Anti-inflammatory drugs are used to reduce inflammation, a reaction of the body that helps to prevent the spread of infection. There are two types of anti-inflammatory medications:
- The corticosteroids, also known as anti-inflammatory steroid drugs. They act by blocking the action of the various substances used by the immune system to begin the inflammatory process, or by interfering with the functioning of white blood cells, the cells that eliminate viruses and bacteria from the body. They can be used to counter the inflammation of chronic muscles, tendons or joints associated with trauma or overuse, or to cope with inflammation associated with an allergic reaction (including those that manifest in the form of asthma or allergic rhinitis, urticaria and atopic dermatitis), or inflammation associated to an autoimmune disease (such as rheumatoid arthritis or systemic lupus erythematosus). Sometimes their intake is also required in case of chronic obstructive pulmonary disease (COPD).
- The non-steroidal anti-inflammatory drugs (NSAIDs). They work by reducing the synthesis of prostaglandins, molecules involved in inflammatory processes. They act by blocking one or more steps of the metabolism of arachidonic acid, the precursor of prostaglandins. In addition to fighting inflammation, NSAIDs may also be used as analgesics and antipyretics. Thus, they can be taken in case of headache, menstrual cramps, toothache, and trauma to the soft tissues (such as sprains and tears), infections, various forms of arthritis (including rheumatoid arthritis), osteoarthritis, back pain and chronic neck pain.
How should anti-inflammatory drugs be taken?
The steroids can be taken in the form of tablets, injectable solutions (in the blood, in the joints or muscles), nasal sprays, oral sprays, creams, gels or lotions. The NSAIDs are available in the form of tablets, capsules, granules, injectable solutions, suppositories, eye drops, creams, gels or lotions.
Some anti-inflammatory based drugs can be purchased without a prescription; these are products designed for short-term use and to treat minor problems. However, at high doses, these drugs can only be prescribed by a doctor.
Contraindications and warnings associated with the use of anti-inflammatory drugs
The anti-inflammatory drugs are not free from side effects. The steroids may increase the vulnerability to infections. The magnitude of this and other risks, however, depends on several factors, in particular on the type of corticosteroid assumed, its dosage and the duration of treatment.
The tablets, especially if taken long term, can trigger an increase of appetite that often leads to increased weight, thinning of the skin or the appearance of acne, peptic ulcers, slow healing of wounds, slow children's growth, muscle weakness, or mood changes.
Moreover, those who take long-term steroids by mouth run a greater risk of developing diabetes, high blood pressure, osteoporosis, glaucoma and cataracts. The corticosteroids that are inhaled may instead cause the appearance of thrush in the mouth, while the injections in the joints can cause pain and swelling.
Finally, injected into a vein, corticosteroids can instead cause rapid heartbeat, insomnia and mood swings. The steroids can also interact with other medications or interfere with their action. Among the medicines at risk are included anticoagulants, anticonvulsants, anti-diabetic, anti-retroviral, bronchodilators, live vaccines, and NSAIDs.
The NSAIDs are associated with a small increased risk of heart attack, stroke or heart failure. However, in this case the real danger depends on the assumed type of molecule, the duration of treatment and the doses taken. The short-term use may instead trigger less severe adverse effects but sometimes still serious, such as ulcers, stomach bleeding and kidney damage. NSAIDs can also trigger allergic reactions and interfere with the activity of antihypertensive drugs.
In general, these drugs should not be taken in case of allergy to aspirin, gastrointestinal bleeding, peptic ulcer, kidney or liver problems, heart disease, use of anticoagulants, coagulation disorders, and if you consume more than 3 alcoholic beverages a day. More specifically, aspirin should not be taken before age 16, from children and teenagers who may have the flu or chickenpox (because of the risk of Reye's syndrome). Other cases where the intake is not recommended are pregnancy and nursing, kidney or liver disease and stomach ulcers (or a high risk of developing them).
