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For the treatment of musculoskeletal conditions and ailments, there are a variety of orthopaedic medications available to relieve oneself of pain. Orthopaedic physicians mostly prescribe three classes of drugs - nonsteroidal anti-inflammatory drugs (NSAIDS), corticosteroids and anti-rheumatic drugs (DMARDS). Approved by the FDA, these orthopaedic medications are safe. However, a prolonged use of these drugs can lead to a number of unwanted side effects and may pose some risks.
Non-steroidal Anti-inflammatory Drugs (NSAIDS)
This class of drugs are in most common use. Among these aspirin, ibuprofen abd naproxen groups are available over the counter. For other NSAIDS, prescription from an orthopaedic doctor is essential. Majorly available in pill form, these NSAIDS include drugs like diclofenac, etorolac, flurbiprofen, ketoprofen, oxaprozin, piroxicam, nimesulide and etoricoxib. Orthopaedic physicians prefer to prescribe one of these anti-inflammatory drugs at one time.
NSAIDs drugs help provide interim relief to patients. These drugs are beneficial in reducing inflammation, pain and fever. Non-steroidal anti-inflammatory medicines can provide you relief for a temporary period but they are not meant to cure the ailments that lie underneath.
Risk & Side effects of NSAIDs
Though NSAIDs drugs are considered to be safe, an extended dose of these drugs may sometime cause serious side effects, particularly in patients suffering from arthritis. As NSAIDs pills only control the symptoms, it is always advisable to consume the lowest doses possible.
Effects on Gastro-Intestinal (GI) Tract
On an average, up to 5% of people who take NSAIDs drugs continuously for a year have been seen to suffer from serious side effects ulcers, bleeding and tears in the gastro-intestinal (GI) tract. Prolonged use of NSAIDs drugs causes irritation along the GI tract; the tract includes esophagus, stomach and intestines. Elderly patients have a higher risk of developing these side effects. Patients with previous cardiac ailments also run a higher risk of getting the side effects.
NSAIDs like aspirin are known to affect the clumping of platelets in the blood. In case of an injury or an open wound, the use of this drug can lead to bleeding problems. That is why, the use of aspirin is prevented two weeks before a person goes for an orthopaedic surgery.
Effects on Liver & Kidney
NSAIDs also prove to be virulent to liver. Though initially it is not very apparent, blood tests can easily testify the altered levels of certain liver enzymes. As an individual ceases the use of NSAIDs, the functioning of the liver returns to normal.
It is essential to exercise caution if a patient with past history of kidney problems begins taking NSAIDs. Non steroidal anti-inflammatory drugs can also affect the kidney thereby preventing the organ from filtering wastes properly.
Other Possible Side effects from NSAIDs
Different individuals react differently to different NSAIDs. Some possible side effects that may arise due to consumption of these drugs include skin rashes, running nose, polyps in the nose, headaches, asthma etc. Drugs like salicylates can also result in impaired hearing. The range of these side effects, however, is contingent upon the health of an individual and on the ailment for which he is being treated.
Corticosteroid class of drugs are prescribed to treat serious ailments like rheumatoid arthritis. Corticosteroids bear similarity with the adrenal cortex hormones. These medication not only help to relieve inflammation and provide energy but also assist tissue repair in the body. Like NSAIDs, these drugs are also associated with a number of side effects and risks.
Orthopaedic doctors usually prescribe corticosteroid medications including cortisone, prednisone, prednisolone and methylprednisolone. Corticosteroids can be given to individuals in a number of ways - orally, through an intravenous needle or by injecting it directly into the inflammed tissues. The doctor may also prescribe Corticosteroid cream to be rubbed on skin. Cautious monitoring is required while using Corticosteroids. Though these category of anti-inflammatory drugs provide instant relief against inflammation, they are at the same time highly toxic.
Risks & Side effects of Corticosteroids
Depending on the dose of the drug, period of intake and body sensitivity, Corticosteroids can lead to a number of side effects as well. Some of the most commonly noticed side effects in the body are as follows.
Use of Corticosteroids may result in reduced bone growth, a condition medically known as osteoporosis. Prolonged intake of these drugs also causes compression fractures of the vertebrae. Development of osteoporosis can be commonly seen in people aged sixty years or above. To prevent this unwanted and grievous side effect, the doctor may recommend calcium and vitamin D pills along with the corticosteroid drugs.
High dose of corticosteroids also increases body's ability to get bacterial infections. At times, these drugs can also suppress the infection symptoms, as in the case of abscesses and bowel tears.
Corticosteroid medications can also affect the hormone production of pituitary and adrenal glands. This hormonal deficiency can also happen even after taking moderate doses of corticosteroid drugs. The chances of developing this adrenal insufficiency are higher when you begin reducing the dosage. As withdrawal from corticosteroids medication can lead to harmful side effects, you need to reduce the dosage gradually. Due to withdrawal or reduction in the dose of corticosteroids, individuals may get sicknesses including fever, nausea, vomiting, low blood pressure, reduced sugar level etc.
Disease-Modifying Antirheumatic Drugs (DMARDs)
Unlike the NSAIDs and corticosteroids that relieve pain and inflammation, DMARDs affect the underlying disease. These orthopaedic drugs are known to decelerate the course of joint diseases. They do not completely cure the ailment though. In many patients, the use of DMARDs can provide relief for a span of a few months or years, after which the symptoms are restored.
Types of DMARDs
These drugs include medicine groups like hydroxychloroquine and chloroquine. Since 1950s, these anti-malarial medicines have been used to cure rheumatic diseases (rheumatoid arthritis and lupus) in patients. Comparatively, use of chloroquine causes more side effects than hydroxychloroquine. Patients can develop various side effects from the use of these drugs - indigestion, skin rash and eye problems.
Intake of penicillamine drug affects the functioning of the immune system. On an average, a quarter of the patients who use this drug develop side effects within the first year. Side effects from penicillamine can include reduced number of blood platelets, drug-induced lupus, skin rashes, protein in the urine etc.
Comparatively a new entrant in the range of orthopaedic drugs, Sulfasalazine is generally taken to cure ailments like rheumatoid arthritis and spondyloarthropathies. This drug can lead to side effects like abdominal pain, liver disorder, nausea, low sperm count and blood disorders among others.
This drug has also long been used to treat rheumatoid arthritis as well as juvenile chronic arthritis and psoriatic arthritis. Usual dose of gold is once a week, being injected into the muscles. Side effects include reduced number of blood platelets, diarrhea, blood disorders, protein in the urine, lung disorders, sores of mucous membranes, skin rash etc.
Prolonged intake of this drug may lead to side effects like nausea, loss of appetite, hyper secretion of liver enzymes etc.
This is an effective drug in decelerating of some diseases. Use of cyclosporin can lead to kidney problems and high blood pressure in patients.
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