• The Gaudie

The Downside of Painkillers

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by Moyosola Tijani

Painkillers are a part of a group of drugs which are collectively known as NSAIDs or Non-steroidal anti-inflammatory drugs. NSAIDs are used to alleviate pain, reduce fevers, prevent blood clots (when used in small doses) and reduce inflammation (when used in high doses). NSAIDs act in a pretty straightforward manner by preventing the action of cyclooxygenase enzymes 1 & 2 (COX-1&2). In a perfect world, these enzymes are involved in the production of prostaglandins, which are implicated in inflammation and thromboxanes, which are vital in the blood clotting process; however, an excess production of prostaglandins and thromboxane can cause problems.

NSAIDs can be divided into two groups : selective and non-selective drugs. Selective NSAIDs inhibit only COX-2 while non-selective NSAIDs inhibit both COX-1 and COX-2 enzymes. Examples of selective NSAIDs include celecoxib and rofecoxib. Non-selective NSAIDs include ibuprofen, aspirin and naproxen.   Most painkillers are non-selective. As a result of this, while they alleviate pain, they can also cause duodenal and gastric ulcers. Duodenal ulcers are characterized by upper abdominal pains and gastric ulcers are characterized by a dull and burning pain which is worsened when food is consumed.

Now, you may be wondering why drugs which were designed to cure illnesses could possibly cause more problems. As mentioned above, NSAIDs mainly inhibit the action of COX enzymes which would normally produce prostaglandins. These prostaglandins are not completely terrible. They are involved in physiological processes in the body. For instance, prostaglandins decrease acid production in the stomach. Therefore, by inhibiting the COX enzyme, we start a chain reaction which would result in the excess production of stomach acid. This excess acid would eventually deplete the protective lining of the stomach and cause injuries which are referred to as ulcers. In the kidneys, prostaglandins are also involved in maintaining renal blood flow. Therefore, an excess use of NSAIDs can cause nephritis and kidney injury.

If you have read this article up to this point, you may now be skeptical about using NSAIDs. However, these drugs are not completely evil. They just need to be used correctly and in moderation. Before taking any painkillers, you should consider the risk factors. There is a high risk of developing any of the side effects mentioned above if you have a history of stomach bleeding or ulcers, or if you are on an anticoagulant or steroid therapy. It is also important to note that painkillers must never be taken with alcohol as this could cause dangerous drug interactions.

Painkillers are one of the most common drugs used in the world today. They are also one of the leading causes of drug interactions and toxicity. These drugs are relatively safe to use. However, they just need to be used with care and under the supervision of a physician.  

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