDA Unsafe List of herbs ( including Ephedrine/ma huang, Comfrey,
Chaparral, Germanium, Jin Bu Huan, and Pennyroyal).
Complementary RX:
Various supplements can be complementary to traditional over the counter medication and
prescription drugs. Chondroitin Sulfate and Glucosamine can help arthritis problems if
taken for at least a few months and if taken with needed conventional medical treatment.
Anti-oxidant vitamin supplements help the body resist aging changes including those which
may increase pain problems. Melatonin supplements can help with sleep disturbance problems
in patients with chronic pain. Gingkobiloba may help increase mental alertness in certain
individuals.
Excessive vitamins, nutritional supplements, calcium, herbal remedies and special dietary
supplements can be quite expensive, cause health problems and often prove to be
unnecessary. A consultation with a physician familiar with such agents is invaluable in
guiding safe and optimal use of all available remedies. Physicians can offer cost saving
tips in obtaining various nutraceuticals, vitamins and health enhancing products.
Links:
National Center for Complementary and
Alternative Medicine -
QuackWatch Home Page
Food and Drug Administration
Institute for Safe Medication Practices
|
